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Cutting: Why Teens Hurt Themselves

Signs of Cutting Self-injurers are good at hiding evidence. Look for:
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David Pohl

  • Mysterious bruises, cuts or wounds.
  • Wearing long sleeves, jackets or pants year-round, or using other cover-ups, like wristbands. Disney star Demi Lovato, 18, who admitted last spring to being a cutter, resorted to scar makeup and big bracelets to fool those close to her.
  • Unwillingness to participate in activities like swimming that expose skin.
  • Spending long periods of time alone, particularly in the bathroom or bedroom.
  • Bloodstains on clothing or tissues.
  • Razors, knives or other sharp objects hidden among belongings.
  • Withdrawal from family or friends.

If You Discover Your Child Is Cutting

  • Avoid overreacting or judging. Expressions of shock or horror and statements like "How could you do this?" add stress and discourage your child from confiding in you.
  • Seek professional help immediately. The more ingrained the habit, the harder it is to overcome.
  • Show respectful curiosity. In a matter-of-fact tone, ask leading questions to help your child acknowledge her problem and recognize she needs help. Try, "How do you feel before and after you cut?" or "What kinds of things make you want to injure yourself?" or "How does cutting help you feel better?"
  • Monitor computer usage. There are message boards that encourage self-injury by providing tips for cutting and concealing marks.
  • Be observant. Many kids go through cycles of cutting when they're feeling out of control, then stopping during periods of calm.
  • Don't use punishments (like grounding) or rewards (letting him stay out late). They rarely work. Cutting is a medical issue, not a disciplinary one.

Treatment for Cutting

Not just any therapy will do. Kids who self-injure occasionally stop on their own, but parents shouldn't count on it. "Cutting is only a symptom," says Lader. "They won't get better until they overcome their inability to handle emotions." And that usually requires professional assistance. The most promising approach so far involves dialectical behavior therapy (DBT), which teaches teens two things: how to deal with stress, and how to be more effective in relationships. "The focus is on mindfulness, recognizing and accepting whatever's coming up at any particular moment," says Dr. Peterson. "Patients learn to be at peace with negative thoughts and feelings as they arise, rather than do things to try to force them to go away." Family therapy is also an integral part of recovery. "Teens who feel distant and disconnected at home are much more vulnerable," says Dr. Peterson. "Kids who are able to decompress by talking to parents are far safer."


Originally published in the July 2011 issue of Family Circle magazine.