Kids who cut

Why and what you can do to help.
April 4, 2016
Serious young girl
Photo: Getty Images

It’s hard to understand how hurting yourself can make you feel better, but that’s how it is with cutting.

If you’ve noticed cuts on your teen or pre-teen’s arms, are finding bloody tissues in the trash, bloody clothing in their room or noticing blood spots in the shower, it may be time to explore if your teen is cutting.

“Kids cut because they feel awful with all capital letters, and it gives them some temporary relief,” said Craig McFadden, a licensed behavioral health specialist with UCHealth’s Mountain Crest Behavioral Health Center in Fort Collins.

According to reputable studies, 12-37 percent of middle school teens cut and 12-20 percent of older teens cut in the U.S. Interestingly, 25 percent try it just once. The good news is nearly half (40 percent) stop within a year, but it can become a coping mechanism that teens bring into their adult lives.

As far as self-injury behaviors go, cutting is the most common, followed by scratching. Some kids also burn themselves, bang their heads or punch themselves. Kids cut their arms, thighs and hips (easy to hide) and sometimes other areas like their necks and backs. More girls cut than boys.

Why kids cut

“Cutting is a very secretive behavior, and teens cut for many different reasons. Kids who cut have huge, overwhelming feelings and they don’t have the words to express them. Maybe they are being abused or bullied or feeling anxious or depressed. Maybe they suffer from extreme perfectionism and it gives them a sense of control. Or it could be a mental health issue like bipolar setting in where they can’t sleep, feel agitated and their thoughts are going fast. It also can be a way of punishing themselves. Cutting brings relief and momentary calm,” McFadden added.

For those who try it once, it might be that a friend suggested it or they heard about it and felt stressed so they thought they’d give it a try. Then they found out they didn’t like it and it didn’t help. But for those who get the 5- to 30-minute relief it brings, it feels worth it.

If you suspect your child is cutting there are things you can do to help. McFadden offers sound advice for parents who are faced with this stressful parenting challenge.

Don’t freak out

“First, don’t freak out. Be concerned, not worried. To me, worried is fearful as in ‘Oh my God! Why are you doing that!’ and concerned is alert and thoughtful as in, ‘Tell me more about that.’ That’s what you want your teen to see. Kids do a quick radar sweep to see if you are okay, and if you freak out, they decide it’s better to hide their feelings,” McFadden said.

He goes on to say that kids tend to personalize everything. If they sense they caused you stress they see it as their fault and they think they did something wrong. Once that happens, they will start denying it’s a problem and simply learn to hide it better. That’s why taking on a curious yet concerned demeanor works best when dealing with cutting or any concerning behavior.

Be in it with your kid

The message you want to send is, “I’m here for you and you can count on me.” You might reveal that you don’t like the cutting but you don’t want them to feel ashamed. Send the message that you are open and ready to listen. Do this by asking open-ended questions and letting your teen guide the conversation.

McFadden often starts by asking, “What does it do for you?” and showing understanding. He recommends that parents could say, “What I know about cutting is you are having big feelings that you don’t know what to do with, so what’s going on?”

“Get them talking about what they see as the next step. You may be 10 steps ahead of them but you need to start where they are at. Ask them questions about what they think might help or what has helped before, or what other activities make them feel better,” he suggested.

As tempting as it is, don’t believe promises that they will quit or help keep it a secret from others. Cutting needs to be taken seriously and addressed before it becomes a go-to coping technique, compulsion or they hurt themselves.

Seek help

“Nobody wants to admit their kid needs help or that they need help helping their kid, but usually individual therapy and parent-teen therapy are needed,” McFadden said.

It may be tempting to minimize cutting or write it off as teens being teens, but it’s best to seek help from a trained therapist who can get to the crux of the issue and provide your teen with alternative coping skills.

“If someone who feels awful has something that makes them feel better, they are not going to give it up easily. Cutting isn’t normal teen stuff, neither is large mood swings, isolating greatly or struggling in more than one sphere of their lives, like school, home or friends. Even if you think it’s a phase, get them evaluated so you know for sure,” McFadden said.

Signs of Cutting

  • Unexplained cuts, scratches usually on arms and legs.
  • Covering up with long sleeves even when it’s warm out.
  • Skipping gym or the pool to avoid exposure.
  • Finding razor blades or knives in their room.
  • Seeing bloody rags, clothing or tissues in their room or trash.
  • Finding blood splatters in the sink or shower.
  • “Generally, if you see evidence of blood around, ask about it and see how it feels when they answer. Is it plausible? If not, consider cutting,” said Craig McFadden with Mountain Crest.High-risk behaviors for cutting
  • Isolating and antisocial behavior, angry outbursts.
  • Dropping grades, losing friends.
  • Perfectionism – Have to get As or they are a failure.
  • Fatigue, poor sleep, appetite swings.
  • Anxiety, depression.
  • Abuse, bullying, substance abuse.
  • Mental health diagnosis such as depression, anxiety, bipolar, psychosis, conduct disorder.
  • A sense that something is “off.”When your teen needs helpMountain Crest Behavioral Health Center, a division of UCHealth in Fort Collins, offers a full range of behavioral health treatment programs, including programs designed for teens. The center offers two outpatient programs:Intensive Outpatient Program for Teens
    Runs six weeks; meets three times a week for three hours a day. Participants share their struggles and learn skills to help them work through difficult times. Teens ages 13 to 18 learn effective coping skills, using DBT (dialectical behavioral therapy).This family-centered program offers pick-up from school and dinner for the teen so that parents don’t have to miss work for their child to participate.Individual Outpatient Therapy for Teens
    Child and adolescent psychologists, licensed psychotherapists and psychiatrists offer individual psychotherapy, family therapy and psychological testing.For more information, call Mountain Crest at 970.207.4857.

About the author

UCHealth is an innovative, nonprofit health system that delivers the highest quality medical care with an excellent patient experience. With 24,000 employees, UCHealth includes 12 acute-care full-service hospitals and hundreds of physicians across Colorado, southern Wyoming and western Nebraska. With University of Colorado Hospital on the Anschutz Medical Campus as its academic anchor and the only adult academic medical center in the region, UCHealth pushes the boundaries of medicine, providing advanced treatments and clinical trials and improving health through innovation.