My teen is cutting; are they suicidal?
Cutting is one of the most common ways to inflict self-harm- to hurt one’s self intentionally, or “self-injury.” Cutting can be done with scissors, razor blades, safety pins, pencils, etc; other forms of self harm may include burning, scratching, puncturing one’s skin, or hitting self.
Most parents panic when they discover their child has been cutting and are instantly fearful that their teen might want to take their life. Sadly, as many as 1 out of 4 teenagers (most commonly girls) use cutting as a coping skill. However, the majority of teens who self-harm do not wish to take their own life. Cutting appears to be suicidal behavior, but is primarily used to self-soothe; this is also called nonsuicidal self-injury (NSSI).
Teenagers are motivated to cut for various reasons and by various stressors; while self-injury makes sense to the teen to an outsider this seems to be very bizarre and unsettling behavior.
One way of understanding cutting is to view it as a way to get in touch with one’s emotions. Some teens feel numbed to the pain in their lives, but say they feel alive when they cut; through cutting they can access everything they feel. This is true for Sarah, a 16 year old who has been listening to her parents’ brutal arguments at home for the past year, is being bullied at school, and is obsessed with staying at the top of her class. Sarah feels scared, misunderstood, and overwhelmed but pushes through her day without stopping to acknowledge everything she is facing; she feels out of touch with herself. Through cutting, however, Sarah finds the space to cry and feel pain- she feels alive.
Still other teens say they are releasing their emotions when they cut; stress, sadness, overwhelm, or depression build up inside, and with a cut these feelings drain out of them. Some teenagers are very touch with their feelings; so in-touch that their emotions seems to pile up inside of them, ready to explode. Through cutting these teens find release. In my work with teens who self-harm, I often hear that the cutting “give a voice” to the pain that they couldn’t put words to.
Self-injurious behavior can also be reinforced physiologically. There is research that suggests endorphins are released when cutting; as a teen cuts endorphins are released into the blood stream making the teen feel a mix of relief and pleasure, mimicking a “high.” These endorphins also serve to block out the physical pain that would otherwise be experienced. Unfortunately, this euphoric affect serves to reinforce cutting as a bad habit.
While cutting is not a sign that suicide is imminent, it is still an unhealthy behavior for several reasons: it could be a symptom of other psychological or emotional illnesses; sometimes cuts are made deeper than were intended and teens can seriously injure themselves; there is the potential for cuts to become infected. (It is common for teens to make horizontal cuts or scratches on their body; if you notice your teen is making vertical cuts up their arm, especially near the radial artery, this could indicate suicidality.)
Perhaps you do not know for certain that your teen is cutting; here are several warning signs that your teen may be self-harming:
Odd or suspicious scars
Wounds that don’t heal
Cuts in same area
Wearing long sleeved clothing in warm weather
Refusal to change in the gym locker room- or any appropriate environment where skin exposure is appropriate or expected (i.e. swim suits, doctors appointments, etc)
Isolating self; avoiding social settings.
Reluctance to shower (as this hurts fresh cuts)
Talk about self-harm
Viewing history on social media of self-harm videos/cutters
What do I do? My teenager needs help!
Ignore your teen, assuming they are trying to be manipulative.
Comment about how disgusting it is.
Criticize their choice.
Shame your teen.
Be surprised if your teen doesn’t want to talk about their self-injury.
Let your teen know you love them.
Listen to understand; ask them to share what is going on in their lives.
Help your teen understand that cutting may be a distraction from pain, but it can not solve pain.
Talk about other alternatives to cope with unpleasant feelings.
Try to identify triggers and stressors in your teens life; there may be pieces of your teen's life that may need to be re-evaluated or cared for.
Seek professional help immediately for your teen; ideally, treatment for cutting is more successful if done before 10 episodes of cutting (wherein it may become habitual).
Accept your own emotions; it is normal for parents to experience a wide range of feelings- from fear, to anger or disgust. Parents need help working through their own reaction to their children so they can reach out to their teen without being triggered, and can benefit greatly from seeking out parent coaching.
If you have found out that your teenager is self-harming, or simply has the urge to, contact me immediately; let me help you get your child back to a place of health and happiness. You do not have to figure things out on your own.
Information compiled from:
Child Mind Institute
American Association for Marriage and Family Therapy
Jeannie Colvin, MFT; Child and Adolescent Development lecture at Vanguard University
Tracy Alderman, Ph.D., The Scarred Soul: Understanding and Ending Self-Inflicted Violence.