Self Mutiliation

Explain "Doctor Patient Confidentiality" to her. NO ONE will know she's in therapy unless she chooses to tell them, ditto NO ONE will know what happens in therapy unless she chooses to tell them.

Cutters cut. It feels fantastic. As good as sex. Emotional pain gets washed away in an endorphin response to physical pain, and then it's just endorphins and release. And it's addicting as all get out. A cutter "promising never to do it again" is like an alcoholic promising never to drink again, or an addict never to use again. MILLIONS of addicts and alcoholics quit using and drinking... but the vast majority need a LOT of help in learning new coping mechanisms.

Unlike alcohol or drugs, substituting physical pain for mental and emotional pain is a lot more difficult. It's more like an eating disorder. Addicts and alcoholics can "just" not pick up... but a person with an eating disorder can't quit food. The same thing is true with cutters. A cutter may well instead take up rock climbing or another high adrenaline sport... where when they're upset they can hurt themselves in a "socially acceptable" kind of way. Or they may turn to drugs, or sex, or anything else that whitewashes emotional pain. She's figured out a "trick" to short circut her body's natural responses to emotional pain. Without therapy, even if she quits cutting, I'll lay $50 on the table she'll keep finding the other tricks to flood her system with endorphins instead of dealing with the problem at hand.

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Talking to your pediatrician might help, but I might also contact your local boys & girls club or any program working with youth...they will probably have many different resources in addition to truly 'knowing' who has success in working with youth going through difficult times.

I have extensive history working with high risk youth and while the cutting is super scary, the cutting rarely is dangerous. Most of the youth I knew who cut used it as a coping tool because the sensation from the cutting made them feel emotionally better. In a way, it is her solution right now because she doesn't have any other tools that work as well...right now. You might try to express to her that she isn't crazy for cutting, many people who don't know how to handle extreme emotions turn to cutting and seeing a therapist typically helps them find other coping skills that are not only safer but work even better (infected skin can get out of control quite rapidly in some cases, which impacts the image-conscious youth even more!). It might even work to help her recognize that if she doesn't seek help in figuring out other ways of coping, she will feel crazy anyways because typically cutters keep their secret pretty well, which manifests into an even stronger belief that there is something 'wrong' with them...the cycle of shame and blame over cutting eventually feeds itself until the cutting happens to deal with the fact that the cutting is happening in the first place.

I guess what I mostly want to convey here is that you should maybe take a deep breath and try with all your might not to view her cutting as the scariest thing ever because what you think about her matters more than you will ever imagine...and if she see's you are scared of her behavior, she will probably assume you are scared of her and think it's because she's crazy or is a bad person on some level. And in order to make YOU feel better, she'll conceal her suffering and it might manifest into something much larger and scarier than cutting.

Let her know you love her and care about her and that when she's hurting, you want her to feel safe, but you also want her to feel confident and smart and beautiful and capable because you believe she is all of those wonderful things. Let her know that she is not alone and things will work out if she wants them to and asks for help. Her well-being is what matters more than anything else. There is nothing wrong with not knowing what to do, but there is something wrong with not trying to find solutions to painful challenges...let her know you believe in her and will have her back no matter how long it takes.

All of the above sentiments have been said to me by youth in similar and worse positions over the years. They want to trust their parents and they want their parents to trust them. If they think their parents don't trust them, then they don't trust their parents...if that makes sense? Provide a caring and supportive relationship and let your daughter know that while she might be afraid to see a therapist, you are her mother and love her and want to protect her, even protect her from herself. Let her know she will have a say in who she decides to stay with as far as therapists go, you will trust her judgment on this, but that the decision about seeing a therapist in general needs to be made by you at this time. This way she knows she has some control (important for her to feel safe with herself...not feeling in control leads to more cutting). If she can trust you with this, you will return trust in her judgment as time goes on about whether therapy is working or if a different therapist should be tried. Make sure she's an active participant in deciding if the therapist is working out so she has buy-in and feels like she is actually doing something, besides cutting, to help herself. Will help her confidence...and this is what you want, things that boost her confidence legitimately (complementing teens for silly things, like breathing or putting a dirty dish in the sink sets the bar low, they see right through it, and it makes them feel less competent).

I'm sorry if any of this sounds confusing...feel free to e-mail me if you have any questions or need me to clarify anything. I just felt the need to share what I know so you can start to calm down a bit, be present for your daughter instead of distracted by your fears, and so you can realize there is hope here and maybe, when all is said and done, the cutting being discovered leads to resolution of the deeper things going on that she's successfully hidden from you until this point. We don't want our kids to hide such things from us even if it's really scary to see them.

OK...sorry for long response...I'm done:)

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oh I'm so sorry. I would say that she needs to talk to someone, but be very careful who you get to talk with her. Sometimes therapists come across as very judgmental about cutting. She needs someone who is very gentle and will get her confidence because self-mutilation isn't really about self-esteem. It goes deeper. And if she felt it helped her feel better, she may think she won't do it again, but she will. Also, has she done it before and it's hidden under her clothes?

Let me explain -- I used to self-mutilate -- and I couldn't stop well into adulthood. This is not an act of hurting yourself, this is an act of self-preservation. Your daughter expressed it very well -- something bad was happening and she thought it would help. In other words, she was so overwhelmed with awful feelings that the only way she could get out of it was hurting herself. The pain and blood shake you out of the psychological pain you are experiencing so that you can deal with the physical pain. That was my experience. That means you are in some real psychological pain and your instinctual response is to save your entire self by hurting yourself a little bit.

She is not crazy. She is not bad. She does not think that she is worthless. Just the opposite. She is sane, courageous, and feels she is worth so much that she will hurt herself to save herself. But, she is in serious trouble and she needs to deal with the source of that trouble -- and so will you. The reason she is in this situation is because she doesn't want to talk about the real problem and she is in conflict. She doesn't want to go to a therapist because she doesn't want the issue to come out -- she probably knows very well what it is -- and not necessarily because people will think she's crazy. She'll try to run from any situation with a therapist unless she is fully confident that what she has to say will be safely handled. You have to find that safe place for her -- and fast.

PS -- what sounded like a minor issue to you is probably just the straw that broke the camel's back so to speak. She has a deeper issue, but this one made it all too much to bear and triggered the behavior.

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Don't just drop it. She needs to at least be assessed by a mental health professional who is familiar with cutting. I would try talking with her at some time she is calm and explain therapy is not about being "crazy" but about learning how to cope with your feelings in a healthier way. I worked with a teenage girl who was cutting and had the same worry (that I thought she was crazy) so she is not alone. If she still doesn't want to do it ask her to think about and bring it up again. Eventually it could turn into nagging but that seems better then pushing her into a confrontation and having her refuse completely. You can always go to counseling yourself if she won't go. You would be setting a good example and hopefully getting some professional advice on how to handle the situation--even if you only go a few times.

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I'm glad you're taking this seriously. Since it's a series of cuts, she must have been working at it for awhile before she got sufficient relief from the difficult feelings she was having.

Don't dismiss her issue as minor. Take pains to let your daughter know you want her to bring her problems to you, and that you care about her experience. She won't do that if she doesn't trust you. Everything is big to a 13yo, and will be for the next several years.

I'd give her a chance to communicate with you further on this. Can you make some "dates" with her, lunch or shopping or manicures, or working on a special project together that gives you time to talk? If she's resistant to opening up to you, then I would consider counseling. A ped would be a one good place to start. I wish you both well.

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Hi K. :-)

Sometimes kids cut themselves in order TO FEEL... they feel so isolated and numb to the pain that they actually want to have a sense of being alive.. this is extremely serious and not something that was a one time "habit" that your daughter is sorry for and won't do again... this needs further investigation and help... it has NOTHING to do with being crazy, so please let your daughter know this.. it has to do with PAIN and how to help her deal with it, and life that goes along with this pain, sometimes.

Please seek assistance ... asking your pediatrician can be a good start, also phoning your local mental health hospital to ask for a referral. In my experience, there isn't something such as "watching her more closely".. unless you plan on being with her 24/7... then nothing is close enough, please get her help asap.

hugs,
A. R.N., Energy Medicine Practitioner

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Cutting is really serious and even if your daughter only did it once, there is a chance it could happen again. I have talked to my girls and my son about it, as well as the choking game and other things I have heard about. They were a bit shocked that kids would feel so bad that they would want to hurt themselves. Demi Lovato recently signed in for therapy and I used her as an example since they know who she is and my girls like her. It is not crazy to look for help. And it can be nice to be able to talk to someone outside family and friends.

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Please get her help. It is very rare that they can quit this behavior on their own. My little sister went on to pulling her hair out :(

What she is trying to tell you is that she cant cope. She does not know how to deal with stress. She needs to see a counselor and they can tell her how to deal with this issue. Without harming herself.

You are both in my thoughts and prayers. ((hugs))

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To answer another question with the same answer: if you have health insurance, check to see if they have a behavorial services group. You can talk to them first and they'll run down a list of questions to assess where she might be and how to do it. If you don't have this option, then reach out to the local hotlines.

And be watchful for other poor coping skills or decision making habits. Could be a redflag.

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Absolutely she should talk to a therapist.
You don't need to take her to the pediatrician to get a referral.
Just call the pediatrician's office.
The therapist will NOT think she's crazy. And neither should you.
This kind of cutting is done by (I don't know how many) young teens.
Later, after you have read more answers, and perhaps have done some research yourself, you might have some understanding about this so I'm not going to try to explain it here.
In any event, see if you can get her to a therapist
who is accustomed to dealing with teens with this kind of behavior.
And, if she'll let you, reassure her that you know she isn't crazy.
And that there are better ways to reduce stress and anxiety.
And you're going to help her learn these ways.
Congratulations on being a mom she can talk to safely.

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People cut to feel that they have control over a situation. I beat my head into a wall. It's strange, but sometimes I just get so mad, that I have to find a way to release it. It doesn't happen very often, but I can see why people would cut. It would probably help your kid to talk to someone, but it would probably be best if it wasnt a school counselor, she obviously is embarrased about it and doesnt want anyone to know.

Of course, the fact that you saw it at all shows she wants help, even unconsciously. There are plenty of places to cut that no one would see if you really wanted to hide it.

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Something like this should be not left alone. Don't think that you can push her into therapy but I would give her tons of reassurance and love now and try not to put your fears above her needs (something that I'm sure that would be VERY easy to do in this situation). I would respect her privacy and not do or go behind her back and tell someone about her problem. Your trust is very needed right now. Cutters sometimes stop when they get older but some thing is very wrong and she is unable to cope with her feelings.
I wouldn't trust her in her saying that she will never do it again. I think that this is her way of getting you to leave it alone. I'm sure she feels alot of shame in what she is doing and doesn't want people knowing about it.
I would do a TON of research on the subject before making any hasty emotional decision.
From one mom to another, I'm sorry that this is happening to your little girl and to you.
I hope and pray that she comes around and is willing to open up about her feelings.
C.

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I would have her seen by a therapist and just explain to her that this does not make her "crazy", she needs help, that you love her too much to see her harm herself and treat herself this way and people need to get that kind of help all the time. You want to do everything you can for her. And anything she discusses with a therapist is strictly confidential.

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Chances are she learned this from other kids in school. Some kids do it just for fun, or what they think is fun, some kids to it when they get real upset. I can say that when I was real young, like 2nd-3rd grade I would scratch my self when I got real upset. That was before I even knew anything about it at all, it was more like instinct.
I would say that if she is getting upset enough about school to do this, I would take her out and homeschool. It's not worth risking what could happen to have her in school.
I would make sure to be more involved in her life, this is the age where they starting looking more to their friends than parents. Their friends become a bigger influence in their life than parents. Obviously if she would do that rather than talk to you.
I would try theorpy, but NOT at school. And not make it all about her. Have it be about you guys getting closer, and just a little bit about what happened.
P.S. What is minor to us, is major in their world.

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You've gotten many people advising you to seek help for your daughter, and I agree wholeheartedly--I just wanted to add that I'm an example of what happens when parents don't do that. My parents (my mom especially) were very religious and did not trust psychiatry, and suffered from the usual misconceptions about mental illness (though, in their defense, this was back in the 70s). I was doing the same thing as your daughter, and it was the start of a long slide toward a very serious bout of depression that I suffered when I went away to college. That didn't get treated adequately either....in brief, I didn't get adequate medical help for my depression until I was in my mid-30s. By then I'd established a pattern that would last for decades--and may happen again, for all I know, though these days I do a pretty good job of managing it. The sooner these things are dealt with, the better. My suggestion is to couch it on terms of "let's help you figure out ways to deal better with stress" instead of "oh my God, you're cutting yourself." Your daughter has major stresses coming up in life; being 13 is just a rehearsal. She may not realize it, but she needs you. Hang in there....P.S. This is serious, but be not dismayed: it's not a sign that your daughter is on the road to the loony bin. I think she will emerge from this much stronger and saner.

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Get professional help today-do not wait-there is a problem and it is not going away on its own.

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You should get her some help. These are the warning signs of very dangerous and scary behavior. You need to stay calm and not over react but you do need to get her help. Find out what therapy is covered by your insurance and get her into to see a therapist. Either a LCP Licensed Clinical Psychologist, or LCSW Licensed Clinical Social Worker. They will help her work through her feelings. If this talk therapy doesn't solve the problem and the therapist thinks you daughter is depressed or has an axiety disorder they will then refer you to a doctor that could prescribe medication to help. You need to emphasize to your daughter that she is not crazy but that growing up is hard, and a lot of teenagers need a little extra help managing their feelings. It is also important that she doesn't feel alone or like she is broken. My parents did not act on the warning signs when I was a teen and things got a lot worse before they got any better. You have a chance to save your daughter from bigger problems by getting her help now.

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Well I know I'm in the minority here, but if this were my daughter, my first reaction would not be to rush her into " therapy" unless there was reason to believe this wasn't an isolated incident. You said she did it in response to a situation at school - has the situation been resolved, or is it an ongoing thing that is causing her constant anxiety? I'm not saying don't take this seriously - you should - but I think talking with her about other ways to deal with stress, and watching her closely for a period of time would be my first step. But you of course know your daughter best - if you think there is any reason to believe this will become a pattern instead of a one-time mistake, talk to your pediatrician for a referral.

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Yes, call the pediatrician. Truth is you just don't know if this was a one-time copycat or a thing she has been doing repeatedly. Think about the "courage" and calmness it took to sit with a razor and make those cuts. Scary. Don;t dismiss it. Even if she just did it once, clearly something is bothering her too much. But odds are it is more, this isusually related to and OCD like compulsion and could get worse. You will really hate your self if you don't check it our and it gets worse.. Having her speak with the pediatrician and a therapist won't make her do it more unless she was already good at it.

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I'm trying to put myself in your shoes. If it were me I would ask myself this question: If I don't do anything about this now (ie - therapist/counselor) and it happens again, or something worse happens...will I kick myself for not attacking the issue when it first presented itself.

I think your answer to that question will help you decide.

It may truly be a one time thing. I am a firm believer in therapy. Teenage years are so tough in general. As long as you find someone who specializes with teenagers and with self mutilation I don't see the harm in getting her to talk a bit. Even if it is just about love triangles and petty teenage stuff.

Good luck to you and your daughter

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Yes, I'd start with her pediatrician and ask for a refersl, however I'd probably speak with her doctor beforehand to give a heads up... Then tell your daughter that she needs to see the doctor to get a new DTap for tetanus (and she really should get a current shot since she's exposed herself to cuts from metal).

Good luck.

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Pay attention, because she may need to get some help. I never heard of doing this because it's "cool" - that just sounds stupid. My sister, who is 40, does this - not to freak you out - but it's because she's in emotional pain and has trouble dealing with her feelings. When she cuts herself, she can "feel" the pain on the outside that she's actually feeling on the inside. If you know that your daughter has difficulty dealing with emotional situations, strong emotions, get her the help.

She's also going through puberty which is a rollercoaster of emotions. Don't take this lightly. I kinda feel like we blow off puberty a bit re. how it impacts a kid, but if you think about it - it's like "reverse menopause", and we all know how much we're all dreading and/or not enjoying THAT transistion!

If she needs counseling, she'll need to get it regardless of what she thinks people will think. And you can get counseling after school hours and on weekends, so she doesn't have to do it when other kids would notice. Counseling would be more to help her understand WHY she's doing it and develop other ways to cope - so it's more like learning something.

Hope that helps, and best of luck!

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It doesn't matter if this was an isolated incident. Cutting herself is an abnormal way of dealing with whatever is bothering her and she needs to learn healthy ways of coping. These issues are not just going to go away on their own. We all have to deal with stress throughout life. She apparently needs help with this before it becomes worse.

Hello, I read all of the comments and they are correct, your daughter need to talk to someone and when she do let this be between you ahd her and if she want to let others know that she is seeking help, let her tell it. Now days being a teenager is a very hard job . Sit with your daughter just you and she spend time together and talk and maybe she will open up to you. I know that you might feel a little alone, but you arent. Eventhough we don't know you or your family, we all care. I can tell from the comments. Please take care of this and let us know the outcome. I will pray for you and your family. Don't wait because one day she might cut to deep/ stay strong and remember we are all here for you. Go In Peace

I would take her to see a therapist. Explain that going to a therapist does not mean that she is crazy and that it's just like going to a doctor when she's feeling sick. It's just another way of taking care of her heath. In other words, if you can de-stigmatize the idea of going to therapy, I think that would help. (And of course, it's completely private so no one has to know if she's still not comfortable with it.) It's so great that she told you the real story of what was going on with her, and it gives you a the chance to try to make sure it doesn't happen again. As others have mentioned, she needs to learn other coping skills that are more healthy. Once she has those tools, she can use them when she is feeling hurt or pain instead of resorting to cutting or other destructive measures. You can check with your insurance company to see what therapists are covered and then check them out online and/or call their offices for information.

FWIW, my niece did this once several years ago and never did it again. Keep watching her closely (without being intruding) and you may want to get "Hold on to your Kids" by Gordon Neufeld from the library. You can start with the 3rd section if you're in a hurry. He talks about how to get and keep a close connection with your kids. No matter what, this is always a good thing.

p.s., one of his teachings is that if kids don't have a close connection with their parents, they form it with their peers. I don't know about you, but I'd rather be the connection point - with my years of experience and love for my kids.

update: there's also Ross Campbell's "How to Really Love your Kids".
Please note I do not in any way think that you don't care for your daughter. In honesty, I think that you care a great deal. What I am wondering is if she mistakenly *feels* like that love is not as strong as it is. These are addressing her perception of things.

Hi K.,

Definitely DO NOT let this go. It is a very serious situation. I taught sixth grade for a number of years, and this problem has been a growing 'trend'. However, it is usually a sign of a much deeper issue.

I never used to understand why doing something physically painful to yourself could make you feel better. THEN, I faced a time where I dealt with depression. I never became a cutter, but I began to understand...the physical pain takes away from the mental pain. Physical pain is considered 'normal' and someone with mental pain is still looked at as being 'sick' or having something wrong with them. The stigma is slowly changing as more and more people need daily meds to balance their brain chemicals to feel 'normal'. However, for a teenager, it is far from being accepted.

I would most definitely take her to her doctor to get advice on what type of doc would be best. Tell her that no one needs to know, if she feels uncomfortable with others knowing or judging. She needs to understand that treating things like depression is like treating diabetes. Your body needs meds to work properly. Her brain chemicals MAY not be working properly, and that is why she is feeling how she is feeling.

She may not need medication at all and just someone to talk to, to work through her thoughts and feelings. She needs to know that there is NOTHING wrong with her!!! The cutting is simply a symptom of things in her body just regulating (through puberty changes), or just not quite working the way they should be working.

She needs to know you are there for her no matter what, and she may not always agree with your decisions, but she will eventually understand that everything you do is in her best interest.

Be strong, and please don't ignore this,
L.

I seek help of some kind - therapist, pediatrician, etc... This could be a one time thing or it could get out of control quickly and leave you regretting not having done anything more.

For some reason, in a few groups these days, cutting is "cool".Nonchalantly check her friends for cuts too,its def, worth the introspection.

I think the kids still call it "emo"

K. - I can HIGHLY recommend Christian Counseling Center in Annapolis. If your daughter is so desperate about a situation at school that she is cutting herself, she needs intervention at school and probably outside of school as well. This is not something to play around with!!!
J. -
mom of a 14 yo son who periodically has talked about suicide since age 8! Yes, we use CCC.

Not to freak everyone out, but when I was in middle school, for some reason a lot of girls would cut themselves. For them it seemed kind of like a trend. (?) It was really weird. Two of my closest friends did it because they didn't know how to cope with certain situations, no matter how small they were. It was really frustrating for me to try to be there for them, but they would constantly hurt themselves.
They "grew out" of it by highschool at least.

For your daughter, I would want to get her in for a mental health assessment at least. If she's afraid people will think she's crazy for going to therapy, just tell her she doesn't have to tell anyone about it. Also inform her that regular people, not only crazy people, go to counceling/therapy all the time, because quite honestly, life is hard. On everyone, not just teenagers.

I hope I was of some help. Good luck with this :)

Please don't ignore it, or let it go. In my opinion, this is a cry for help. and of course she feels crazy and that people will look at her funny. try to honor her need for privacy, but by all means, get her some help. a therapist now will save so much heartache later. confidentially get some referrals from your pediatrician regarding therapists. Then take her and drop her off. She has got to talk about whatever is really bothering her, and it sounds like she could really use a professional. She will do it again. Or something else. she won't mean to, but she will, and then she will feel guilty becuase she promised you she wouldn't. Let her know you will do everything to keep her therapy low key and no one else need to know. You could also call your local child and family services department and ask them for a list of name of teen therapists they recommend. Good luck, I'm sure you are scared, but you are doing the right thing!

If it makes you feel any better I do know a girl who did it a couple of times and then stopped.

But take everyone else's advice.

Go with your instincts on this! Talk to the pediatrician.