E-mail updates
Follow on Twitter
Subscribe to RSSBy Linda Carroll and Diane Mapes
The Tacoma, Wash., mom knew something was up with her 11-year-old daughter when the girl kept leaving school with stomach aches that disappeared as soon as she got home. But she didn't know how bad things had gotten until the school called one day two years ago to tell her the sixth grader was sobbing and threatening to hurt herself.
“I told the principal 'I'll be right there,” says Abby, a 34-year-old special education teacher from Tacoma, Wash., whose last name is being withheld to protect her daughter. "When I got there, they'd already called the paramedics. That's when she told me, 'Mom, I've been cutting myself.'”
Abby was shocked to learn her daughter had been using the family's steak knives to deliberately cut herself on half dozen occasions. But, as it turns out, her story isn’t as unusual as we'd like to think.
A sobering new study of 665 kids between the ages of 7 and 16, found that a full 9 percent of girls and almost 7 percent of boys surveyed have engaged in self-injurious behaviors such as cutting, banging their heads or hitting themselves.
In fact, researchers found that kids as young as 7 were harming themselves as a way of dealing with unbearable psychic pain. The study of kids in third, sixth and ninth grades found that 7.6 percent of 3rd graders and 12.7 percent of 9th graders surveyed engaged in what researchers called nonsuicidal self-injury.
"Most people think of kids in elementary school as happy-go-lucky,” says Benjamin Hankin, an associate professor of psychology at the University of Denver and the co-author of the study. “They don’t expect kids this young to be having these kinds of problems.”
And, says Hankin, there are signs that self-injurious behaviors may be on the rise among younger kids. While there aren’t hard statistics, “anecdotally, you talk to parents, teachers, and other professionals and they say that it’s definitely on the rise,” he adds.
Many experts believe that kids who turn to cutting and other forms of self-injury inherited a predisposition to anxiety, depression and other emotional issues. The cutting is a way of dealing with the emotional pain.
Hankin has other research that points to a mix of genetic and environmental factors.
“Our data would suggest that the majority of these kids are experiencing really significant environmental stress, such as peer bullying, peer exclusion, gossip, and relational aggression,” he says.
Abby says that after talking to her daughter, who was adopted, about her cutting behavior, she learned that the girl was being bullied at school.
"She hung out with another girl who wasn't the most popular and she and this girl got made fun of and bullied," she says. "Our daughter had talked to the principal and her teachers, done what she was taught to do, but it wasn't working. And we didn't know the whole story. She had an abusive background with her birth family and stuffing her feelings is second nature with her."
Dealing with the pain
For the new study, Hankin and his colleagues found that until ninth grade, boys were almost as likely as girls to injure themselves. But at ninth grade there was a dramatic shift with girls three times as likely as boys to start harming themselves as a way of coping with stress.
Experts interviewed by msnbc.com said they weren’t surprised by the findings.
Kids are feeling pain and they don’t know how to deal with it, says Dr. Jonathan Pletcher, clinical director for adolescent medicine at the Children’s Hospital of Pittsburgh at the University of Pittsburgh Medical Center.
"It’s a way of coping with stress and anxiety – of inner discordant feelings,” Pletcher goes on. “In a young teen it’s hard to find the words to describe how they’re feeling. They come at this through a process of experimentation. Then cutting becomes a ritual that they build their days around. It’s a way of dealing with all the stress and negative feelings that accumulate during the day.”
While, as the study shows, some kids start younger, cutting and other types of self- injury often begins in middle school, says Dr. Mark DeAntonio, a clinical professor and director of inpatient child and adolescent services at the Resnick Neuropsychiatric Hospital at the University of California, Los Angeles.
“It’s a very overwhelming time of their lives,” he explains. “And they develop this as a way of self-soothing. I know it’s a little hard for adults to get their heads around the idea that self-injury can be self-soothing, but I’ve talked to a lot of adolescents and what they say is that it distracts them from psychic pain. And the physical pain is a lot easier to cope with than the emotional pain. It centers them.”
The self-injury doesn’t have to be dramatic. Some kids will just use a nail file to scratch themselves on the ankle or abdomen, Pletcher says. “It’s a way of calming down the nerves,” he explains.
Because the physical pain can distract the nervous system, it can lead to calmer emotions, Pletcher says. And because of that, cutting can be a bridge to help kids deal with life until they get the help to develop better coping skills. Experts warn that parents should never just ignore this kind of behavior, hoping it will eventually go away on its own.
“The biggest mistake a parent can make is assuming they know why the kid is doing it and not challenging the adolescent to say why and what’s going on,” DeAntonio says.
Copy-cat cutting
Sometimes, though, the cutting may not be about a deeper meaning.
“In our American society there is a cultural fad quality to it,” DeAntonio says. “'If you’re not doing this then you’re not a real teenager.' Some feel they have to do it as a rite of passage.”
And sometimes, it’s a case of copy-cat, experts say.
“One kid may be doing it and their peers find out and then they may emulate it,” says Dr. Steve Pastyrnak, division chief of pediatric psychology at the Helen Devos Children’s Hospital in Grand Rapids, Mich. “In that case it’s probably a little bit of nature and nurture going on.”
That might at least partly explain cases where cutting seems to run in a family.
One San Antonio mom discovered two of her daughters were cutting themselves more than a decade ago, at ages 12 and 13.
"My older girl would cut herself on her wrists and then cover it up with bracelets and my younger girl would do her hip," says Patricia, a mother of six whose last name is being withheld to protect her daughters’ privacy. "Our older daughter was more outward with the signs. She was more rebellious and more testing of authority but our younger girl didn't show those signs until ninth grade. She was following our older daughter."
She says she finally saw the marks on her older daughter's wrists and confronted her about it, trying to find out why she was doing it. Once she discovered the 12-year-old was cutting herself as well, she became even more vigilant.
Both Patricia and Abby sought therapy for their daughters, who they say no longer cut themselves.
If parents suspect their child is cutting, they should have a conversation to try to find out exactly how dangerous the situation is and if the child needs help, says Hankin. If that's out of the question, however, he suggests parents try to get them to talk to someone else.
“What we would encourage you to do is to follow your gut,” he says. “And if you don’t want to have a conversation about this with your child, then let them have it with the pediatrician or a nurse or a school counselor. They can comfort the child with the fact that the conversation is confidential so the child is more likely to talk. A lot of kids worry that their parents are going to get mad.”
More from Vitals:
16 percent of teens have considered suicide, study finds
Food allergies more common in city kids
Leave a Comment:
As a psychiatric R.N. who works with adults, I feel it necessary to mention what the authors of the article apparently won't. I have worked with a number of young college women who have scars on their wrists when admitted to our facility. Invariably they have been subject to sexual abuse from the time they were children, often younger than 5. I learned that they would be very relieved if, on the initial Nursing physical assessment and history and interview, I said to them "how young were you when the sexual abuse started and are you free of it now?" They would look at me in astonishment & say "how did you know?" And I would point to their wrists, explaining that I had seen such scars all too often & they would say "I thought I was alone."
@padrighean, not everyone with self-harm problems have been sexually abused.
There are a variety of reasons for self harm. Most of these young kids have internalizing disorders. They have no way to express what is going on (various sources) and they discover that cutting helps.
Seeking help from a professional who can help them express what is going on and help them to develop other coping skills is the answer.
Eric Meyer, Ph.D., LPC, CAC III
When I was in grade school kids would rub an eraser against their arm vigerously which would create a burn and turn into a huge scab. This was to prove that they were tough. LOL Kids...
I have a doctorate in psychology and I can assure you that not everyone that self harms has been abused. As others have said, self-harm can be caused by a variety of things.
It's well known that suggestable people can sometimes be convinced by a trusted clinician that they have been abused when it never happened. Families have been broken up and people wrongly sent to prison over "recovered memories of abuse" that never happened. It goes without saying that suspected abuse must be taken seriously but jumping to conclusions is the worst move you can make. In my opinion it's irresponsible and dangerous to take self-harm as an infallible sign of abuse as you appear to do.
This article almost makes cutting seem like a disorder that you talk to your kid about, or perhaps mention it to their school counselor. Parents need to take action sooner, if possible, and take the child directly to a pediatrician for a referral to psychiatry/psychology. If your child/teen repeatedly complains of a stomach ache that seems to go away when they can stay home, he/she is already showing signs that need to be discussed with a physician.
If you or other biological family members have struggled with depression, anxiety, personality or eating disorders, the child may have inherited the genetic predisposition to respond to stress/anxiety in unhealthy ways. Kids may also turn to drugs, alcohol, sex, reckless driving, and defiant behavior when they cannot deal with stress/anxiety/depression.
Earlier treatment, which may include psychotherapy, medications, exercise/sports, group activities, and a change in the stressful environment may prevent cutting and suicidal behavior and give the kid better ways to cope with their mental pain.
If self-injurious behavior has already surfaced, then it is imperative that the parent seek professional medical care for the child right away - not waiting to see if it gets better after a chat. Sexual abuse is an extreme example; children can display these behaviors during a parent's divorce, or when being bullied, or in many other situations. Instruct children to report other kids who engage in these behaviors, just as they should be told to report a suicidal kid or one who abuses animals or bullies.
These situations are MORE SERIOUS than this article implies and need faster, professional attention.
I wholeheartedly agree with you! On everything! It's very serious and needs immediate attention. The typical cutter is hiding it from you so why would he readily agree to treatment if you "confront" him with your suspicions? First of all, "confront" is such a threatening word, and if you go in with that attitude, you've already lost. Your kid isn't going to talk to you if you 'confront' him. Secondly, since he's hiding it, he's not going to admit to wanting or needing any help. Of course he needs help. ASAP.
By the way, my theory about the gender gap in this disorder is .... older boys aren't less likely to be involved in it, as is the current thinking -- I believe boys are just a whole lot better at hiding it.
Dialectical Behavior Therapy is one of the best treatments because it teaches the person different, more appropriate coping skills for their stress and anxiety, and really helps them in all aspects of life. Everyone has stress in their lives but some people need extra help to figure out how to handle it.
Here's a link to a website about Dialectical Behavior Therapy... What is DBT?
You can't fix stupid.
For Mark Taft to say, YOU CAN'T FIX STUPID! You need to get a life! There is nothing stupid about a young child willing to due damage to his or herself in order to deal with their enviroment! I have 3 children and GOD knows they growed up not knowing that they need to do something as strong as this to cope in the world.
Thank you Mark for reminding us of that truth AND volunteering yourself as a true-life example.
Atta boy, Mark. Thanks for unwittingly offering up yet another example of the beauty of irony!
My entire left arm is all scarred up from cutting myself. I had tons of stitches too as sometimes I went insane. It came from horrible psychic pain like the article said. And I was in my thirties when I hurt myself.
I am a college educated woman with two bachelor's degrees. It has nothing to do with "stupid," it has everything to do with despair. After a lot of therapy with a GOOD therapist, I have been able to recover.
Get help and don't stop until you find a competent therapist. And if you're a parent, get ready to hear that you're probably a big part of the problem. But, if you love your child, face the truth or you may be looking for an undertaker.
I wish this article took a more serious approach to this, as others have said. I started cutting when I was almost 15, and by the time I started cutting, there was ALREADY serious issues going on. Like others have said, cutting is hardly the first sign.
Also, cutting isn't always a sign of abuse. While there are very strong correlations with sexual abuse and cutting, to assume anything about a patient is dangerous and unwise. Also, no one wants to be treated like some kind of statistic. I've had my fair share of therapists try to tell me that if I did/experienced A, then I must do/feel B, and frankly, all it did was piss me off and turn me off to therapy all together.
It took me until I was 25 to finally stop cutting (I'm almost 27 now), and there are days I still think about it.
@epo9, padrighean did not say everyone and she does make a excellent point. Unlike your useless comment.
But, padrghean says s/he would ask, "how young were you when the sexual abuse started and are you free of it now?" of any girl with scars on her arms. Therefore, s/he's assuming that cutting=sexual abuse.
Some might have sexual abuse in their past. Others may have physical or emotional abuse, neglect, peer relationship problems etc.
Often times there is more than one source, and more importantly its necessary to develop other coping skills.
Exactly Hambone. I have known 3 cutters. Two were young teenage girls, and, admittedly, I don't know if there was abuse or not. The other was a 26 year old man. He was experiencing a SEVERE emotional trauma and resorted to this behavior. Apart from this trauma in his life, he is a very centered, well-adjusted person. It was the strangest thing I have ever seen. He even joked afterward that he felt like an "adolescent emo kid." Whatever the case, it is not always about sexual abuse and it is not always who you might think.
I was six when I started biting my wrist as hard as I physically could in response to physical/emotional/psychological abuse. We were an upper-middle-class academic family and we looked just great on the outside, but behind closed doors, it was pretty grim. I had no place to put this agony; I could hardly retaliate against adults, so I bit the tar out of myself pretty regularly. This did not stop until I was 36 and got a tattoo on that wrist as a promise to myself that I would never allow abuse to make me hate myself enough to do that. I hated myself because I felt I was so worthless that I had deserved the abuse. I was also 6 when I first wanted to kill myself--or, at least, simply to die--because the world would be a better place if I was not here.
Thank you for sharing. Your story helps others to see how this behavior develops even in young children.
Obviously, trauma can be connected to self harming behavior.
Nanamouse, my family too. Wealthy upper class, professional, religious. We "looked" good, but boy were we broken. I don't feel I hated myself, but it was true that the physical pain temporarily distracted me from my broken heart.
My mother was extremely abusive physically and emotionally, and sadly, still is. For most of us with this much pain, without good professional help, it's really difficult to even survive. Please get help or help someone if you see them suffering.
Sharkto--from one to another--big hugs. I am good now; now I help. More hugs...
My heart goes out to any parent dealing with a cutter. My granddaughter was a cutter when she was 12. She would use anything that she could break the skin with. It got to a point where her parents would hide all the knives and razors in the house. She would use jagged pieces of plastic, metal paperclips. The scarriest this is the pain didn't seem to bother her.
They finally moved her to a new school and separated her from the group of friends that she was associated with. A lot of the girls in her former school were cutters. She is no longer a cutter but she has scars all over her body. So sad that children can become so depressed and desparate to resort to self mutilation.
My son has had issues with this, and our family, though not perfect, is definitely not abusive. Much of the literature about this disorder does a lot of finger-pointing at the parents, which doesn't help at all when the family is kind, loving and supportive. Sometimes high-achievers put a lot of pressure on themselves, and internalize their anxiety only to let it out through self-harm. It happens. We had not the slightest idea what was going on until one day he sent me an email asking for help, and I was completely shocked (and yet thankful beyond belief that he reached out). Admittedly, it's very difficult for me and my husband to understand *why*, but we do know that he needs help. The hands-down very best treatment we have seen is Dialectical Behavior Therapy aka DBT and I highly recommend it for anyone dealing with this very difficult and scary problem.
The study suggests that this problem manifests itself through a combination of environmental and genetic factors...really? What a revelation. Tell all the doctors, psychologists, and other learned professionals that conducted this study, "thank you," ever so much. I'd never have guessed that the reasons behind this behavior could be both genetic and environmental. I'm shocked that there are two schools of thought on human behavior. I thought all was cut and dry, imprinted, stamped, and forged when the egg co-joined with the sperm... I'm in shock!! Just think of all the possibilities and other information out there, now that we know this aspect of the human pysche and related behaviors. I can't wait to find out more. Come on, you can let it out of the bag now. What really came first, the chicken or the egg?
I think you can associate this behaviour to a very 'male' reaction when you get REALLY mad. I recall numerous times punching a wall when im p***ed off, and yeah, it does make you feel a bit better - calm down slightly. But why?
Was it becuase I let some anger out on the wall? pretending the wall was this persons face? ie this is something I wanted to do to them, but couldn't?
Or was it the pain I felt in my hand after doing it which calmed me down? the hormones released through the pain, made me feel better?
Can't anybody smell "FAD?" Look up EMO, or scene, goth and other types kids choose to emulate. It isn't just jocks and nerds.
First of all, I'm not "emo" and I really don't classify myself into any "scene". But you are just feeding the NEGATIVE, UNTRUE stereotype that "all emos are cutters". NOT TRUE. EVERYONE inevitably jumps to that conclusion about emos, don't they?
You need to learn that NOT ALL of the kids in a certain scene act the same, and STOP generalizing.
I am 56; this started 50 years ago and went on for 30. Hardly a 'fad.'
I've been around plenty of scene and emos in my life. I only ever met ONE person who did it for attention/ just because. The ones who didn't do it for "fashion" did it because they actually had very trying times in their lives. And for your information, not every emo or scene person cuts. That's just a stereotype.
God Almighty. This is horrible. I pick the skin around my cuticles like there is no tomorrow. I think it is the same type of thing. Ouch!. Awful
One of my grandsons started pricking himself with small sticks and thorns when he was three years old. His father was verbally abusive when he was around, and often would not show up when he made promises to takek him places.
That later escalated into self-tattooing. I have seen a lot of tattooing on teens, both male and female, who have troubled home lives.
That is just awful. I am sorry
This is a symptom of a much bigger problem in society. Violence is becoming more prevalent as a reaction to our crumbling society. In urban and inner cities, gang violence, vandalism, and other outward violence is rampant. Meanwhile, in suburban areas, teens and young adults engage in self-harm and suicidal behavior. This is not exclusive, but statistically the numbers don't lie.
But instead addressing the bigger problems in society people keep playing the blame game and pretending it doesn't exist. Until we admit our society is a house of cards, these symptoms of decline will keep getting worse. We need to give the kids, teens, and young adults something more to believe in than materialism, rhetoric, political and religious wars.
Really, look at the bleak future in store for most teens. They know that after high school they can't get anywhere without college which many cannot afford because their parents have been hit by the economy. So once they take on massive debt to finish college, there's no guaranty they will even get a decent wage for their work. They see all the money being sucked up by a chosen few and may never be able to afford to buy a home for a family because once they take on their school debts they can't even dream of getting a house loan. All they see is everything costing more money and not being able to get anywhere unless you sell yourself out to get it. And then to top it off they see the so called "adults" acting like children and arguing endlessly over petty political issues and religious ideals, as if some lying politician or the clergy is going to fix it. No wonder you have so many teens dropping out of the race before it even starts by turning to self-harm, violence, drugs, and crime. Wake up, our young people are crying out.
I am in the financial situation you are describing, but I refuse to succumb to depression. I dont have student loan debt because I am smart enough to know to not buy something until I can afford it out of pocket.
I sympathize with your situation. I hope you can keep strong. But this is about a lot more than money. Its a psychic problem as you stated in your other comment. From a young age kids are seeing their parents working themselves into the ground and getting no where but further into a hole of pressures and worry. Then they are told that the need to believe in this "ideal" that they can see will lead to the same meaningless treadmill. There is more to life than living for the weekends and still having no time for the things that bring true joy.
@Morlack
I think Shanad was touching on something much more than just financial troubles.
@Shanad
I think you're on the right track with your post. There's a philosophical problem with our society. We've reached a point that many of us no longer gain satisfaction from what we do for a living. We go through the motions but find little of value in our careers, relationships, and means of entertainment. It's all been done and there isn't much left but materialism - a very short-term way of coping with the world around us. What can I watch on TV, what new model phone is available, how high/drunk can I get, and so on in order to sufficiently distract myself from reality?
I don't think any amount psychotherapy or medications can fix something like this. There is real pain being experienced by people who haven't suffered abuse at all. This is a sign of a larger issue. Nihilism has taken root - that "meaningless treadmill" that you describe is a perfect analogy. Prior generations would cling to religion/faith in attempts to combat this, but we are progressing to the extent that it is no longer effective. The abandonment of social and value frameworks provided by ancient mythologies has mixed results. On one hand, we are better off in that we have begun to shed the psychological enslavement that has plagued us since the dawn of man. On the other, we have no meaningful replacement to structure our lives around. And when rampant materialism fails to satisfy us, we're left with individuals who cannot cope with the daily stresses of life. There is simply nothing to look forward to. Self-harm and even suicide will take place under such circumstances.
Travel the world, view a sunset over the ocean, climb a mountain, skydive.. one can do all of these things and still feel empty. This is the problem we are facing and will continue to deal with as time goes on.
In fact, researchers found that kids as young as 7 were harming themselves as a way of dealing with unbearable psychic pain. I know of mental, emotional, and physical pain, but I have no idea what psychic pain is. At different times throughout my life, when circumstance have become horrible, I have become horribly depressed, but I never crossed the line to harming myself. Whenever my circumstances improved my depression would quickly evaporate, so I believe my depression is solely based upon circumstances rather than a chemical imbalance. I suspect that is true for most people.
Cutting is not new - it's a VERY old practice and over the centuries has travelled through many cultures. Many, many people have practiced self mutilation.
What is the common thread? Psychologists want to diagnose it as a disorder - no so - the common thread is association with the occult. What are those kids watching, playing and reading? Its mainstream these days, that why so many are practicing it.
Get rid of it, don't watch it, play it and the "disorder" will stop.
The occult? Stop huffing the paint thinner!
Think, you are just wrong. This isn't about the occult.
ThinkVoice-
Cutting is not a disorder. It's the motivation behind the cutting that could be a disorder. That is a judgement to made by experienced clinicians, of which you are obviously not.
As someone who runs a children's clinic I can say that the biggest area of neglect is that of a comprehensive history upon intake with these kids. The reasons for non-suicidal self injury are many. OCD for example is one that few take into account. I have seen a girl with 3 marks from scratching her left wrist only to look and find 3 on the right. Some have been abused, some have mood disorders, some other traumas such as bullying. Remember that just the tip of the iceberg is above water, the other 80% is under the surface.
I self-injured for a number of years when I started dealing with childhood issues. I was sexually abused and neglected. I stuffed all this for many years and didn't start dealing with it until after I had my daughter and was divorced.
I was dealing with PTSD, BPD and was severely depressed but still forcing myself to work until I just couldn't handle it any longer and had to go out of work.
For those who have come up with their own unique ideas as to why people self injury: there are many different reasons, each as unique as the person.
And the person who mentioned hitting a wall - I have done that before to get rid of stress or anger. I have found that punching something soft only makes the anger worse.
Reading this makes my heart ache. I've been there, though luckily to a lesser degree than many. We really need to reevaluate the way we treat ourselves and our children. There are obviously a lot of very unhappy people out there. So sad.
From the time I was 11, I use to cut myself daily. Some days it was just once or twice and others it was a lot more than that. I didn't get treatment until I was 16. I was dealing with a lot more than I should have. A parent dying, being kicked out by the other parent at 16 (in the middle of the night, at that). It was rough and I ended up in foster care and in a treatment facility. Sadly, they did not help me because they didn't understand the behavior. I wasn't trying to kill myself, I was making the pain stop. Today, I have not cut in almost 7 years. I would like to say it gets better, but some days the urge still comes over me. I can't wear a bathing suit because of all my scars. I can't wear a tank top or shorts either. It was a decision that I regret, especially since my children are getting older and they notice my scars on the days I choose to wear a tank top. My oldest has asked what they were and I haven't gone into too much detail on how I got them, but I plan to be honest with my kids when they get older.