Up to 10 percent of young adults self-harm. Here, one woman shares her story of what it was like to grow up a "cutter" and what parents really need to know.
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Teenage girl on balcony at evening twilight

It began slowly, innocuously. A cut here. A scrape there. And while I don't know how it started or why—it's been 20 years since I injured myself with purpose, with intention; 20 years since I dragged sharpened objects across my skin—I can still recall the feeling I got. The "high." Why? Because I was a grieving 15-year-old, one who lost her father two years earlier. I was an abused and neglected 15-year-old who grew up in chaos. My personal life was full of hurt and sadness. It was in disarray. And because I was an unwell 15-year-old; I was living with an undiagnosed and untreated mental health condition.

Self-harm became an outlet. It was my escape like it is for so many. According to Crisis Text Line, people who self-injure often do so because they need and/or want a sense of control. They long for salvation and release.

"Self-harm and self-injury are any forms of hurting oneself on purpose," explains an article on Crisis Text Line. "Usually, when people self-harm, they do not do so as a suicide attempt. Rather, they self-harm as a way to release painful emotions." It's a way "to cope with and process the hard things" in one's life. That was the case for me. I wanted to see something. To feel something. To remind myself I was still alive. Depression had zapped this feeling from me and left me gutted. I was a ghost in a shell. But seeing blood? Feeling pain? It meant I was still breathing and my heart was still beating. In spite of the emptiness and numbness, I was still "there." 

Now, I could tell war stories—of my actions and injuries. I could tell you about trips to the doctor's and counselor's office. About infections, irritations, and forced therapy. I could tell you how I hid my wounds, with clothing, jewelry, and one creatively placed scrunchie. And I could tell you how I did what I did. The tools I used. My behaviors, tics, habits, and methodology. But I won't because they are my stories. They do not add context or color. They mean nothing to anyone aside from me. I also do not want to become something of a poster child for self-injury and self-harm. I do not want to inspire others, in some strange, unprecedented way.

But if you're here, you want answers. You're likely dealing with this in your family, in your very home. The first thing I want to tell parents is this: If your teen, tween, or child is injuring themselves—be it via cutting, scratching, burning, or another means—know they are hurting. They are struggling. Something is wrong. They are in pain.

If your teen, tween, or child is injuring themselves, they may be scared and ashamed. I knew what I was doing was "wrong" but I didn't see any other options. There was no way up, or out. If your teen, tween, or child is injuring themselves, they may be overwhelmed and confused. Many who self-injure cannot pinpoint the reason. Rather, it becomes a habit, or tic. And if your teen, tween, or child is injuring themselves, they likely want help—though they may not know how to ask for it or what they need. They likely do not know what to say.

Here are some things every parent should know about self-harm and how they can help their child.

The Causes of Self-harm Can Vary

While self-injury and self-harm are often viewed as coping mechanisms, ones which are maladaptive, there is no one cause. Some people injure themselves as an escape, particularly from feelings of helplessness, hopelessness, fear, grief, sadness, and anxiety. Others cut or burn themselves because they lack alternatives. They do not have the means to handle external pressures. It becomes a crisis management tool. And others use self-harm as a form of stress relief. Instead of turning to running, for example, they use injury to release their pain.

"NSSI [nonsuicidal self-injury] is frequently used as a coping mechanism during times of intolerable distress when an individual isn't able to recruit healthier ways of coping," says Deepak Prabhakar, M.D., M.P.H., the chief of medical staff at Sheppard Pratt, a private, nonprofit provider of mental health, special education, substance use, developmental disability, and social services. "The majority of people say they engage in NSSI to make painful emotions, like sadness or shame, go away. Other people hurt themselves when feeling numb, saying things like, 'I wish I could just feel something.' Some want to make bad things stop, and others punish themselves."

He adds, "Most people say they cut or do other things to hurt themselves for more than one of these reasons."

Here are some of the most common causes of self-harm, according to the Mental Health Foundation:

  • Depression
  • Anxiety
  • Difficulties at home
  • Bullying
  • School stressors and pressures
  • Low self-esteem
  • Drug and alcohol use
  • Being a member of a LGBTQ+ community

Self-harm Can Be Addictive

As with other maladaptive behaviors, self-harm can be addictive—particularly if/when the individual harming themselves feels relief. "When they realize it helped make them feel better, they may be likely to do this again when upset and overwhelmed," explains an article from Sheppard Pratt. "Once this pattern starts, it can be difficult to resist the urge to harm unless there is a replacement behavior or therapeutic intervention." That said, hope is not lost. Many individuals can and do gain control of this behavior. 

Most Who Engage in Self-harm Are Not Suicidal

Despite the fact that cutting, burning, and/other forms of self-injury can be suicide methods, most individuals who self-harm are not suicidal. Approximately 10 percent of young people self-harm, according the Mental Health Foundation, and it's used as a way to manage whatever difficulties are going on in their lives. "Some people have described it is a way of staying alive and surviving these difficulties," the foundation explains.

But it's important to note that accidental suicide can and/does occur. "Accidental suicide from cutting too deeply, or other dangerous behaviors, is a big risk," explains the Sheppard Pratt article. For this reason, it is imperative the person self-harming seeks and/or receives appropriate care.

Stopping Is Not Easy

Telling someone to "just stop" self-harming or to "knock it off" isn't going to "save" them, nor is it helpful. Your child is hurting and self-harm has become an outlet for them. Stopping is not that simple. Quitting self-harm requires much more than willpower, explains the National Alliance on Mental Illness (NAMI). Rather than berating or shaming your loved one—or offering them an ultimatum—you should be as supportive, patient, and understanding as possible.

"Calmly approach your child in a quiet moment. Be curious and non-judgmental, and let them know that you have noticed some things (cuts, bloody tissues, etc.) that you want to ask about," says Helene D'Jay, MS, LPC, clinical director at Newport Academy, an American mental health treatment program for teens and young adults. "Let your child know that everyone needs coping skills to handle tough emotions, and that although they have found a coping skill that may work for them, there are other ones that can help them even more." D'Jay stresses that it's important for parents not to be angry or overly emotional, either. "Be curious and open to hear what they have to say," adds D'Jay.

You should also remove any and all objects from the house that a child is using to self-harm, or—at the very least—make them difficult to access.

Self-harm Can Be Treated

The good news is that, while self-harm can be and feel scary, there is both help and hope. Many who injure themselves recover, breaking the cycle in a healthy way.

Parents should speak with their child's pediatrician or another trusted health professional to see what the best form of treatment would be for their child.

There are various support services and treatments available, including cognitive behavioral therapy (CBT), which focuses on building coping strategies and problem-solving skills, and psychodynamic therapy, which helps to identify the problems that are causing distress and leading to self-harm. There are also numerous online resources and support groups, including S.A.F.E AlternativesThe Cornell Research Program on Self-Injury and Recovery, and The Adolescent Self-Injury Foundation.

"Treatment begins with an assessment from a professional, such a psychiatrist or therapist," says D'Jay. "They will determine the root causes of the struggles through a verbal assessment." They will then work with the patient to come up with a treatment plan.

If you or someone you know is in crisis, text "START" to 741-741 to immediately speak to a trained counselor at Crisis Text Line. You can also contact the Substance Abuse and Mental Health Services (SAMHSA's) National Helpline at 1-800-662-HELP.