Have you ever met someone who cuts himself or herself as a way to cope?
Whether you knew it or not, you likely have.
Cutting is one of a series self-injury behaviors that young people may use to gain a sense of relief from emotional pain, a sense of control over problems in their lives, or feel a break from pressures in their lives.
While cutting is the most common form of self harm, other self-injury behaviors include burning, picking or reopening wounds, punching/hitting oneself, inserting objects into the skin or purposely bruising or breaking one’s bones.
Why?
Lisa Lowery, MD, MPH, section chief of the division of adolescent medicine at Spectrum Health Helen DeVos Children’s Hospital provided insight into this concerning behavior, from its causes to how to help a young person struggling with self injury.
First of all, Dr. Lowery wanted to make a few things clear.
“Cutting or self-injury behaviors might seem ‘fringe’ to many parents,” she said. “It isn’t. Cutting can happen in any race, socioeconomic class, family. Many also often believe it is a suicidal behavior. While cutting can be accompanied by depression or psychological disorders, for most, cutting is a coping mechanism.”
Cutting discovered. Now what?
For anyone to see evidence of cutting in a teen, it’s always by accident. Cutters go to great lengths to hide scars and open cuts.
Discovery triggers panic in the discoverer because it is alarming, obviously, to see scars or blood. Dr. Lowery cautioned that if you see signs of cutting in your teen, the worst thing you can do is freak out, become angry or emotional.
“Remember that you don’t have to (and can’t) solve anything in the moment,” she said. “Stay calm and caring. Hide shock.”
If the teen is willing to talk about it, simply listen without telling them they must stop. Make an appointment to meet with a professional who specializes in adolescent medicine. As doctors who have dealt with this kind of issue regularly, it is the best starting point.
“I am non-threatening to your child,” Dr. Lowery said. “I can talk to him or her from a safe perspective.”
Dr. Lowery added that she works to build trust and maintains confidentiality with her patients. She is often able to learn how the patient started cutting, how long it’s been going on.
“Some know, some don’t,” she admitted.
Dr. Lowery also tries to learn how the patient feels that cutting is beneficial, for example, does the teen cut to calm down? Do they need to relieve pain? Do they need to feel pain? Do they cut alone, or with a friend or group? The answers to these questions offer clues as to how the teen can best be helped.
Getting help helps. Seek help.
“We have open conversations about it,” Dr. Lowery noted. “Once I’ve confirmed that the teen isn’t suicidal, we start talking about other coping mechanisms.”
For example, some of her patients use deep breathing, bracelets, rubber bands or necklaces as part of mindful meditation when they have the urge to cut.
Cutting can be a symptom of a condition called Borderline Personality Disorder. For patients who may have this disorder, Dr. Lowery first works with psychology professionals to diagnose the condition. Patients often exhibit a long pattern of unstable romantic, family and social relationships.
Getting dialectical behavior therapy can help. A targeted form of cognitive behavior therapy, it helps patients learn to monitor and respond to mood swings and emotional triggers more positively, with safe coping behaviors.
In some instances, anti-depressant or anti-anxiety medications may be recommended.
“By carefully educating, monitoring and selecting a medication, starting on low doses, and developing a clear plan with the patient, the medications can help patients gain control over their emotions,” Dr. Lowery explained. “I give realistic expectations. It takes a while to feel the improvement. This is a marathon, not a sprint. Start low, go slow and watch as we go. This is a scary time for families. It’s important to know that we will work together. Depending on how severe it is, we will act accordingly.”
For young people who feel the need to experiment with self injury, Dr. Lowery advised that they tell a trusted adult.
“I know it’s not what you want to do,” she said. “But you can feel better. You can stop scarring your body. Or tell a friend and ask them to help you get help.”
For those who might be the friend, know that you are doing your friend a favor by telling an adult. Cutting isn’t something to be embarrassed about. It is a sign that a person is having trouble working through some problems.
Help is available and can turn things around for the better. Everyone deserves to feel better. Everyone deserves help.
Reprinted with permission from Spectrum Health Beat.
