Tricia Jeter knows that razor blades cannot solve her problems anymore.

She didn't use them to try to kill herself, she said. There was just something about cutting her skin and watching the blood.

A relief. A sense of control. A way to dull the pain inside.

"It's the satisfaction of knowing it will hurt, and you can control it," said Tricia, 15. "Even though it hurt, it was just a relief."

Afterward, Tricia would resume her everyday life, which includes a boyfriend and a supportive family. She hangs out with friends, takes dance classes and dreams about being a doctor in the Air Force.

Tricia, a freshman at Carroll Junior High School in Southlake, is one of thousands of teen-agers who hide scars from self-inflicted cuts under jeans and long-sleeve shirts.

Self-mutilation, self-injury or cutting leads as many as one in 250 people to repeatedly hurt themselves.

Self-injury typically begins in adolescence, when youngsters often struggle with low self-esteem and have problems expressing feelings. Freshmen, who face many new pressures, may be particularly vulnerable, psychology experts say.

Tricia told her mother in November that she was cutting herself. She is now seeing a psychologist.

She fits the profile of a self-injurer.

They are usually young women with good backgrounds, perfectionists who have a difficult time talking about feelings, said Karen Conterio, administrative director of Self Abuse Finally Ends, a 15- year-old program in Illinois that treats self-injurers.

Almost 90 percent of self-injurers say they are discouraged from expressing emotions, according to Conterio's research. Almost 50 percent report past physical or sexual abuse.

Most have low self-esteem, she said.

These conditions, coupled with hormone changes, make adolescents especially susceptible to self-injury, she said.

"There is a real sense of being out of control. This is a way to attack the body to regain control," said Conterio, who co-wrote Bodily Harm: The Breakthrough Healing Program for Self-Injurers.

Tricia said she was not abused, but her family life was strained. She grew up with an alcoholic father and remembers nights when he would pass out on the floor, she said.

Her parents divorced about five years ago. For a while, it was just Tricia, her two sisters and their mother. Tricia is close to her sisters, Whitney, 13, and Katy, 19.

In 1998, Tricia's mother remarried. Having a stepfather was a big adjustment. Tricia said she has never been close to him or to her mother, who stay busy with their jobs.

Tricia, like other freshmen, also has problems with self-image. She said she has never felt as pretty as other girls at school. About two years ago, she went on a severe diet and lost about 20 pounds.

Last year, when Katy moved out to live with her boyfriend, Tricia said she felt abandoned.

"I felt everything was going to pieces," she said.

Tricia then started hurting herself by scratching her arms until they bled. Usually, she scratched under her sweater, where no one could see.

Soon, Tricia began using razor blades on the inside of her upper arm. She also has burned her wrist with matches.

"You get used to the scratching," Tricia said. "It's almost as if you need something else."

She went to great pains to hide the scars. Sometimes, her mother or her sisters would ask about the marks, but she would make excuses to ease their minds.

Karyn Mally, Tricia's mother, said she was shocked when she found out that her daughter had been hurting herself for a year.

"I thought we had a good relationship, but I guess she just didn't want to tell me," Mally said. "I should have known what was going on. I should have been more compassionate."

'A coping method'

Self-injurers are grasping for a way to cope with painful emotions, experts say. By hurting themselves, they lower the intensity of their rage, loneliness or disappointment to tolerable levels.

Endorphins, which the body releases when it is injured, are also believed to help relieve the chemical imbalances that most self- injurers suffer from, experts say. The chemical changes, which last about two hours, may explain why teens report feeling calm and relieved after they hurt themselves.

"I just felt like I had taken like a load, a burden, off me," Tricia said.

Stephen Levenkron, a New York psychotherapist who wrote Cutting: Understanding and Overcoming Self-Mutilation, said self-injurers tend to lose sight of reality.

Many self-mutilators enter a trancelike state and claim that they cannot feel the pain, he said.

Courtney Spickelmier, a junior in the magnet science academy at Lyndon Baines Johnson High School in Austin, said she had a similar feeling before she would cut herself.

"Usually, the reasons why I did it is because I felt like I was in a dream, like I wasn't really there," she said.

"It's just a feeling that you can't really explain. It's like all you want to do is sleep because the nightmares you have were better than your life," Spickelmier said.

"I cut myself because I want to live. It's just a coping method," she said.

Levenkron said teens rationalize cutting.

"The kids don't represent themselves accurately," he said. "They're not calling it pain anymore. They're calling it intensity."

The dramatic gestures are not teen-age rebellion or botched suicide attempts. In most cases, self-injurers have deeper problems, such as depression, anxiety or post-traumatic stress disorder, said Lindy Garnette, director of child and family mental health services for the National Mental Health Association.

"Often there is a mental health issue, but often it's an undiagnosed problem," she said.

Unless underlying problems are treated, self-injurers will hurt themselves for years, experts say. The episodes, which usually worsen, can result in permanent body damage or accidental suicide.

A Northwest High School freshman, who asked that her name not be used, said she knew that if she did not stop cutting, she might accidentally kill herself.

"I was thinking I would end up doing it too deep and end up almost killing myself, but I didn't want to kill myself," she said.

The student said she was terrified to tell her parents that she had been hurting herself for four years.

"It's just really sad because you feel you have so much pressure to try to please everybody so you can't act out like other kids do when they have problems," she said.

She said she has not cut herself since she had an emotional talk with her mother three months ago.

"As soon as you admit it, it just gets easier," she said.

Other teens say they struggled to stop cutting.

"I can stop doing the behaviors, but I haven't found a way to stop wanting to do it," said C.J. Dahlgren, 19, of El Paso, who cut and burned herself throughout high school.

Dahlgren's first cut was a self-punishment after her grandfather's death. She felt guilty, she said, because she had not talked to him in two years. Eventually, she cut herself any time she argued with her mother, got a speeding ticket or received a low grade.

"Most of the time when people start this, it's because they feel they're out of control," said Dahlgren, who has had skin grafts to cover some scars on her arms. "What they have to realize is that this is going to control them and their lives."

A way to heal

With medication and therapy, most self-injurers can recover, experts say.

"What parents and friends have to face is the old-fashioned word heartbreak - that someone they love is mentally ill," said Levenkron, who has treated 50 cutters in 25 years.

As part of Tricia's therapy, her psychologist has instructed her to draw on her arms with a red pen when she feels like cutting. She has used the approach at least three times.

Other self-injurers are advised to replace cutting or burning with lesser pain, such as holding ice. Healthy coping techniques such as talking, writing or drawing are also recommended.

Recovery requires tremendous work by patients as well as their family and friends, Levenkron said.

Tricia's mother says she takes extra steps to nurture and protect her daughter. She often checks on her, as she did when Tricia was a baby, she said.

"I find myself now going upstairs to make sure she's OK," she said. "I'm not comfortable yet, so I try to gear my life and days around her to make sure she's not alone."