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The Informed Parent

Self-inflicted Injury

by Peter W. Welty, M.D., F.A.A.P.
Published on Sep. 22, 2003

You all are very familiar with the “terrible twos”. Reams of printed material have educated us all. But what of the “surly teens”? Are you, as the parent , prepared to take on this battle? We are aware of the prospective mood changes, defiance, and independent struggle that present in our young near-adult. What do we do if the teen goes one step further?

Let us assume that your daughter is going through all the “normal” teen antics. When was the last time you REALLY looked at her? Did you notice any markings on her arms, legs, or face? Is she cutting herself?

When parents see that their teenager, usually a young adolescent girl, has been self-cutting they begin to panic. Harmful behaviors such as self-cutting and self-burning may be present in as many as ten percent of teenagers according to a recent research study.

Self-cutting may also be a contagious activity, and first-time cutters often learn about the behavior from others who have done it before. It can sometimes be used to achieve status within a particular peer group.

Who are the kids who typically engage in this type of self-harm? According to studies a typical self-cutter is a sexually active teenage girl who may frequently smoke marijuana and might have a history of running away. She may be bulimic. The cutting tends to be associated with some type of an emotional crisis. Most of the girls who self-cut once do it again.

The self-cutter generally is not alarmed about her activities--in fact, she may like the way she looks and generally does not associate the behaviors as being destructive. The cuts tend to be shallow. One can observe multiple superficial cuts on the wrists, legs and forearms. Self-burning behaviors often follow a similar pattern.

The self-cutting activities generally are not suicide attempts. In fact, only 0.5 percent of self-cutters commit suicide. The cutting does, however, represent the adolescent girl’s cry for help. About 30 percent of teenage girls who self-cut will eventually develop a psychiatric illness or a personality disorder. Self-cutters need to be referred to mental health services immediately.

Girls who are referred to therapy services as early as possible generally will develop insight into their maladaptive behaviors. Through group and individual therapy, teenagers learn other, more appropriate ways of gaining control over the emotional crises which seem overwhelming to them.

Parents need to stay aware of their daughter’s behaviors and friends. They should have a good idea of their daughter’s coping skills. The parent needs to stay open, accessible, and available to provide support, should their daughter wish to share feelings regarding a particular emotional problem that is difficult for her to manage.

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