Over the holiday school vacation, I found out that our 14-year old daughter has been engaging in what is called “cutting.”  When I confronted her, she admitted that she and a couple of her friends use a small pocketknife to cut on their arms and legs. Since she’s wearing winter clothing, we never knew until now. She says it’s just a “game” but we are frightened. What makes a child do this? What do we do now?

The practice of self-cutting has been around for a long time. Usually, people use household articles such as a small knife, a piece of broken glass, a shaver and even articles such as pens and pencils. People usually cut on their arms, legs and stomach area depending on how much they want to hide the scars. Cutting has three main purposes:  

§         Most commonly, cutting is a coping mechanism

§         It is a cry for help.

§         It is a group practice and sort of a “right of passage” for teenagers.   

As a coping mechanism - Cutting is an individual and private practice. It is an attempt to deal with a painful emotional experience. Often, kids (and adults) feel flooded and overwhelmed by the intensity of these difficult feelings. If they don’t have effective coping skills and can’t talk about their feelings, they resort to unhealthy methods to distract and numb themselves. These methods may include: use of drugs, alcohol, sex, excessive sleeping, overeating, under-eating, excessive exercise, rage, cutting and, in extreme cases, a suicide attempt.

• Cutting is a distracting and numbing mechanism. The infliction of physical pain distracts   from the emotional pain. The internal, emotional tension that may feel like, “I’m going to explode” is relived by the physical experience of pain and drawing blood. Additionally, it can be used as a self-punishing method.

• As a cry for help - Cutting is a non-verbal message to others (such as parents and friends) that the person is suffering and need attention. The cutting is a way to shock others and move them into action.

• As a “right of passage” - Cutting is an aspect of our teens growing fascination with blood and physical pain as a method of self-expression.

The most common and seemingly acceptable manifestation of it is the widespread practice of piercing and tattooing. All “right of passage” rituals must include daring: showing courage   taking risks and being secretive. Being able to cut yourself in a group is a way to demonstrate that you are: strong and courageous (commonly known as “cool”), loyal to the group and a full participant in the secret that now bonds you. In other cases, the group cutting is an act of support and solidarity with one member who is truly an emotional, private cutter. 

If your child has been cutting as a group practice, talk to her about peer pressure and about how secure she feels in her social status and with her friends. Explore her self-esteem and the possibility of choosing different friends. If your child has been cutting in private, you need to start communicating with her about her feelings and experiences. Psychotherapy and sometimes medication (if depression or anxiety is severe) could be very helpful. Your child, and possibly the entire family, may need to develop better coping mechanisms, better communication skills, and you may need to become more attentive to subtle signs and signals from your child. 

Einat A. Bronstein, LCSW, Psychotherapist
7750 Clayton Road
Clayton, MO 63105

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