Cutting to Cope

Editor's Note: Several years ago Walt Mueller addressed the issue of cutting and self-injury in this publication. Since then, the practice has unfortunately become more mainstream and has reached fad status in some areas. As a result, Ken Mueller recently spoke with a number of kids who cut to find out more and to discover how we should respond.

"Reba," a 17-year-old, has a hard time controlling her emotions. She often takes some good-natured joking from her siblings, but she doesn't like it. At the age of 15 she was sexually harassed by a classmate in school for an entire year. As a result she began cutting herself, first with safety pins, then with razors, knives or pretty much anything sharp she could find. She's even been suicidal at times, over little things like forgetting her cell phone. Shocking? Yes. But perhaps the most disturbing thing about Reba's behavior is that she is a Christian, raised in what she calls a happy, loving, Christian home. Like most other destructive behaviors, cutting has moved into the church, and many Christian teens are getting involved. Those behaviors that we have so neatly bookmarked as "of the world" are finding their way into our homes at an alarming rate.

Cutting, also known as self-injury (SI) or self-mutilation (SM), can take on a variety of forms, from actual cutting of the skin with sharp objects to burning themselves, punching themselves or banging their heads against the wall. Cutting has been popping up more in movies, music and other areas of pop culture, and, as a result, it is reaching near epidemic proportions. So much so that "Jessica" tried it a few times but stopped because she felt everyone was doing it: "I saw that it was becoming more of a fad than a problem solver." Though growing up in a solid Christian home, she has struggled with matters of faith, was suicidal for a time and is on medication for depression.

Since cutting is generally done in private, no one really knows how widespread it is, however experts say upward of three million Americans hurt themselves on a regular basis. The majority, but not all, are female teens. Cutting generally begins on a small level. Reba began with safety pins, while Katie began with hot candle wax and dull knives. "Jamie," now 18, started last year with scratching. But like drugs, SI is an addiction. Those who cut generally need to increase the destructive behavior over time, cutting deeper and more often with sharper implements in order to get the desired effect. Reba says that as time went on the cuts went deeper: "I needed more pain. I needed more blood. The cuts that once brought me relief no longer could. It became an addiction, and I just needed to cut … to handle everyday life."

The desired effect for most cutters is simply to feel something, anything. They cut for a variety of reasons, but the desired end result is that it somehow relaxes them and helps them to feel better. Many say they are unable to feel emotional pain in their life and are incapable of crying. By hurting themselves, they are forcing themselves to feel pain. It is a catharsis, allowing themselves to release the pain that is bottled up inside. And doctors say that cutting releases endorphins that actually make the cutter feel good. Loni, a 16-year old, says, "I never talked to anyone or let anyone see my feelings." Like many who cut, she is shy and believes she has no friends. Cutters often don't feel loved by friends or family, and may even have poor body image and suffer from eating disorders. And even those who are well-liked feel like outsiders. For Katie cutting was a way to deal with the emotional abuse she suffered at the hands of her mother: "the scars that she caused were on the inside of me … when I began cutting, those scars she created in me came to the surface."

But again, these are generalizations that don't apply to every cutter. Many of these kids are attractive teens who "seem" to have it all together in terms of activities, academics, appearance and athletics—even stable families. Jamie is a self-described perfectionist who would cut when she expected too much from herself. She is in gifted programs at school, but suffers from anxiety and depression. In fact many have been diagnosed with depression. And for most, cutting is as far as it goes, though there are some who have expressed suicidal feelings. Reba and Jamie both say they have had suicidal feelings but don't think they could go through with it, while Loni has tried to drown and suffocate herself, and even threw herself down the stairs once in an attempt to die. Other negative behaviors also often go hand-in-hand with SI. Many of the teens say they have had eating disorders and Teen Vogue magazine even referred to cutting as the "new anorexia." The two are very closely related in terms of causes, especially in terms of body image and family relationships.

The thing most cutters will tell you, however, is that it works. When the pressures (or perceived pressures) of life get too difficult, self-injury helps them to release the pain. Katie says, "the pain in my life would momentarily go away. It was temporary relief to the insanity of my life. Where there is no stability, the cutting will always be there. You know it is going to help. You can rely on it." Which brings up the issue of permanence. Today's teens live in an ever-changing world where family, friends, home and, yes, even church life, are seen as undependable. For kids who are unsure who will be there for them, cutting—and the scars it leaves—offers something tangible and permanent they can hold on to. Loni looks at her scars and sees "a trial I went through and made it through. So if I got this far I might as well keep living and get farther." So while the cutting makes her angry, the permanent scars are like signposts on her journey through life.

Naturally, SI is something most kids try to hide. It is often done on the feet, or other easily hidden areas such as thighs, stomach, breasts, shoulders or upper arms. One clue that a teen might be cutting is the clothes they wear. During the summer they will avoid shorts or bathing suits, opting instead for long pants and long sleeve shirts. There are also other signs. The teens I spoke with say adults should look for drastic changes in mood and emotions, as well as changes in the style of clothing they wear or music they listen to. Some also draw pictures on their bodies, either as an extension or substitute for cutting. Some hide the cuts with wristbands or by wearing large or many bracelets.

With so many teens—including those from Christian homes—getting involved in self-injurious behavior, how are we to respond? As parents, youth workers and educators, we need to be aware of the situation so we can respond in a sound and biblical way.

First, we need to respond in love. All of the kids I spoke with said it was important for the adults in their lives not to "freak out" on them. As Christians we need to extend the unconditional grace and love of Christ to these kids, letting them know they are accepted. Kids who cut already feel unloved, unaccepted and unwanted. More than anything they need to know they are valued. Parents should remain calm, and build a trust with the kids so they know they have someone to go to in hard times.

Second, make yourself available. Katie says to take the issue seriously, but don't overwhelm your kids. Reba says communication is the key, but parents shouldn't try to sneak a peek at the cuts or be too invasive of their privacy.

Third, don't confuse the symptom with the real problem. Cutting is not the problem. It is merely the visible outworking of much deeper issues. Kids cut for a reason, and we need to find out what that reason is. Hiding the knives or removing sharp objects from the house is not only impractical and next to impossible, but it doesn't work. Kids will always find a way to cut, whether it is with their fingernails, staples, straws or other common household items.

Fourth, seek professional help. The issues that cause kids to hurt themselves run deep. Most cutters suffer from depression or similar disorders, and there are those who are trained to help them. Counseling and medication might be a part of the answer. Unfortunately the church often stigmatizes those who seek professional help, but we need to get past that and realize that sometimes such help is needed.

Fifth, take a look in the mirror. Are we a part of the problem? Do we place unrealistic demands or expectations on our kids? Have we passed on to them a variety of unhealthy attitudes? We need to reassess our relationships and discover whether the lines of communication have broken down. This may mean being vulnerable to our kids and admitting where we have failed. We may even need to join them in seeking professional help.

Sixth, cutting presents a real dilemma for youth workers. Those who find out that some of their teens are hurting themselves need to take action, but at the same time need to be very careful. Conventional wisdom is that youth workers should somehow alert the parents to the problem so as to avoid potential legal problems. But this needs to be done very carefully. Most of the teens I spoke with said the youth worker must approach the kid first and convince them to tell their parents themselves. If, over a period of time, the teen refuses, the youth worker may need to inform the parents of the behavior. Each situation needs to be assessed on its own merits, taking into consideration the temperament of the parents and how they are likely to react. There is the very real possibility that informing the parents could create more severe problems, as some cutters are suicidal, and many come from abusive homes.

Seventh, we need to help them find alternatives to cutting. While some stop cold turkey, others need to be weaned off a behavior they feel works for them. Some suggest working down to lesser injurious behaviors like snapping the wrist with a rubber band. However most of the teens told me it is best to find some sort of creative outlet such as writing, music or art. Loni draws on her arms to make it look like cutting. Reba mixes red food coloring with water and pours it over her arms as if it were blood. Remember, the ultimate goal is not just to stop the SI, but to get to the deeper issues that cause the cutting.

Eighth, pray with your kids regularly, letting them know that both you and God accept them unconditionally. They have value by virtue of being created in God's image. He doesn't reject them for their behavior. In fact, these are the kind of people Christ sought out, and we need to duplicate this model of ministry.

Finally, for those of us who are untouched by this issue, keep the lines of communication open with your teens. This goes a long way in preventing many of the issues that manifest themselves in cutting. And we need to pray for our kids regularly that they would seek God in all that they do. If you or someone you know is dealing with this issue, or you just want to learn more, we would invite you to check out the resources on this page. In addition, we have a discussion forum on our Web site (www.cpyu.org/forum) dedicated to the issue of cutting.

Books:

• Bodily Harm by Karen Conterio and Wendy Lader
• A Bright Red Scream by Marilee Strong
• Cutting: Understanding and Overcoming Self-Mutilation by Steven Levenkron
• Bodies under Siege by Armando R. Favazza

Web sites:

• Crimson Ashes (www.crimsonashes.com)
• Teen Hopeline (www.teenhopeline.com)
• Lysamena Project on Self-Injury (www.self-injury.org)
• Christian Counseling & Educational Foundation (www.ccef.org)
• American Association of Christian Counselors (www.aacc.net)

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For more information on resources to help you understand today's rapidly changing youth culture, contact the Center for Parent/Youth Understanding.

©2004, The Center for Parent/Youth Understanding