Cutting: Parents' Nightmare

Form Of Self-Injury Draws More Attention And Is Growing

(WebMD)  Over time, the cutting typically escalates — occurring more often, with more and more cuts each time, Rosen tells WebMD. "It takes less provocation for them to cut. It takes more cutting to get the same relief — much like drug addiction. And, for reasons I can't explain but have heard often enough, the more blood the better. Most of the cutting I see is quite superficial, and looks more like scratches than cuts. It's the sort that when you put pressure on it, it stops the bleeding."


What Parents Should Do

When parents suspect a problem, "they are at a loss of how to approach their child," Conterio says. "We tell parents it's better to err on the side of open communication. The kids may talk when they're ready. It's better to open up the door, let them know you're aware of this, and if they don't come to you, go to someone else ... that you're not going to punish them, that you're just concerned."

Be direct with your child, adds Lader. "Don't act out of anger or let yourself become hysterical — 'I'm going to watch you every second, you can't go anywhere.' Be direct, express concern. Say, 'We're going to get help for you.'"

Parents often mistake cutting for suicidal behavior. "That's usually when they have finally seen the cuts, and they don't know how to interpret it," explains Rosen. "So the kid gets dragged into the ER. But ER doctors aren't always used to seeing this, and find it difficult to understand whether it's suicidal or self-injurious behavior. Many kids who are not suicidal at all are being evaluated and even hospitalized as suicidal."

Unfortunately, "the attitude in hospital emergency rooms can be very cavalier and harsh about self-injurers," adds Lader. "There's a lot of dislike, because it's a self-made injury, so ER personnel can be very hostile. There are all kinds of stories of girls getting stitched without anesthetic. The thing is, after they've self-injured, the girls are calmer — so when they're getting stitches, they feel the pain. Yet the doctor is angry, wants to get this over with."

Psychotherapy should be the first step in treatment, Lader adds. The SAFE web site has a list of doctors who have been to her lectures, who want to work with self-injurers. With other therapists, ask if they have any expertise in working with self-injurers. "Some therapists have a fear reaction to it. The therapist needs to be comfortable with it," she advises.

However, the girl or boy must be ready for treatment, says Rosen.