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Cutting: Why Teens Hurt Themselves

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David Pohl

Two months later, after an argument with her mom over a messy bedroom, Caia grabbed a razor blade and carved grid marks into her arm. The next day Monica pulled Caia out of school—figuring she'd get less of a fight that way—and took her back to the hospital. Within days Caia's doctors insisted she needed the intensive assistance only a residential center could provide.

Monica launched into a major search for a facility. "I was on the computer all the time," she says. "I hardly slept." She finally hired an educational consultant who found Open Sky Wilderness Therapy, a program in Durango, Colorado, where Caia stayed for nine weeks while her mom continued looking for a year-round school. Open Sky wasn't a boot camp, but it did have a rigorous program integrating hiking and camping with individual and group psychotherapy, meditation and yoga. "Caia loves being outdoors, and this place had a strong focus on introspection and relationship building," Monica says. "Still, sending her away was the most difficult thing I've ever done." Caia loved Open Sky. "It was a slap in the face to be removed from everything that gave me comfort," she admits. "They take your clothes and issue you new ones. You do laundry with a plunger and bucket and carry a huge backpack. But it was what I needed."

With Caia gone, Monica toured several year-round facilities and finally chose La Europa Academy, in Salt Lake City, for its focus on fine arts. In addition to therapy, kids at La Europa learn to express themselves through photography, dance and music rather than resort to self-destruction. (They receive school credit, and take academic courses too.)

Caia was away for a total of 13 months, and the reentry was bumpy. "It was hard to transition to my old life," she says. A few weeks after she got home she cut, then immediately went to her mother to confess. "She was so sad and disappointed in herself," Monica says. "But I told her one moment doesn't undo all her hard work." And, in fact, slipups are common. "Many recovering people test the behavior, and the majority find that it no longer provides relief," says Wendy Lader, PhD, president of Self Abuse Finally Ends (SAFE). Caia, says her mom, is now part of that group.

With her daughter stable, Monica faced a different challenge: paying the $200,000 tab for Open Sky, travel and the La Europa stay. She emptied her retirement savings and borrowed the rest. Fortunately, most teens don't require such extensive—or expensive—intervention. "Kids who've just started to cut do well with outpatient therapy," says John Peterson, MD, director of child and adolescent psychiatric services at Denver Health Medical Center. Generally, this means 6 to 12 months of treatment at a cost of about $8,000, some of which may be covered by insurance. (Residential treatment runs about $10,000 to $45,000 monthly.)

Caia is still taking medication and gets overwhelmed and depressed at times, says Monica. "But now on a hard day she comes home and heads straight to the piano to play and blow off steam." The scars on her arms and legs are forever, but Caia has decided that's not always so bad. "A girl at school noticed the marks and showed me her fresh cuts," she says. "I told her I know what it's like to be sick of it all and just want the pain to stop. I was so thankful I could say there are better ways to deal with those feelings."