Memory: I am six years old. I am playing at a friend’s house. “Want to see something?” she asks. She lifts her skirt and points to a row of stitches on her knee. “I fell on some glass. They said it was going to scar,” she boasts. “I didn’t even cry.”
I go home and find an Exacto knife in my dad’s office. I tell myself that this makes me brave. I cut, and a red line springs from my arm, wavers, and drips. I am pleasantly surprised by the rush, the emotional release that greets me as I cut myself. I am left with a faint scar, the first of many.
My experience is not unique. Thousands of children, adolescents, and adults in the United States have a history of self-injury. Studies suggest that it is most common in middle- and upper-class girls and women. Self-injury varies widely—many girls only make shallow cuts or barely visible burns, but others are more extreme, resorting to deep cutting or complete removal of flesh.
Memory: I am ten years old. I have acquired a few dozen scars, little lines etched into my thighs and arms. I casually tell my therapist about cutting myself. She makes me tell my parents, and immediately suggests hospitalization. I am shocked. I don’t understand what I have done wrong. I pretend that I do understand, that I will not cut myself again.
Cutting and other forms of self-injury are not intended to be suicidal. There are many reasons why girls cut. Girls with mental illnesses such as bipolar disorder, depression, and schizophrenia, as well as those who have suffered abuse or other trauma, are most likely to self-mutilate. But many girls with no signs of depression or trauma cut themselves.
Memory: I am seven years old, or eleven, or nine, or fourteen, or twelve. I am in the bathtub. I carefully extract one of the razor blades that I have hidden in a crevice in the wall. Routine. I know how far up on my leg to cut so that no one will notice, how deep to cut to scar. I am always nervous when I make the first cut, but after that, it becomes easier. Adrenaline pushes me to cut deeper and again.
Why do so many girls hurt themselves like I did? The idea of intentionally hurting oneself sounds awful, and I understand that it can be really, really scary for a parent to see a daughter hurt herself. My reasons are fairly simple, and I suspect they’re true for many girls. Cutting allows girls control over their bodies, which especially appeals to adolescents who don’t have control over other areas of their lives or who have suffered physical or psychological trauma. Self-mutilation is especially common in adolescent girls because of our powerlessness in our culture. That’s why there’s also a correlation between eating disorders and self-injury. Both provide a sense of control.
Many girls cut to relieve emotional pain or other psychological distress. I used to cut myself to make the emotional tangible. Hurting my body physically mirrored the hurt that I felt psychologically. The psychological pain was real. It was awful. The way I felt about myself at the time, my mental and emotional instability—that was a problem. My cutting represented feelings that needed to be dealt with.
Most of all, cutting simply feels good. The controlled pain gave me a rush of adrenaline. Cutting is a drug—it gets you high. It can be addictive. If you are in psychological pain already, cutting feels great. That’s a fact parents and others have to understand in order to support a girl who self-injures. No one quite wants to talk about this—how cutting is taboo in part because it is so private and so pleasurable.
Unfortunately, I find that treatment for girls who self-injure often focuses on the concrete act, as if making a girl stop cutting herself will make her pain go away. Treatment that has the sole goal of forcing a girl to stop self-injuring is not effective. Sure, if a girl stops hurting herself, it is probably a good sign, but the real emphasis of treatment should be on the issues surrounding the self-injury. Is she psychologically healthy? Is her home life healthy? Are there areas of her life that feel out of control? What does she need that she isn’t getting?
I’m 17 now, and I don’t cut anymore. But I didn’t stop until I felt that I was aware of the reasons I did cut and felt like I was in control of my life. Actually, I stopped cutting on and off throughout my childhood to make my parents or my therapist happy. But as long as I was in a cycle of low self-esteem, overwhelming emotions, and ineffective choices, I always came back to it. I was finally ready to leave cutting behind only when I felt empowered to manage my emotional health and make effective life decisions.
Many girls come to their parents when they are hurting themselves, but many other girls hide it very well. If you have discovered that your daughter is cutting, she may or may not want to open up to you. The most important thing you can do is to listen to her, and to let her know that you love and support her. Ask her what she needs. Don’t overreact—crying and yelling can make your daughter feel alienated or demonized. If professional therapy is not an option, encourage activities that she enjoys and affirm her self-worth. Most importantly, keep open communication. Together, you can help her identify and treat the causes of her emotional pain and boost her health and self-awareness for the future.