When thirteen-year-old Mia came out of the bathroom in her father’s new house, she was shocked to see a guy from her school.

“Hey, what are you doing here?” he said.

Mia was trembling—this boy had bullied her at school. She discovered that he was the son of her father’s new girlfriend. The girlfriend had just moved into in their home following the divorce of Mia’s parents, and so had her son. Mia’s father didn’t seem to understand her concern, but when Mia talked to her mother, she said her daughter could live with her and her new husband, Luis. But Luis was having none of it. He refused to let Mia move in.

So the young teen found herself living in an environment that felt unsafe. Because of that, she felt only hatred toward her stepfather. To deal with this emotional turmoil, Mia started cutting herself. Eventually, Mia ended up talking to a therapist.

“I cut myself so I can show my mom how much I hate my stepfather and how much he’s hurt me,” she told the counselor. “It makes me feel better when I cut, because it’s like the pain he’s left inside of me leaves my body when I bleed.”

***

Self-injury has been practiced throughout history, dating all the way back to ancient Greece. Today, however, teens can take a video as they injure themselves and share it on the internet with anyone who wants to watch it. Teens who do this have an audience, sympathy, and an immediate response. In fact, an entire subculture of cutting flourishes on the internet, with websites dedicated to providing guidance on how to cut “safely” and how not to get caught. Social media has a steady stream of posts that tout its attractiveness, benefits, and relief.

Self-injury isn’t a fringe phenomenon, unfortunately. About two million cases of cutting are reported each year (with many more cases unreported). Roughly one in five females and one in seven males injure themselves. When asked, most high-school and middle-school students will tell you they know someone who’s cutting.

It can be addictive—there’s growing evidence that opioids are released into the nervous system in response to self-injury. These opioids can also serve as a pain reducer when a teen self-injures.

What Is Self-Injury, Really?

Self-injury can be done in a number of different ways. The more common methods are

• cutting: intentionally cutting your skin on the arms, legs, wrists, genitalia, and other parts of your body using razors, knives, sharp glass, or other objects;
• rubbing your skin harshly with erasers or other objects to burn your skin;
• scratching or scraping your skin;
• picking at your existing wounds or scabs;
• hitting your head against a wall or other hard objects;
• burning yourself with matches or cigarettes.

Often the wounds are shallow, but sometimes teens can cut deep and create serious damage.

If your teen is engaged in self-injury he’s typically not trying to commit suicide, yet the physical harm that results can be serious. Wounds can become infected, deep cuts may require stitches, and self-inflicted blows to the head may cause concussions. The wounds he self-inflicts may even be life-threatening.

Why Do Teens Hurt Themselves?

Self-injury involves intentionally injuring yourself for one of three main reasons:

1. To relieve emotional pain. A teen may be cutting to cope with feelings of emotional pain. As weird as it sounds, self-injury has a feelgood element to it because of the release of opioids and endorphins. Physical pain serves to override the emotional pain the teen is experiencing, at least for a while. And watching cuts physically heal can also symbolize the healing of emotional wounds. If teens are living with emotional numbness from past traumas, the pain of cutting is a reminder that they’re still alive. It’s an “I hurt, therefore I am” perception. The bottom line is that teens who cut are in pain and want relief and escape.
2. To deal with deep-seated hatred. Teens may harbor hatred for who they think they are, or because of something they’ve done or that’s been done to them. It may be because they feel it’s safer to aim their anger or rage toward themselves than toward the person with whom they’re truly angry. Whatever the reason behind their anger, they’re looking for relief.
3. Because of curiosity or to copycat. Maybe a teen has seen someone else do it on social media, in a movie, on television, at school, or while spending some time with a friend and was curious about how it might feel.Boys may be injuring themselves as a sign of toughness.

There are many different reasons why teens hurt themselves. The common thread is that self-harming teens are experiencing some kind of emotional distress. They want relief, and self-harm provides that relief. Of course, the emotional relief obtained by self-harming is short-lived and is usually followed by feelings of guilt and shame. Whether you can understand it all or not, at least get this: it’s all about dealing with unbearable hurt, anger, frustration, and feelings of isolation and self-hatred. If your teen is cutting or harming herself, she is hurting—badly. Her actions speak much louder than her words.

How to Help

As a parent, you can help your child by teaching him or her how to better communicate and manage stress.

Cutting is an indicator of communication problems too. If teens are cutting, they are unable to verbalize and appropriately deal with their emotions, so they adopt an unhealthy means to express them. Talk with your child on a regular basis. Let your teen know you care about what he’s going through and that you’re available to talk about what he’s feeling. Help him find words to express what’s going on inside. Don’t assume he can do that effectively. Try to find an activity that just you and your teen can share, to give you a special bond.

Your child may also need your help learning how to deal with stress. Keep an eye on your child’s stress levels. What are things that put pressure on your child? Is her stress at a manageable level? If not, what can you suggest she do to reduce stress? Teach her about self-care.

You can also give your teen healthy ways to deal with stress. Get specific and practice the options. Maybe exercise or an enjoyable hobby will help. Have him make a menu of things he can do to cope with stress. It may take some time to develop a menu of stress-coping activities and ideas.

Be Alert

You can’t be lulled into complacency thinking that because your teen isn’t acting out that she’s fine. Be aware of signs that she could be cutting. Look for

• scars on arm or legs (girls often cut on the stomach and breasts as well),
• excusing wounds as a result of frequent accidents,
• keeping sharp objects (razors, utility knives) on hand,
• bloodstained towels, washcloths, and sheets,
• wearing long sleeves or long pants, even when the weather is hot,
• difficulties with relationships,
• isolation for long periods of time,
• making statements reflecting self-hatred or worthlessness (“I’m so stupid,” “I wish I’d never been born”).

If you notice any of these signs in your child, start a conversation. You could say something such as, “I’ve noticed some scars on your arms lately. If those scars could talk what would they say?” Don’t downplay it as a phase or a simple cry for help. While those who cut typically don’t do it as a way of attempting suicide, research suggests that 70 percent of kids who engage in self-harm will make at least one suicide attempt; 55 percent will make multiple attempts.¹

Remember, the underlying issues of cutting are deep emotional pain and the inability to effectively communicate and manage emotional pain and deal with it in a healthy way.

Take Action

Cutting is a serious problem. If your teen is cutting, seek help immediately from a licensed mental health professional with experience in this area. Some forms of counseling will attempt to equip your teen with coping skills, as well as the means to articulate and communicate his feelings and tolerate stress better. Therapy may focus on those things even before the actual cutting is addressed. The idea is that if teens stop cutting but can’t deal with emotional pain in a healthy way, they’ll return to self-harming activities.