Overview
Self-injury, self-harm, or cutting is a serious behavior that accompanies many mental illnesses in both youth and adults. Those that engage in cutting can find prolific internet resources that explain how to cut, where to cut, and how to hide it from others. There are groups online that encourage self-harm and some that try to teach adaptive behaviors instead of cutting.
It usually occurs during or after puberty and is seen in both males and females. Self-injurious behaviors can go on for long periods of time, sometimes years, without a parent or caretaker noticing. Those at risk for cutting are those who already have an underlying disorder such as a personality disorder, impulse control disorder, depressive disorder, or eating disorder. It is also seen in those that have experienced a trauma or are living in a chaotic, unhealthy, or unstable situation. The cutters will describe the experience as a release of emotional pain. When the psychological pain is so intense or out of control, self-harm gives the person control over inflicting pain and thus a feeling of control over emotional pain. The point of self-injurious behavior is not to commit suicide or to die, although death can occur from this disorder, but to seek relief. Some might describe the self-harm as a punishment for not being able to control emotions or because they blame themselves for some trauma that occurred. If there is any suspicion that your child is cutting it is important to seek help immediately.
Signs
Signs that your child or a loved one is cutting can be revealed if you know what to look for and where to look. The first, most obvious sign is usually in the clothing. Some cutters might only wear very dark colors to hide the blood stains and will often wear long sleeves and pants even in very hot weather. If you look through dirty laundry, you might be able to find blood stains or stiff areas where blood has dried. Clothing might also become missing or be found in the trash as a way to conceal noticeable stains. Once there is suspicion it is responsible to ask your child to remove clothing in front of you so that they can be checked for fresh or old wounds that have scarred over. Please note that this should only be an option for a parent or a doctor with a parent present. There are also signs that can be found by searching the room and backpack of the child. Anything can be used to self-harm. A comb with broken teeth, a pen, tack, lighter, wire hanger, small pieces of plastic, paper clips and staples, candles, and other objects. Self-harm could be in the form of burning by use of heat or chemicals, cutting, or scratching. Any behavior that can cause pain can be used for self-harm including pinching, punching, or banging their head against a hard surface. If the self harm is severe enough it could require a hospital visit as infections could happen from untended wounds.
Treatment
Treatment for self-harm is included in the treatment required to deal with the underlying mental illness or disorder. With counseling the desire to self-harm can be reframed in a healthy, more appropriate, outlet. Because self-harm is a purposeful but impulsive act, it can be difficult to change the habit of what may be considered a quick fix for the client. Healthy resolutions to emotional pain usually take time, patience, and a level of emotional intelligence that can be learned in a therapeutic setting. If the injuries are life threatening it will be required by law that the person be placed in a hospital for observation and stabilization. If you feel that the injurious behavior is endangering the life of a loved one it is also possible to get them placed in an inpatient facility where they will be supervised at all times and kept safe. Sometimes medication is used to deal with the underlying disorder or to help with impulse control. If the environment is the cause of self-harm it will be necessary to seek counseling for the family to successfully stop the behavior.
