By Rebecca E. Matthews, Ph.D. | Psychologist
What is cutting and why do teens do it?
Cutting is a form of self-harm that is rising in popularity among teens and adults. Both males and females use cutting as a way to reduce unwanted emotions like anger, anxiety, sadness, and tension. Teens cut when they want to escape a difficult situation and as a way of expressing distress. Some teens use cutting as a way to punish themselves. As a parent, finding out your child has used cutting can be incredibly scary and confusing. It is important to remember that cutting is not the same as a suicide attempt. However, people with a long history of self-harm are at greater risk of suicide attempts, so self-harm behaviors should be taken seriously. Cutting and other self-harm behaviors should be viewed as a sign that a person is in emotional pain and in need of a more effective way to deal with their emotions.
Teens choose self-harm to deal with common problems such as disputes with parents, school problems, difficulties with friends, significant others, or siblings, physical ill health, depression, bullying, low-self esteem, sexual problems, and alcohol and drug abuse. Teens appear to be more likely to try self-harm if they know someone else who has tried it. Some parents find that their teen has talked with others about self-harm on social media sites or read people’s blogs related to the topic. There is an abundance of information about self-harm available to teens and the information on the Internet is mixed with messages that both encourage self-harm and discourage self-harm and try to offer support.
Some warning signs that your teen is using self-harm include:
- Unexplained frequent injury including cuts or burns
- Wearing long pants and sleeves in warm weather
- Low self-esteem
- Difficulty handling feelings
- Relationship problems
- Poor functioning at school or home
As a parent, what the heck do I do?
If you are a parent with a teen who has used self-harm, don’t panic! Strong emotions can be like yawns–contagious. Find a time to talk to your teen about what you have observed rather than assuming you know the whole story. For example, “I noticed some marks on your arm yesterday and I’ve been wondering if you have tried cutting.”
Teens that use cutting as a coping strategy may not express themselves easily and may be looking for any excuse not to open up. Do your best to listen to what they have to say without interrupting by telling them what to do, how to feel, or offering your judgment about their behaviors. Let them know you care about them and that you are going to try to find help.
Teens that have used self-harm should be assessed by a child and adolescent psychologist, psychiatrist, or a specialist mental health worker in either a hospital or outpatient setting. This clinician should have experience working with adolescents and self-harm behaviors. If you are unsure of how to find a clinician that can help, you could ask your pediatrician for recommendations. The clinician will gather a detailed account of the events leading to self-harm and assess for suicidal intent. There are several types of therapy that may be effective in treating self-harm and any related conditions.
In Dialectical Behavior Therapy (DBT), the clinician works with the client to identify the triggers of the self-harm behaviors so that the client can better understand them and then change them. Once these behaviors are better understood, the clinician and client work to develop alternative behaviors. The clinician works with the family to change their interactions with their teen as necessary using parent management skills. DBT teaches both behavior change and acceptance. Teens that cut typically have difficulty tolerating distressing thoughts and emotions, so learning to tolerate, rather than change an emotion, is a powerful skill. DBT teaches mindfulness, which helps a person live in the present and appropriately perceive thoughts and actions of those around them to reduce anxiety and depression.
Other Forms of Treatment for Cutting
- Cognitive Behavioral Therapy helps clients identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.
- Psychdynamic Psychotherapy focuses on identifying past experiences, hidden memories, or interpersonal issues at the root of the client’s emotional difficulties through self-examination.
- Psychopharmacology may be necessary to provide medications for depression, anxiety, or other mental health disorders associated with self-injury.