When I look around the community for good people doing good things, I need look no further that to one of my previous Interns, Kristine Newton. She brings her maturity and competence to the counseling room to help, among other situations, teens who are cutters. If you are one of these teenagers or if you know one, you would do well to read this article. I asked Kristine to write something to help us understand what’s going on that drives this behavior and also what can be done to help the teen move from despair to a more mature contentment. Need help? Call Kristine. She’s good.
It seemed like a normal night, their teenage daughter, Alice had come home and said good night. She seemed safe and happy; Mom and Dad were relieved and began to watch TV. Less than ten minutes later, Alice came down the stairs, face flushed, tears in her eyes and blood gushing down her arm. While her parents were relaxing, Alice had gone to her room and slashed her arm. She had been cutting secretly for over six months, but tonight she used a box cutter and didn’t realize how sharp the blade was. The cut was so deep it required a trip to the ER and six stitches. Alice’s parents were in shock, what in the world had she done to herself and why?!!
It is estimated that one of every 200 girls between the ages of 13 and 19 in the United States engages in self-harm of some kind; of those 70% cut themselves. When families come to my office, the scene normally plays out like this.
Two very anxious parents and one scowling teenager enter the room and sit across from me. The adolescent informs me, “I will not talk to you or to them!” They either deny the cutting is serious or state that their parents are being overly dramatic. “After all,” the teen says, “It’s not that big of a deal; cutting just makes me feel better.”
“Makes you feel better?!! That is ridiculous!” the parents exclaim. With desperation, the parents turn and give me a look that begs me to talk some sense into their teen immediately.
The weird thing is . . . the teen is at least partially right. Cutting is a coping mechanism that “works” for some people. Scientists have studied the issue, and believe cutting creates a temporary high, similar to the way adrenaline works. For most of us, this does not make sense. How in the world can hurting yourself make you feel better? Like other unhealthy coping mechanisms such as drugs and alcohol, outsiders can easily see the dangers, but the person engaged in it cannot. Cutting is deceptive, destructive, and can be addictive; even though for a time, it helps relieve tension, reduce numbness and/or create a distraction from stressful life events.
While cutting may appear to “work” for the person using it, like drugs and alcohol, it leaves a bitter aftertaste, and is a dangerous illusion. Cutting can lead to unplanned medical expenses, trips to the ER and, infections which sometimes cause life-long health problems. At minimum cutting leaves unattractive physical scars, and never gets to the root of the issue. Emotionally and relationally, people engaged in cutting end up isolated from others, filled with deep shame and self-hatred, and develop incredibly effective skills at hiding reality from those closest to them.
It is important to note that while cutting may look and feel like a suicide attempt, or a cry for attention most times it is not. This surprises most of us. Many people who engage in cutting are not attempting to kill themselves; they see cutting as a way to deal with their pain, so that they can keep on living. While cutting is not often a suicide attempt, it can be a precursor to it, and those who engage in cutting are more prone to attempt suicide in the future. Sometimes like our teenager Alice in the first paragraph, the cutting may lead to an accidental cutting that is much more serious than intended – even accidental suicide.
To help us understand some of the reasons why a person might cut, there are several characteristics that seem common. Most cutters have experienced more than their fair share of pain. Many have been sexually abused, grown up with family members who have drug and/or alcohol addictions, or have experienced an extraordinary trauma in their lives. When we actually begin to hear their stories, it is often a wonder to us that they are still alive, and it is understandable that they are struggling.
A second characteristic is that they often feel they have become a burden to others, they feel isolated, and thus tend to deal with their problems without outside help or advice. They believe others are sick of listening to them, don’t understand them and can’t or won’t help them. Therefore, rather than ask others, they take on the pain themselves and engage in self harm. One client who ended up in the emergency room said, “I didn’t want to kill myself. But I didn’t want to burden my mom anymore by telling her I was down, again! I thought I could cut myself and deal with it that way. But the cut was a lot deeper than I intended. Now I am so mad at myself, I was attempting to take care of myself, but now I have created more drama and cost my parents even more money because of the hospital bill.”
A final characteristic is cutters are very passionate, sensitive individuals who feel their emotions in vivid Technicolor. God has given them a unique personality and emotional framework that has very sensitive receptors to the soft side of life. Many times those who struggle with cutting are fun to be with, exciting to share struggles with, and often very compassionate with others. This places them on a very steep roller coaster ride. The highs are very high and the lows are almost intolerable! The downside: pain they feel at a high level and don’t know how to deal with it. They may try to tell someone they are hurting, but are blown off because others don’t experience the issue at the same intensity.
So what do you do if like the parents in the opening story, you have discovered someone you care about is cutting? Here are six suggestions.
1. Trust. Trust that God loves your loved one even more than you do! He loves to shine light in dark places so that He can bring restoration. Trust in His power, loving-kindness and timing to do what He has promised in your life and your loved one’s life.
2. Don’t Panic. My guess is that like the parents above, you would be a bit freaked out. That is normal. Don’t be shocked by your reaction. It is very important to deal with the problem, but do so calmly and not in a panic. Remember, cutting is usually not a suicide attempt, but it is often a cry for help. Your panic could encourage more hiding, aloneness, and be a precursor to more not less cutting.
3. Communicate love and care. Tell your loved one that you care about them, that you want to be supportive and that you want to see them get help. Do not scold, rebuke, or preach at this point, simply and clearly let them know you are in their corner and cannot be run away!
4. Find a therapist. I recommend finding a good therapist for your loved one. A therapist who is experienced in working with cutters is best. Therapy is often necessary not only to teach the cutter new coping skills, but also to work through the trauma that is at the root of cutting. Therapy also helps to educate the cutter of their sensitive emotional nature so they may see it as a blessing, not a curse, and to teach them to use that gift properly and well. If you are the parent, you should attend sessions as well. This is beneficial. It helps the cutter feel supported, and it will also help you. I know this may sound scary, but the therapist can not only help you know how to best deal with your situation, but also work through any doubts you may be having about your parenting skills.
5. You find a therapist. Dealing with a cutter presents unique challenges; seek a counselor who can help you learn to react to your sensitive loved one in a new and godly way. Even if your loved one will not go to therapy, you should go! Therapy can help you deal with the situation when the person you care about does not want to change.
6. Be a friend. This is a time where your loved one really needs a healthy relationship. Listen when they need to talk, open the door to deeper issues, but don’t try to pound down the door. Make sure that you that you remember how to have fun with them! Don’t treat them like a project or a problem. And be patient. This behavior has usually occurred in secret for some time, a few sessions with a therapist will not make it go away. Like addictions, there may be periods of sobriety and then some relapse.
Kristine Newton, MA, LPC works with adolescents and adults at Heritage Counseling and Consulting, in the Park Cities area of Dallas. Through her earlier work at Heartlight Ministries, an inpatient rehab center for teens, and Metrocare Services, she has extensive experience working with adolescents and adults who have engaged in self harm. To contact her, call 214.363.2345