Articles: Unexplained Scars May Be Symptoms of 'Cutting'
By Denise Mann
Frequent unexplained wounds—primarily cuts and burns—and wearing long pants or sleeves in warm weather may be signs that adolescent female patients are mutilating themselves, according to the psychotherapist author of a new book, "The Luckiest Little Girl in the World" (Scribner, $20).
"Someone who feels that they are losing [touch] with reality may grab for a knife, scissors, a bottle cap, and the combination of the pain and seeing the blood helps them stop 'disintegrating' mentally," explained Steven Levenkron, M.S., who is in private practice in New York City.
The phenomenon is called "cutting," a form of self-mutilation in which people injure themselves with scissors, knives, razor blades or other sharp objects.
Cutting is predominantly a female affliction, according to Levenkron. "Men tend to act outwardly, while women tend to get upset and take it out on themselves in eating disorders and self-harm behaviors," he said.
As many as one percent of the population engages in habitual self-injury, including cutting or burning themselves. The disorder usually begins in early adolescence, between the ages of 11 and 13, according to the Rock Creek Center's Self Abuse Finally Ends (SAFE) Alternatives program in Lemont, Ill., the only U.S. treatment center for cutters or other self-injurers.
Cutting can be a symptom of another psychiatric problem such as anorexia or schizophrenia, or an expression of self-loathing, according to Levenkron.
Cutting is not a form of attempted suicide, he explained. The self-inflicted cuts are not deep and are generally found between the wrist and elbow on the forearm.
"Cutting" is often not diagnosed or treated because self-injurers are adept at hiding their problem and "the profession cringes just like the public" at the thought of someone injuring themselves, according to Levenkron.
Pediatricians and adolescent and internal-medicine specialists should be looking for a series of scars on patients' forearms and refer the patient to a psychiatrist or a psychologist for further evaluation, according to Levenkron.
Wendy Lader, Ph.D., the clinical director of S.A.F.E., said that emergency-room physicians and primary care doctors should not ignore the warning signs of "cutting."
"You get a lot of crazy explanations in the emergency room and if [a doctor] sees multiple scars, they should actually ask the question, 'Is this self-inflicted?"' she said.
The physician should then refer the patient to a psychotherapist or a psychiatrist for treatment, she added.
Treatment for self-injury can include medication, cognitive-behavior therapy and interpersonal therapy, according to Dr. Lader.
Self-injury "is much more common now," she added. "We are seeing it in high schools. It is becoming much more prevalent or out in the open."
"Someone who feels that they are losing [touch] with reality may grab for a knife, scissors, a bottle cap, and the combination of the pain and seeing the blood helps them stop 'disintegrating' mentally," explained Steven Levenkron, M.S., who is in private practice in New York City.
The phenomenon is called "cutting," a form of self-mutilation in which people injure themselves with scissors, knives, razor blades or other sharp objects.
Cutting is predominantly a female affliction, according to Levenkron. "Men tend to act outwardly, while women tend to get upset and take it out on themselves in eating disorders and self-harm behaviors," he said.
As many as one percent of the population engages in habitual self-injury, including cutting or burning themselves. The disorder usually begins in early adolescence, between the ages of 11 and 13, according to the Rock Creek Center's Self Abuse Finally Ends (SAFE) Alternatives program in Lemont, Ill., the only U.S. treatment center for cutters or other self-injurers.
Cutting can be a symptom of another psychiatric problem such as anorexia or schizophrenia, or an expression of self-loathing, according to Levenkron.
Cutting is not a form of attempted suicide, he explained. The self-inflicted cuts are not deep and are generally found between the wrist and elbow on the forearm.
"Cutting" is often not diagnosed or treated because self-injurers are adept at hiding their problem and "the profession cringes just like the public" at the thought of someone injuring themselves, according to Levenkron.
Pediatricians and adolescent and internal-medicine specialists should be looking for a series of scars on patients' forearms and refer the patient to a psychiatrist or a psychologist for further evaluation, according to Levenkron.
Wendy Lader, Ph.D., the clinical director of S.A.F.E., said that emergency-room physicians and primary care doctors should not ignore the warning signs of "cutting."
"You get a lot of crazy explanations in the emergency room and if [a doctor] sees multiple scars, they should actually ask the question, 'Is this self-inflicted?"' she said.
The physician should then refer the patient to a psychotherapist or a psychiatrist for treatment, she added.
Treatment for self-injury can include medication, cognitive-behavior therapy and interpersonal therapy, according to Dr. Lader.
Self-injury "is much more common now," she added. "We are seeing it in high schools. It is becoming much more prevalent or out in the open."
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