Cutting and Self-Harm: Warning Signs and Treatment

By Jeanie Lerche Davis
WebMD Feature

Reviewed by Michael W. Smith, MD

Cutting. It's a practice that is foreign, frightening, to parents. It is not a suicide attempt, though it may look and seem that way. Cutting is a form of self-injury -- the person is literally making small cuts on his or her body, usually the arms and legs. It's difficult for many people to understand. But for kids, cutting helps them control their emotional pain, psychologists say.

This practice has long existed in secrecy. Cuts can be easily hidden under long sleeves. But in recent years, movies and TV shows have drawn attention to it -- prompting greater numbers of teens and tweens (ages 9 to 14) to try it.

"We can go to any school and ask, 'Do you know anyone who cuts?' Yeah, everybody knows someone," says Karen Conterio, author of the book, Bodily Harm. Twenty years ago, Conterio founded a treatment program for self-injurers called SAFE (Self Abuse Finally Ends) Alternatives at Linden Oak Hospital in Naperville, Ill., outside of Chicago.

Picture of an Unhappy Kid

Her patients are getting younger and younger, Conterio tells WebMD. "Self-harm typically starts at about age 14. But in recent years we've been seeing kids as young as 11 or 12. As more and more kids become aware of it, more kids are trying it." She's also treated plenty of 30-year-olds, Conterio adds. "People keep doing it for years and years, and don't really know how to quit."

The problem is particularly common among girls. But boys do it, too. It is an accepted part of the "Goth" culture, says Wendy Lader, PhD, clinical director for SAFE Alternatives.

Being part of Goth culture may not necessarily mean a kid is unhappy.

Lader says "I think kids in the Goth movement are looking for something, some acceptance in an alternative culture. And self-injury is definitely a coping strategy for unhappy kids."

Very often, kids who self-harm have an eating disorder. "They may have a history of sexual, physical, or verbal abuse," Lader adds. "Many are sensitive, perfectionists, overachievers. The self-injury begins as a defense against what's going on in their family, in their lives. They have failed in one area of their lives, so this is a way to get control."

Self-injury can also be a symptom for psychiatric problems like borderline personality disorder, anxiety disorder, bipolar disorder, schizophrenia, she says.

Yet many kids who self-injure are simply "regular kids" going through the adolescent struggle for self-identity, Lader adds. They're experimenting. "I hate to call it a phase, because I don't want to minimize it. It's kind of like kids who start using drugs, doing dangerous things."

Blunting Emotional Pain

Psychiatrists believe that, for kids with emotional problems, self-injury has an effect similar to cocaine and other drugs that release endorphins to create a feel-good feeling.