Articles: Confronting the Unkindest Cut
By Liza N. Burby
PRINCESS DIANA had admitted to deliberately cutting herself several times. Actors Roseanne and Johnny Depp have said they have struggled with the problem.
Self-injury or self-mutilation, as the disorder is known, affects almost 3 million people, primarily females, according to a new book, "Bodily Harm: The Breakthrough Healing Program for Self-Injurers" (Hyperion, $24.95) by Karen Conterio and Wendy Lader. It usually begins around puberty and is the deliberate mutilation of your body, including cutting or burning your skin, bruising yourself through a premeditated accident, scratching your skin until it bleeds or interfering with the healing of wounds - or, in more extreme cases, breaking your bones, amputating digits, eating harmful substances or injecting your body with toxins.
The authors, who are the directors of the SAFE (Self-Abuse Finally Ends) Alternatives Program in Chicago, say the intent of self-mutilation is not to commit suicide but to manage emotions patients feel unable to express verbally. Estimates are that 1,400 out of every 100,000 people have engaged in some form of self-injury and that one-half to two-thirds of self-injurers also have an eating disorder.
Warning signs include: excessive scratching, razor cuts (although self-injurers usually make the marks where they can't be seen), crude or excessive tattoos or body piercing, loose clothing and long sleeves worn even in warm weather to hide injuries, flimsy excuses to explain injuries, or a cache of odd objects such as bent paper clips, pieces of glass or razor blades. Certain behavioral changes - low self-esteem, difficulty handling feelings, problems with school work, home life or relationships - could indicate problems.
If you notice any injury that might have been self-inflicted, gently confront your child. "A lot of parents think by ignoring it, it will go away or if they pay too much attention to it, it will be like rewarding their child," Lader says. "The best way to approach it is without using shaming or disgusted language. Instead, ask, `I noticed lots of scratches on your arms and legs. Did you do that to yourself? I'm here to listen to what is going on for you.' "
Conterio says: "Recognize this is a family issue. The whole family has a problem if one person has a problem. A lot of this is about patients' not feeling comfortable sharing their feelings with their family, and often we find these are families in which the style of parenting is to be either close-minded or overinvolved...these teens usually feel worried about what will happen to them if they share with their parents what they are doing, or they think their parents have enough of their own problems so why would they want to hear about their child's?"
The authors advise parents to work with their teen and seek the help of a psychiatrist who is familiar with the disorder. They will provide your therapist with a phone consultation. SAFE has an information line at 1-800-DONTCUT.
Another thorough book on the subject: "Cutting: Understanding & Overcoming Self-Mutilation" by psychotherapist Steven Levenkron of Manhattan (W.W. Norton, $25). He has been treating self-injurers since 1976 and says that, in general, they can be treated within a year. Like Conterio and Lader, he does not believe in the 12-step approach to this disorder.
"When they have recovered, it means they've made an exchange," he says. "They've found something else to meet the need cutting served. The right way to go is that relationships obviate the need to cut."
Parents or teens who would like to speak with Levenkron about self-injury can reach him at 212-794-1956.
Self-injury or self-mutilation, as the disorder is known, affects almost 3 million people, primarily females, according to a new book, "Bodily Harm: The Breakthrough Healing Program for Self-Injurers" (Hyperion, $24.95) by Karen Conterio and Wendy Lader. It usually begins around puberty and is the deliberate mutilation of your body, including cutting or burning your skin, bruising yourself through a premeditated accident, scratching your skin until it bleeds or interfering with the healing of wounds - or, in more extreme cases, breaking your bones, amputating digits, eating harmful substances or injecting your body with toxins.
The authors, who are the directors of the SAFE (Self-Abuse Finally Ends) Alternatives Program in Chicago, say the intent of self-mutilation is not to commit suicide but to manage emotions patients feel unable to express verbally. Estimates are that 1,400 out of every 100,000 people have engaged in some form of self-injury and that one-half to two-thirds of self-injurers also have an eating disorder.
Warning signs include: excessive scratching, razor cuts (although self-injurers usually make the marks where they can't be seen), crude or excessive tattoos or body piercing, loose clothing and long sleeves worn even in warm weather to hide injuries, flimsy excuses to explain injuries, or a cache of odd objects such as bent paper clips, pieces of glass or razor blades. Certain behavioral changes - low self-esteem, difficulty handling feelings, problems with school work, home life or relationships - could indicate problems.
If you notice any injury that might have been self-inflicted, gently confront your child. "A lot of parents think by ignoring it, it will go away or if they pay too much attention to it, it will be like rewarding their child," Lader says. "The best way to approach it is without using shaming or disgusted language. Instead, ask, `I noticed lots of scratches on your arms and legs. Did you do that to yourself? I'm here to listen to what is going on for you.' "
Conterio says: "Recognize this is a family issue. The whole family has a problem if one person has a problem. A lot of this is about patients' not feeling comfortable sharing their feelings with their family, and often we find these are families in which the style of parenting is to be either close-minded or overinvolved...these teens usually feel worried about what will happen to them if they share with their parents what they are doing, or they think their parents have enough of their own problems so why would they want to hear about their child's?"
The authors advise parents to work with their teen and seek the help of a psychiatrist who is familiar with the disorder. They will provide your therapist with a phone consultation. SAFE has an information line at 1-800-DONTCUT.
Another thorough book on the subject: "Cutting: Understanding & Overcoming Self-Mutilation" by psychotherapist Steven Levenkron of Manhattan (W.W. Norton, $25). He has been treating self-injurers since 1976 and says that, in general, they can be treated within a year. Like Conterio and Lader, he does not believe in the 12-step approach to this disorder.
"When they have recovered, it means they've made an exchange," he says. "They've found something else to meet the need cutting served. The right way to go is that relationships obviate the need to cut."
Parents or teens who would like to speak with Levenkron about self-injury can reach him at 212-794-1956.
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