John, is that a cut on your wrist?-River City Counseling

Although cutting is a concern on an ongoing basis, there are times when it seems more prevalent among teens.  Since I’ve been hearing that it’s on the upswing,  I’d like to share an article I wrote that should give parents some education and direction when it comes to helping their teens cope with cutting.  It ran originally in The Land Park News.

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Not long ago, “Dave,” a 15-year-old boy, came into my office for his regularly scheduled appointment.  Almost immediately, I noticed that he had about a two inch, vertical cut on his left wrist, and I asked him about it.  At first he told me that he’d brushed up against something and accidentally scratched himself, but when I challenged his story he eventually told me that he’d cut himself with a knife.

When I asked what was happening in his life, he told me that the academic pressure from both his teachers and parents was really getting to him.  He felt horrible and hadn’t known where to turn.  Without giving it much thought, he’d cut himself, and the bad feelings went away for a little while.  But before long, the feelings returned.

When I asked Dave if his parents noticed his cut, he told me that he wasn’t sure because they hadn’t said anything.  As the cut was hard to miss, this left me feeling more concerned.  After talking it through, Dave decided that it was be a good idea to have his parents join him for his next appointment.

At the family meeting, I helped Dave talk about his feelings and what led him to cut.  I also asked his parents if they’d noticed the cut.  They admitted that they had and wanted to help, but didn’t know what to do or say, so they kept silent.  This admission helped open up the conversation, and Dave got the support he needed.  He hasn’t cut since.

I know there are times in which it’s tempting not to talk about difficult issues like cutting with our teens.  Rather than having what could be a heated, emotional conversation, parents choose to stay silent.  That way they don’t have to deal with difficult feelings that might surface because their teen’s struggles.  It’s easier to hope the problem goes away on its own.  And sometimes it does.

Unfortunately, cutting is often a sign of something more serious and doesn’t just stop on its own.  Sometimes, talking about what hurts deeply is too overwhelming, so teens use cutting as a way of getting out these feelings and showing others just how much pain they’re in.  Other times, teens feel numb on the inside, so they cut as a way to feel something on the outside, even if it’s pain.

Either way, teens are communicating that something isn’t right and they want someone to pay attention.  They’re shouting and waving their arms in hopes that you’ll notice and do something before the avalanche hits and problems get worse.  This doesn’t mean that you’ll have any easy conversation.  Your teen is probably going to get defensive and deny that there’s a big problem.  At the same time, he or she is also going to be relieved because you’ve noticed that things aren’t OK and you want to help.

It’s important that you let your teen know that he or she isn’t in trouble. Tell them that you’re worried, not angry.  Tell them that you want to hear how they’re feeling, and try to be open to what they say.  Do your best to remain calm throughout the conversation.  If you get defensive and angry and threaten to do things like taking their door off its hinges and grounding them indefinitely, you’ll probably leave your teen feeling that he or she never should have said anything.  Help your teen seek the support of trusted adults, including a counselor, when necessary.

In the end, it’s scary for parents to learn that their teens are injuring themselves by cutting.  Fortunately, I’ve found that if parents provide necessary support when they notice that their teen has started cutting, rather than ignoring it or getting angry, teens often are able to cope with their strong feelings without hurting themselves further.

6 Responses to John, is that a cut on your wrist?-River City Counseling
  1. elizabeth
    January 10, 2013 | 4:36 pm

    There seems to be some similarities to eating disorders also.

    Good advice for anyone, to not be afraid of the negative feelings when you discuss issues. A lot of people would rather hide the feelings than encounter additional anxiety or sadness. But discussion can bring the sunshine in after a patch of stormy weather…….

  2. Geertjan
    January 15, 2013 | 3:38 pm

    In my experience as psychodynamic/psychoanalytic therapist it is very necassary to discover and explorate the meaning of the wrist-cutting or wristslashing. One of the meanings can be that by cutting themselves those patients cut themselves back into life when experiencing verys strong depersonalisation and or derealisation states, which as such are than a very strong /unbearable defense mechanism or as R.Langs would call it a adaptation reaction or mechanism. It always has to do with to strong,that is not manageble by the patients own system of emotion-management.There is then the immediate need of a very precize empathetic understanding (as Ferenczi and Balint decribed it). You have to be very prsent as a person who can bear the turmoil the patient is experiencing and stay open and receptive for the patient and communicate this silently, nonverbal and verbal. Indeed are there much similarities to eating disorders and other forms of self injuring.

  3. Ariella
    January 15, 2013 | 10:27 pm

    Hello John, you point out the positive role of parental understanding and support, which I thoroughly agree with. However, we live in a less than ideal world and it is often the parents’ own inability or unwillingness to understand and support their child during tough times that makes our work even harder and the young person’s problem response to his/her sense of hopelessness more entrenched. It is very important, in this case, that other significant relationships are identified,brought in and actively engaged in the adolescent’s life. These alternative parental figures will provide the elements of safety, acceptance, unconditional respect and love that are at the core of the process of building the sense of belonging and the positive attachment a young person needs to develop resilience and a healthy self-image.

  4. Suzanne
    January 17, 2013 | 6:36 pm

    Great article. Thanks. When working in residential treatment with adult female parolees who were also addicts this was an issue that FREAKED OUT the staff. As I am sure you are well aware, training them to see it as a cry for help/attention rather than an overt suicidal gestures was so important. The other issue which I think is paramount to discuss with teenagers and parents alike, is the addictive quality of cutting. I don’t like what’s happening. What will take it away? Cutting? It hurts but It feels good. Do it again. This becomes a cycle which parallels that of the obsessive-compulsive nature of any addiction, including, as someone noted previously, eating disorders, but more specifically, binging0purging type of Anorexia-Nervosa within the DSM-IV-TR-revised. Anyway, thank you so much for posting this. I will certainly be able to use your article in practice.

    • Steve DeBenedetti-Emanuel
      January 17, 2013 | 6:54 pm

      Suzanne, thanks for adding to the conversation . I’d love to hear more about your thoughts on the OCD like aspect of cutting.

  5. Allison Ackerman, Ph.D.
    January 23, 2013 | 8:26 pm

    Thanks for this lovely article which addresses consisely what goes on dynamically for cutters, their families and how parents need to handle their own and their childrens’ feelings.

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