Parenting Challenges – Cutting

Self-harm or self-injury, often cutting, is believed to occur in some 7%-14% of adolescents who do so at some time in their life. As a divorced parent, is your child at greater risk and how do you spot this behavior and deal with a teen who is cutting?

What is self-harm or self-injury?

This is the act of a person inflicting injury on themselves, most often by cutting but can include burning, punching themselves or banging a door closed on their own hand or other such acts. Cutting can be done with blades, utility knives, tabs from soda cans, metal clips from pen caps and many other sharp instruments. Cutting occurs most commonly on the wrists, stomach or legs but can be located elsewhere.

Age and gender play a role in self-injury

Cutting and other self injury behaviors most often start in the early teens. This is most likely due to the emotional challenges and pressures of adolescence but the reasons are not fully understood. Most studies suggest that girls are more likely to exhibit such behaviors though it does occur in boys. It is not clearly understood why there is a gender difference.

Why does a teen cut themselves?

The most common motive given for teens cutting themselves is that the act of self-injury provides relief from strong negative emotions.

Common motivations include

• Relieve anger
• To forget about something
• Relieve anxiety

Self-injury is sometimes termed para-suicidal behavior but for the vast majority of teen cutters, they are not trying to commit suicide. In fact teens often describe the sensation of feeling alive during and after cutting whereas they felt numb before they hurt themselves. The injuries are usually superficial and more serious injuries are usually accidents.

For students, self-harm can erupt at times of specific stresses including examinations and school pressures.

Larger psychological issues underlying cutting are not uncommon

There may be larger underlying psychological problems in teenage cutters such as depression or borderline personality disorder and many seem to have been sexually or physically abused or exposed to a traumatic childhood event. It is very important to get professional help not only to deal with the self-injury behavior itself but also any underlying issue.

How do you know if your teen is cutting or causing self-injury?

Teens that cause self-injury are very secretive and hide their behavior from friends, parents and professionals. Those who are cutting on the wrists or legs will often wear long clothing to cover any temporary marks from cutting or any scars that develop from repeated cutting. Such clothing may appear inappropriate in warmer weather. They may avoid activities like swimming or gym where those marks might be revealed.

A stereotype has grown up around emo kids (a loose term covering a type of music and associated fashion) that includes cutting. While some kids may cut to be part of the perceived emo culture, for the most part this is just a stereotype.

What should you do if you find out your teen is cutting?

While your first reaction may be to recoil in horror or feel angry and ashamed, these kids need your help. By reacting angrily you may make the child less cooperative, make them feel more ashamed and push the behavior even more underground. Giving them an opportunity to communicate with you is important. Being non-judgemental and explaining that you want to understand how they are feeling may allow them to open up.

However self-harm is an inappropriate coping mechanism and may well be repeated and become an established pattern soprofessional help is highly advised. Mental health professionals who specialize in this behavior should be your first choice. You can get referrals from help groups or your family doctor.

Are children of divorced parents more at risk for this self-harming behavior?

It is not clear if children of divorced parents are more at risk or not. Certainly divorce and associated stress and instability may contribute to a teen’s inappropriate coping response i.e. self-injury but other issues often precede self-harm.

Common problems preceding self harm

• School or work problems
• Difficulties or disputes with parents
• Difficulties with boyfriends or girlfriends
• Disputes with siblings
• Physical ill health
• Difficulties or disputes with peers
• Depression
• Bullying
• Low self esteem
• Sexual problems
• Alcohol and drug abuse
• Awareness of self harm by friends or family

Will my teen cut again?

As many as 30% of adolescents who self harm report previous episodes, many of which have not come to medical attention. At least 10% repeat self harm during the following year, with repeated behavior being especially likely in the first two or three months.

Factors associated with repeated self harm

• Depression
• Alcohol or drug misuse
• Chronic psychosocial problems and behavior disturbance
• Disturbed family relationships
• Alcohol dependence in the family
• Social isolation
• Previous self harm
• Personality disturbance