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Cutting: The Frightening Disorder of High-Achieving Teens

By Monika Downey

Brandon (not his real name) walked into his first day of junior high with the same array of feelings felt by many 12-year-olds: excitement, anticipation and even a normal dose of fear. Readily accepted into a Bay Area college preparatory school, Brandon had always been a well-adjusted child who enjoyed school and excelled. He is a typical Bay Area student – one that would never be labeled as “troubled” or “difficult.” He always got along well with others and was considered a good influence on his friends. Nobody could have predicted the downward spiral he was about to take in his new academic environment.

The pressure of transitioning to a new school, the intense academic demands, and adjusting to the tumultuous years of adolescence began to strain. Brandon became overwhelmed in school and his grades began to slip. He was physically exhausted from soccer practice, dropping into bed after hours of homework. His grades slipped even further and he was unable to catch up. His parents and teachers assumed that he just wasn’t putting forth enough effort and came down harder and harder on him, adding to the rocketing stress.

"I was really trying to do my best. I really was,” says Brandon. “I got so mad at myself for not doing well enough in school. No matter what I did, I kept messing it up.” Although this took place more than two years ago, the pain left by his failures still flashes in Brandon’s eyes as he talks. “I let my parents and my teachers down. After awhile, I just hated myself for not doing as good in school as everybody wanted me to.”

Brandon was angry for disappointing those he cared so much about. Crushed with feelings of failure for forgetting another homework assignment, Brandon sat in class one day, unsure of how to handle the overwhelming emotions. He took a sharp pin and scratched a thin line in his arm. Feelings of anger, frustration and hatred for himself churned as he used the pin to scratch another line, a way of punishing himself. As a slight streak of red blood gradually appeared, Brandon felt calmer, more relaxed. The anger and disappointment toward himself subsided. He continued this practice until his parents found the thin gashes, external manifestations of the Brandon’s internal pain.  



An Alarming Rise in Self-Injury

This behavior is far more common than many parents and educators would guess. The disorder, known as “self-injury” or “self-mutilation,” is simply known as “cutting” to Bay Area teens. It involves the intentional harming of oneself by cutting or scratching the skin. Razor blades, broken glass and even seemingly harmless objects like paper clips or thumb tacks are used. Although there are other forms of self-injury such as burning oneself or pulling hair, cutting is the most frequent form.

In the competitive Silicon Valley, it is spreading at a startling rate. Although exact numbers are hard to estimate due to the secretive nature of the behavior, Dr. Samuel Judice at the UCSF Langley Porter Institute estimates the number to be as high as 1 in 50 teenagers. Nationwide statistics show that self-injury affects more than 2 million children and adults. Even more surprising is the type of adolescent engaging in this dangerous behavior – teenagers from middle and upper socio-economic families, teens that are high academic achievers and those that seem socially well adjusted.

ldquo;Cutting used to be a mark of severely disturbed kids but now crosses every socio-economic level,” says Judice, who sees self-injury primarily with girls but also with some boys. According to Judice, self-injury is seen in all types of families, but has a tendency to rear up in those experiencing divorce and in adolescents with overly critical parents.

Researchers see a strong biochemical correlation that makes cutting, once started, difficult to stop.

"When people engage in self-injury,” says Judice, “a chemical is released in the body that makes a person less anxious, less intense and actually brings calmness to them. This chemical crosses the same receptors in the brain that T.H.C. (the active ingredient in marijuana) does.”

This finding may explain the addictive nature of cutting.

Judice encourages parents to have any child who is found cutting evaluated by a professional. Although the behavior is usually not an attempt at suicide, only a professional is able to make this determination. Self-injury needs to be taken very seriously because there are always underlying things that have made the child turn to cutting.

“This usually won’t go away by itself and there is a good chance that it can get worse,” says Judice. “Most parents are shocked when they find out their child is cutting, but they need to remember that it can be treated with a good outcome. The earlier they get help, the better.”



Good Kids Facing Too Much Stress

Teenagers cut as a way to relieve stress and intense emotional pain. They self-injure when unable to deal with the torrent of emotions. Family conflict, depression, failing in a sporting event and perfectionism can precipitate the problem. Experts warn that today’s society has a tendency to neglect the emotional and internal development of a child, particularly when busy lifestyles mean less time for face-to-face engagement between parents and children.

Kyle Eaton, vice-principal of a middle school in Santa Clara, is one of many educators who believe today’s teenagers need more time communicating with parents on a regular basis. Not only does he think a lack of communicating pushes kids toward cutting, he also blames popular culture for romanticizing the behavior in music and movies.

“Be in tune to what your kids are going through,” says Eaton. “Take the time to sit down and eat with them, to listen to them and spend time with them."

Eaton contends that children are far too isolated, holed up in their rooms with video games, television and computers.

“Allowing your kids to isolate themselves only sets them up for failure,” says Eaton, who encourages parents to take these devices out of bedrooms and to put them into more central areas to prevent isolation. This not only allows parents a better chance to interact with their teenagers, it allows parents to discuss what their teenagers may be seeing on television and on the Internet.

Today’s teens need to do very little to hear about self-injury. Although it would be easy to assume that self-injury is a relativity new phenomenon, there are accounts that date back to the Bible. It is found in almost every avenue of popular culture: books, movies, song lyrics, music videos, cutting Web sites and popular television series, such as ER and Buffy the Vampire Slayer.

Do these bursts of media increase the number of teenagers trying to self-injure? Not according to Tonja Krautter, a Bay Area specialist in adolescent psychotherapy.

"Some teenagers may begin self-mutilation because they are copying the behavior, but those kids don’t continue; they stop,” Krautter says. “The ones with deep, underlying problems are the ones that continue.”



The Problem Behind the Problem

An example is Brenda, the pseudonym for a Bay Area 14-year-old, who is among the many teenagers who got the idea of cutting after seeing Thirteen. The movie portrays a teenage girl who turns to self-injury after being emotionally wrenched apart by the pain of adolescence.

Brenda’s mother wishes that her daughter never had the opportunity to see it and partially blames the movie for giving her daughter the idea to cut. Although Brenda has since stopped cutting, she still attends counseling sessions to deal with the many underlying problems that her self-injury uncovered.

ldquo;Brenda started cutting during a hard period in our lives,” says her mother. “I definitely think she did it as a way to deal with stress and also for attention from me. Brenda struggled with being overweight and had very low self-esteem. There is always something behind it if a child starts cutting, always a reason.”

Finding out that your child cuts is both shocking and frightening.

"When I first found out, I was livid and at the same time just trying to understand why she did it,” Brenda’s mother continues. She encourages other parents to teach their children how to express their feelings, so that they do not become overwhelmed.

so emphasizes the need to teach children how to express their feelings, which she feels doesn’t happen enough because of the number of latchkey kids, the abundance of technology and the collapse of the extended family.

"Society is not teaching children how to deal with their feelings. We try to rescue them from experiencing difficult feelings, instead of helping them build internal coping mechanisms to help them deal with disappointment," Krautter warns.



Advice to Parents from the Young Experts

Samantha (not her real name) is a local sixth-grader who recently began cutting when she had trouble dealing with events in her life. She knows almost a dozen friends who also cut. Recently, she made an effort to stop.

ldquo;I cut when I am stressed – like when my parents are angry at me and they get all mad. I also started cutting when I would do badly in school or when I had problems with my friends,” Samantha explains.

She advises parents who discover that their child is cutting to “Be calm and remember to tell them you understand. Most of all, don’t make them feel bad about it – they already feel really bad.”

Krautter echoes this advice. She encourages parents to always confront the child about the behavior and not to minimize it or ignore it. However, “don’t freak out. Remember to be supportive,” she says. “Tell them what you’re noticing and ask them if they would talk to someone (a counselor), so that you can figure this out together.”

Krautter also says it is important to remember that this behavior is a choice and that teenagers have the ability to change what they are doing.

As for Brandon: He is doing well since he changed to a school that offers a well-rounded program that focuses on more than academic excellence. His advice to parents seems much wiser than his 13 years: “If your kid cuts, it’s a signal for help. I couldn’t explain to anyone how I felt inside. Remember that a cutter is always trying to tell you something about how he is feeling.”



RESOURCES

Web sites

S.A.F.E. (Self Abuse Finally Ends)  www.Selfinjury.com

Secret Shame (Comprehensive Web site) – www.crystal.palace.net/~llama/selfinjury

List of movies, music, etc. that mention self-injury –
www.anthology.self-injury.net  

Books

The Scarred Soul: Understanding and Ending Self-inflicted Violence, by T. Alderman (Oakland, CA: New Harbinger, 1997).

Bodily Harm: The Breakthrough Treatment Program for Self-injurers, by K. Conterio and W. Lader (New York: Hyperion, 1998).

Coping with Self-mutilation: A Helping Book for Teens Who Hurt Themselves, by A. Clarke (Center City, MN: Hazelden, 1999).

Living on the Razor’s Edge: Solution-oriented Brief Family Therapy with Self-harming Adolescents, by Matthew Selekman (New York: Norton 2002).

Monika Downey is a San Jose-based freelance writer and former teacher.

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