Last Sunday, I was a guest on the Street Soldier radio show on 106.1 KMEL. The topic was how teenagers are impacted by social media. The topic of depression and cutting came up during the conversation. The adults were shocked to hear about the cutting and the teens tended to feel the cutting was more of an issue for the girls. However, as a psychotherapist who works with teenagers, I have observed the increase in teenage cutting over the years. I have also observed that a behavior that once was believed to occur mainly in girls is also occurring in teenage boys. From what I have seen it appears that just as many boys are cutting as girls.
The first question I often receive when I mention cutting is, what is it? Cutting is any behavior that a person engages in with the goal of self-mutilating. Teenagers cut with razors, knifes, paper clips, staples, using erasers or even scratching themselves. These are just a few ways teenagers have found to self-mutilate themselves. Since this is an activity associated with a great deal of guilt and shame, I am sure there are more ways that we have not learned about yet.
Also because cutting is associated with a great deal of guilt and shame our statistics on how many teenagers cut are not entirely accurate. Most recent studies indicate that approximately a third of all teenagers have tried cutting or actively cutting (CDC). If you noticed the research shows a third of all teenagers, which means boys too. I have more and more teenage boys who say they are cutting, have cut or are thinking about it. Cutting occurs in boys too. We need to be aware of this fact. Cutting can lead to accidental suicide attempts if an artery is cut or permanent damage if nerves in the arm or legs are severely cut. These are things that teenagers and parents don’t think about.
Why do teenagers cut? The reasons I commonly hear is it is easier to deal with the physical pain than the emotional pain they are feeling. Teens who are severally depressed state that cutting reminds them they are alive. They are so depressed that they feel nothing, but when they cut they feel. Also teenagers cut as a way to punish themselves because they are ashamed about something they did or they feel they have let their parents down. Cutting is a way to deal with the guilt and shame they are experiencing.
If we look at how boys are raised, cutting is a good fit for boys. Most boys grow up learning that boys can’t cry and if you express feelings of sadness or disappointment you are weak. Teenage boys are always supposed to look like life is perfect and they can handle anything without help. Cutting allows them to express sadness, fear or embarrassment in private. No one knows they are cutting or how they are feeling. Unfortunately, this leads to a vicious circle where emotions can get out of control and a boy may end up doing something he never indented to do.
At this point, most people working with teenagers consider cutting an epidemic. In fact, the CDC does consider teenage cutting to be an epidemic. Additionally, the little research we have about this behavior supports this idea, but we are unable to determine how severe the epidemic is in teenagers. When I mention cutting to a teenager now, they don’t look shocked. Instead they talk about it like we are talking about the weather. They often tell me about friends who are cutting too. Most teens who cut have friends that cut. Most teenage boys who have girlfriends tend to have girlfriends who cut too. This has been my experience.
Cutting can be a very dangerous behavior and does need to be treated with psychotherapy. If you feel your teen may be cutting, talk to them in an understanding manner. Do not give them any reason to feel guilty or ashamed if they say yes. As I stated above, the teen already feels a great deal of shame and if they feel they will be looked at in a shameful manner or that you will be shocked they will never open up to you. You need to reassure them you love them and you only care about their safety.
I said it needs to be treated with psychotherapy. Find a psychotherapist who specializes in treating teenagers and in treating self-mutilating behavior. This is very important because if the therapist acts negatively or shocked, the teenager will shut down and therapy may not work with any other therapist because the teenager now assumes everyone is judging them. I have had teens test me in various ways because of what a previous therapist said about their behavior or what the therapist said to their parents. They need to feel safe and accepted by their therapist if therapy is going to work.
I have included some risk factors and warning signs for you to be aware of in case you think your teen might be cutting:
Knowledge that friends or acquaintances are cutting
Difficulty expressing feelings
Extreme emotional reactions to minor occurrences (anger or sorrow)
Stressful family events (divorce, death, conflict)
Loss of a friend, boyfriend/girlfriend, or social status
Negative body image
Lack of coping skills
Wearing long sleeves during warm weather
Wearing thick wristbands that are never removed
Unexplained marks on body
Secretive or elusive behavior
Spending lengthy periods of time alone
Items that could be used for cutting (knives, scissors, safety pins, razors) are missing.
While this is a scary subject, I have worked with many teens who have overcome this issue. The important thing is as parents you are accepting and non judgmental. Also you need to be aware that this issue does exist. My last point is that boys cut too. Girls are not the only teenagers engaging in this behavior.
Dr. Michael Rubino has over 20 years experience treating children and teenagers. He has treated many teenagers who cut and is considered an expert in this area. For more information regarding Dr. Rubino visit his websites http://www.rcs-ca.com , http://www.RubinoCounseling.com , or his Facebook page, http://www.Facebook.com/Drrubino3