Razor slashes slice their macabre design up and down her left arm. Her legs and her neck wear a similar roadmap of pain. Mary is a cutter. Mary is just 13. Late at night, she would sit in her bedroom drunk on the wine she'd stolen from her parents' cupboard, and pick up the steak knife she had taken from the kitchen or the razor she'd lifted from a shaver. And then calmly, deliberately, she would slice into her flesh until the blood would flow.

"I would just watch it bleed," says Mary, who asks that we not use her real name. "It's hard to explain, so just bear with me. I guess it just felt like a stress reliever -- I was getting the emotional pain out with the physical pain."

Her parents had no idea what she was doing, no clue that their only child was so tormented that she was deliberately injuring herself. After all, she was the class valedictorian, she had lots of friends, two loving parents and a comfortable upbringing. When she was eight, Mary had been sexually molested by an elderly man in the local hardware store, but she had put that behind her with the help of a counsellor. Or so they thought. This summer, her mother wondered why Mary was wearing long sleeves in the sweltering heat.

"I'm cold," her daughter told her. "Can't I wear a sweater if I want to?"

Her mom put it down to teenage hormones until Mary's counsellor called to say that she was worried about her. Mary had e-mailed her at 2:45 a.m. that morning to confess that she'd been drinking and cutting herself.

With those words, Mary's parents entered the secret, frightening world of self-injury.

It is far more common than most of us realize. Cutting, burning, scratching -- self-injury is the silent scream for help. A study by Karen Conterio and Dr. Wendy Lader, founders of the original Self Abuse Finally Ends (SAFE) Alternatives program in Chicago, found that 1% of the population is prone to self-injurious behaviours. Most are female.

The practice was most famously outed by Princess Diana when she admitted in her extraordinary 1995 BBC interview that she deliberately cut her arms and legs during her unhappy marriage. "You have so much pain inside yourself that you try and hurt yourself on the outside because you want help," she explained.

Young Victims

B.J. Thom, executive director of SAFE Canada, says their therapy program in London and Toronto has treated cutters as young as six years old. "About 75% of our clients have been abused and 25% are teens and 82% are female," says Thom, a cutter herself until seven years ago. "It has no financial, ethnic or social boundaries. We all do it to handle crises and stresses in our life."

But, she insists, it is not a form of attempted suicide. "Freud was probably the one who stated it best back in the 1940s that self-mutilation is a little suicide to prevent the big one."

Nor is it manipulative, adds Dr. Lorne Korman. "There's been a lot of stigmatizing of people who self-mutilate as attention seekers," says Korman, head of the anger and addiction clinic at the Centre for Addiction and Mental Health. "It usually has nothing to do with that at all. ...One of the very common functions of self-mutilation is that it reduces their distress."

At the beginning, Mary says, she only scratched the surface of her skin. "Then I started to get really deep. The more blood I saw, the more relief I felt."

Mary's mother was horrified to discover what her daughter was doing. She was even more distressed to learn from their family doctor that five other girls in their small town were doing the same thing -- but there was very little help available for any of them. "There are 7,000 children in the province of Ontario on waiting lists for mental health services -- 7,000! It's unacceptable."

She was told they would have to wait two years to get Mary ongoing therapy. They were lucky enough to be able to afford private counselling -- but what about those who can't?

"It's not just kids who cut -- it's all kinds of kids who need mental health services that they are just not getting," her mom says. "It's a travesty."

So as her daughter heals, her mother fights for all those who still have not. She's written the health minister, the premier and all the MPPs. Ernie Eves has promised to sit down with her. She's still waiting.

Mary hasn't cut for more than a month now. She is in therapy and on anti-depressants. "I still get depressed, but not to the point that I want to cut. I play guitar and keep busy.

"The worst part is looking and seeing the scars that probably will never go away. You just think to yourself, 'What was I doing?' Life, it's pretty sweet right now."