CUTTING, SELF HARM
Injuring yourself on purpose by making scratches or cuts
on your body with a sharp object — enough to break the
skin and make it bleed — is called cutting.
Cutting is a type of self-injury, or SI. Most people who cut
are girls, but guys self-injure, too. People who cut usually
start cutting in their young teens. Some continue to cut into
People may cut themselves on their wrists, arms, legs, or
bellies. Some people self-injure by burning their skin with
the end of a cigarette or lighted match.
When cuts or burns heal, they often leave scars or marks.
People who injure themselves usually hide the cuts and marks
and sometimes no one else knows.
Why Do People Cut Themselves?
It can be hard to understand why people cut themselves on
purpose. Cutting is a way some people try
to cope with the pain of strong emotions, intense pressure,
or upsetting relationship problems. They may be dealing with
feelings that seem too difficult to bear, or bad situations
they think can't change.
Some people cut because they feel desperate for relief from
bad feelings. People who cut may not know better ways to get
relief from emotional pain or pressure. Some people cut to
express strong feelings of rage, sorrow, rejection, desperation,
longing, or emptiness.
There are other ways to cope with difficulties, even big
problems and terrible emotional pain. The help of a mental
health professional might be needed for major life troubles
or overwhelming emotions. For other tough situations or strong
emotions, it can help put things in perspective to talk problems
over with parents, other adults, or friends. Getting plenty
of exercise can also help put problems in perspective and
help balance emotions.
But people who cut may not have developed
ways to cope. Or their coping skills may be overpowered by
emotions that are too intense. When emotions don't get expressed
in a healthy way, tension can build up — sometimes to
a point where it seems almost unbearable. Cutting may be an
attempt to relieve that extreme tension. For some, it seems
like a way of feeling in control.
The urge to cut might be triggered by strong
feelings the person can't express — such as anger, hurt,
shame, frustration, or alienation. People who cut sometimes
say they feel they don't fit in or that no one understands
them. A person might cut because of losing someone close or
to escape a sense of emptiness. Cutting might seem like the
only way to find relief or express personal pain over relationships
People who cut or self-injure sometimes have other mental
health problems that contribute to their emotional tension.
Cutting is sometimes (but not always) associated with depression,
bipolar disorder, eating disorders, obsessive thinking, or
compulsive behaviors. It can also be a sign of mental health
problems that cause people to have trouble controlling their
impulses or to take unnecessary risks. Some people who cut
themselves have problems with drug or alcohol abuse.
Some people who cut have had a traumatic experience, such
as living through abuse, violence, or a disaster. Self-injury
may feel like a way of "waking up" from a sense
of numbness after a traumatic experience. Or it may be a way
of reinflicting the pain they went through, expressing anger
over it, or trying to get control of it.
What Can Happen to People Who Cut?
Although cutting may provide some temporary relief from a
terrible feeling, even people who cut agree that it isn't
a good way to get that relief. For one thing, the relief doesn't
last. The troubles that triggered the cutting remain —
they're just masked over.
People don't usually intend to hurt themselves permanently
when they cut. And they don't usually mean to keep cutting
once they start. But both can happen. It's possible to misjudge
the depth of a cut, making it so deep that it requires stitches
(or, in extreme cases, hospitalization). Cuts can become infected
if a person uses nonsterile or dirty cutting instruments —
razors, scissors, pins, or even the sharp edge of the tab
on a can of soda.
Most people who cut aren't attempting suicide. Cutting
is usually a person's attempt at feeling better, not ending
it all. Although some people who cut do attempt suicide, it's
usually because of the emotional problems and pain that lie
behind their desire to self-harm, not the cutting itself.
Cutting can be habit forming. It can become a compulsive
behavior — meaning that the more a person does it, the
more he or she feels the need to do it. The brain starts to
connect the false sense of relief from bad feelings to the
act of cutting, and it craves this relief the next time tension
builds. When cutting becomes a compulsive
behavior, it can seem impossible to stop. So cutting
can seem almost like an addiction, where the urge
to cut can seem too hard to resist. A behavior that starts
as an attempt to feel more in control can end up controlling
How Does Cutting Start?
Cutting often begins on an impulse. It's not something the
person thinks about ahead of time. Shauna says, "It starts
when something's really upsetting and you don't know how to
talk about it or what to do. But you can't get your mind off
feeling upset, and your body has this knot of emotional pain.
Before you know it, you're cutting yourself. And then somehow,
you're in another place. Then, the next time you feel awful
about something, you try it again — and slowly it becomes
Natalie, a high-school junior who started cutting in middle
school, explains that it was a way to distract herself from
feelings of rejection and helplessness she felt she couldn't
bear. "I never looked at it as anything that bad at first
— just my way of getting my mind off something I felt
really awful about. I guess part of me must have known it
was a bad thing to do, though, because I always hid it. Once
a friend asked me if I was cutting myself and I even lied
and said 'no.' I was embarrassed."
Sometimes self-injury affects a person's body image. Jen
says, "I actually liked how the cuts looked. I felt kind
of bad when they started to heal — and so I would 'freshen
them up' by cutting again. Now I can see how crazy that sounds,
but at the time, it seemed perfectly reasonable to me. I was
all about those cuts — like they were something about
me that only I knew. They were like my own way of controlling
things. I don't cut myself anymore, but now I have to deal
with the scars."
You can't force someone who self-injures to stop. It doesn't
help to get mad at a friend who cuts, reject that person,
lecture her, or beg him to stop. Instead, let your friend
know that you care, that he or she deserves to be healthy
and happy, and that no one needs to bear their troubles alone.
Pressured to Cut?
Girls and guys who self-injure are often dealing with some
heavy troubles. Many work hard to overcome difficult problems.
So they find it hard to believe that some kids cut just because
they think it's a way to seem tough and rebellious.
Tia tried cutting because a couple of the girls at her school
were doing it. "It seemed like if I didn't do it, they
would think I was afraid or something. So I did it once. But
then I thought about how lame it was to do something like
that to myself for no good reason. Next time they asked I
just said, 'no, thanks — it's not for me.' "
If you have a friend who suggests you try cutting, say what
you think. Why get pulled into something you know isn't good
for you? There are plenty of other ways to express who you
Lindsay had been cutting herself for 3 years because of abuse
she suffered as a child. She's 16 now and hasn't cut herself
in more than a year. "I feel proud of that," Lindsay
says. "So when I hear girls talk about it like it's the
thing to do, it really gets to me."
There are better ways to deal with troubles than cutting —
healthier, long-lasting ways that don't leave a person with
emotional and physical scars. The first step is to get help
with the troubles that led to the cutting in the first place.
Here are some ideas for doing that:
Tell someone. People who have stopped cutting often say the
first step is the hardest — admitting to or talking
about cutting. But they also say that after they
open up about it, they often feel a great sense of relief.
Choose someone you trust to talk to at first (a parent, school
counselor, teacher, coach, doctor, or nurse). If it's too
difficult to bring up the topic in person, write a note. Identify
the trouble that's triggering the cutting. Cutting is a way
of reacting to emotional tension or pain. Try to figure out
what feelings or situations are causing you to cut. Is it
anger? Pressure to be perfect? Relationship trouble? A painful
loss or trauma? Mean criticism or mistreatment? Identify the
trouble you're having, then tell someone about it. Many people
have trouble figuring this part out on their own. This is
where a mental health professional can be helpful.
Ask for help. Tell someone that you want help dealing
with your troubles and the cutting. If the person
you ask doesn't help you get the assistance you need, ask
someone else. Sometimes adults try to downplay the problems
teens have or think they're just a phase. If you get the feeling
this is happening to you, find another adult (such as a school
counselor or nurse) who can make your case for you.
Work on it. Most people with deep emotional pain or distress
need to work with a counselor or mental health professional
to sort through strong feelings, heal past hurts, and to learn
better ways to cope with life's stresses. Although cutting
can be a difficult pattern to break, it is possible. Getting
professional help to overcome the problem doesn't mean that
a person is weak or crazy.
Inspirations Teen Rehab Therapists and counselors are trained
to help people discover inner strengths that help them heal.
These inner strengths can then be used to cope with life's
other problems in a healthy way.
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