According to the U.S. Department of Health and Human Services, approximately 2 million people in the United States—mainly female teenagers—intentionally injure themselves every year. While self-mutilation can be a one-time, experimental occurrence, experts say this unhealthy coping mechanism can become addictive. “Self-mutilation—particularly teens cutting themselves with razor blades or other sharp objects—is a destructive way that some kids deal with feelings such as anger, frustration, depression and shame,” says Irma Coto, Clinical Coordinator on staff at Nicklaus Children's Hospital, formerly Miami Children's Hospital. “They focus on the physical pain of cutting, and it helps them forget about the emotional pain that is building inside.”

Cutting for the first time is usually impulsive, and the “rush” teens get from this behavior may cause it to escalate into a compulsion. As a result, the cutter can have dozens, if not hundreds, of cuts on his or her arms, legs and chest—all areas that can easily be covered by clothing.

Why Some Teens Cut

While cutting is seen by outsiders as an illogical way to deal with pain, those who perform the act say it is an attempt to control feelings they can’t handle on their own. When they don’t express their problems verbally, the emotions accumulate inside, and cutting is performed to relieve tension or to feel in control of a situation.

“Though the portion of the brain that needs emotional and social rewards is very active in the teen years, the part that controls impulses doesn’t mature until adulthood,” Coto says. “When teens don’t have the capability to cope with difficult situations, they may adopt a mentality that makes cutting seem like a logical solution to pain.”

However, it’s deeper than that. When a person cuts compulsively, the brain begins to associate the experience with relief. As tension builds, the body begins to crave the feeling it experiences during cutting, and the urge to cut can control a person’s day-to-day activities.
 

Hiding the Pain

As the marks and scars left by cutting heal, it’s not uncommon for cutters to hide the slashes with longsleeved shirts and long pants—even in the heat of the summer. Cutters often become secretive and close themselves off from their friends and family members, so parents may be the last to know that their child has a serious problem (see sidebar, “Know the Signs”). “When parents suspect their son or daughter is cutting, it’s critical to talk with the child about the problem and then reach out to professionals for help,” Coto says. “Though cutting is not an attempt at suicide, it’s still considered an extremely risky behavior that needs to be addressed. Parents aren’t always equipped to handle this level of instability on their own.”

Learning to Cope

Treatment for teens who perform self-mutilation can include everything from individual and group behavioral therapy to family therapy and medication. During treatment, therapists and counselors will work closely with teens to help them learn different coping mechanisms. “Because cutting can turn into an addiction, it can be a hard pattern to break,” Coto says. “However, with guidance and support, teens can move on from this dangerous habit.”

Published by the Department of Psychiatry at Nicklaus Children’s Hospital.