Stressed Out Teen Girls: Cutting to Cope

Part one: Molly’s story

Published on November 28, 2012 by Lucie Hemmen, Ph.D. in Teen Girls: A Crash Course

Meet Molly:

Molly is a high-performing 16-year-old teen girl in her junior year of high school. She has a nice group of friends, works hard in school and gets excellent grades. Molly also has multiple activities she admits she doesn’t really enjoy anymore but feels are necessary to “get into a good college.”

Molly remembers a time when she enjoyed both school and her activities, but is far too burned outnow to enjoy either.

What most people don’t know about Molly is that she sometimes cuts herself, in the privacy of her bedroom or bathroom, “just to feel relief or sometimes, just to feel something.”

“It started as an impulse. Of course I know a lot of girls who cut so the idea came to me and I started with a paper clip. I ran it along the inside of my arm until it made a mark. Then I went deeper until I made myself bleed. It was totally engrossing and I can’t explain why but it made me feel better. I graduated to straight edge razors and, at the time, it seemed perfectly fine to me. It was a little secret compartment of my life where I had all the power and control.”

Molly’s mom saw the cuts when she walked into the bathroom as Molly got out of the shower one day. Scars and partially healed lines marked Molly’s abdomen and upper thighs. Understandably, Molly’s mom was alarmed and confronted Molly.

“It’s a sickening moment when it hits you. You have a child and you love that child and you just don’t think she’ll grow up to purposely hurt and scar herself. Fear and anger and confusion all blew up inside of me and I regret the way I handled it.”

Molly was enraged to have her secret revealed. She was also overwhelmed by the experience of seeing the cutting from her mom’s point of view. She felt her mom did not understand at all. To make matters worse, her mom began watching her nervously. Followup conversations were awkward. Frustrated and concerned, Molly’s mom soon connected Molly to therapy.

Shocked and Confused Parents

The idea of cutting oneself, on purpose, to feel better is a mindblower for parents. At one of my parent education talks, a mom asked about cutting and one of the dads in the audience assumed we were talking about “cutting class.” His jaw dropped when it was explained to him.

Of course, we knew kids who made poor coping choices when we were teens and made a few ourselves. The low hanging fruit of the Coping Tree includes self-medication with drugs and alcohol, shoplifting, reckless driving, high-risk sex, and other non-beneficial activities that “fix” feelings while putting the teen at risk.

But teens who secretly cut themselves as a way to express, control and witness their emotional pain? Jaws drop.

While self-harming is not a new phenomenon, this particular offshoot is showing a disturbing rise in popularity. Accurate statistics are hard get but if you ask a professional who works with teen girls (therapists, counselors, teachers, coaches); you are likely to hear it is becoming more and more common.

How It Starts

Cutting has a contagious element and therefore spreads in stressful environments that contain greater numbers of vulnerable subjects. Eager to please, overly stressed teen girls are at risk.

Many girls share that they are sickened yet fascinated when they first hear of cutting. From there, the information is stored on a shelf in their consciousness. It is an option.

Depending on factors including stress level, stress sensitivity, emotional development, emotional support and overall lifestyle health and balance, a teen girl either will or won’t explore cutting herself.

Why It “Works”

Cutting is a coping mechanism which means it is a way to regulate feelings. Unfortunately, it “works” in that teens report it makes them feel better. They like that they can control it, keep it secret, see and feel a “result,” and express emotions people don’t seem to like, especially anger and sadness.

To make things worse, the brain wires quickly for this behavior, creating a stress + cutting = relief circuit that becomes harder and harder to break over time.

Ideally, teens employ healthier coping strategies when under stress. For example, a stressed teen might exercise, talk with friends, take a nap, have a good cry, or write in a journal to relieve stress.

Instead, cutting and other low ranking coping strategies are hastily adopted because our teens have no time, support, or creativity to develop better coping mechanisms.

Cutting Is A Symptom

It’s important to think of cutting as a symptom, which means it is secondary to a core problem. The core problem is that fewer teens have an opportunity to experience full and healthy development in a reasonably (not overwhelmingly) challenging environment.

Externally, our teens are under too much pressure. Internally, our teens lack sufficient emotional development to help them cope with it.

External stressors are numerous, varied and interrelated. Teen girls today experience much more stress than what was common in their parents’ generation. Much more than boys, girls put themselves under extraordinary pressure to be super smart, super attractive, and super well-liked (preferably adored) by everyone. Not an easy list to master.

Additional heavy hitting stressors: getting into “a good” college, not letting people down, looking attractive, looking stylish, being thin, being really, really good at everything, keeping up with commitments, keeping up with expectations, and lastly: surviving it all to get a good job so they can work even more…for the rest of their lives.

The combination of way too much stress and too little time for healthy development drives the cutting epidemic. Cultivating good, solid, healthy coping behaviors requires time, support from others, and a new way of thinking about authentic and sustainable success.

In my next blog, I will clear up common misconceptions about cutting, while offering ways to support teens in creating better coping and healthier lifestyles. We’ll also catch up with Molly, who is doing extremely well today and has trouble believing she ever cut herself to feel better.

Cutting to Cope Part Two

How to identify, respond, and seek help for cutting behavior in teenage girls.

Published on January 23, 2013 by Lucie Hemmen, Ph.D. in Teen Girls: A Crash Course

Molly Cuts Herself to Feel Better

In Part 1 of this series, you met Molly, a high performing 16- year-old in her junior year of high school.  On the outside, Molly looked like she had it all together.  On the inside, Molly struggled with feelings of anger and sadness.  She used self-cutting as a way to feel better.

“It started as an impulse. Of course I knew a lot of girls who cut so the idea came to me and I started with a paper clip.  I ran it along the inside of my arm until it made a mark.  Then I went deeper until I made myself bleed.  It was totally engrossing and I can’t explain why but it made me feel better.  I graduated to straight edge razors and, at the time, it seemed perfectly fine to me.  It was a little secret compartment of my life where I had all the power and control.”

What to Look For

Molly’s mom found out about Molly’s self-cutting one day upon encountering her daughter emerging from the shower.  Even though Molly chose to cut on her belly and upper thighs as an attempt to keep her behavior an absolute secret, a chance meeting in the bathroom revealed her behavior.

Like a lot of parents, Molly’s mom was shocked and horrified.  The encounter triggered a heated interaction that left both parties stunned and wary of one another.

While Molly was committed to keeping her behavior a secret, I have heard other girls say that they test people to see if they will notice the cuts.  “My friends noticed right away and confronted me, but I think my parents looked the other way.”

Indeed the parents of this teen girl later shared, “We suspected something was going on but didn’t know how to handle it.  The idea of self-cutting is foreign to us and so how do we approach a topic we can’t fathom?”

In other cases, parents find out about the cutting through the peripheral support system. Teachers, coaches, friends of the teen or parents of the teen’s friends learn of the behavior and call it to the attention of parents:

“Thank God my daughter’s coach talked to me about Brandi’s cutting. I was really upset but had time to get myself together before talking to Brandi about it. I got her in to a counselor right away.”

The way a teen dresses, especially when it represents a change, can serve as a red flag for self-cutting:

“When my tank top wearing Hanna began wearing long sleeves everyday, no matter what the weather, I knew something was off.”

Cutting paraphernalia can also tip parents off to the secret:

“At first I didn’t put 2 and 2 together. I would see paper clips partially opened in the bathroom or an exacto knife out on my daughter’s desk. I didn’t really think much of it.  Then, I heard a reference to self-cutting on a television show and it hit me. I needed to have a conversation with my daughter.”

Understandably, when parents learn about the behavior, emotions run wild creating a huge risk for a bad interaction. You can avoid that!  In fact, your response could be the best thing that’s happened to your relationship with your daughter since you put glow in the dark stars on her ceiling.

How To Respond 

Believe it or not, you have your own Pause Button and you can push it.  The last thing you want to do when you find out or suspect your daughter is self-cutting is to hurry into any interaction.

Instead:  Pause.  Breathe. Restabilize.

This is tough because learning your child is hurting herself, on purpose, to feel better is as jarring as a dunk in an Alaskan ice pond. Parents feel an icy horror and panic that is hard to direct productively.

A solid rule of thumb when it comes to shocking news is to pause and focus on stabilizing yourself first. If you allow your feelings about the shocking news to propel you into an interaction, it will surely go badly.

Pausing allows your brain to recover and begin working properly.  Pausing allows you to move out of your brainstem (fight/flight/freeze) and into your pre-frontal cortex, the thinking part of the brain.

To further re-stabilize yourself, you can:

  • Take time to process the information
  • Take time identify and acknowledge your feelings
  • Talk to supportive friends
  • Consult a professional on the subject
  • Prepare your approach to your teen

When confronting your teen, it is crucial to be gentle, direct, and concise.  Name what you see, suspect, or have been told without inundating your teen in too many words or your emotions:

“Honey, I see cuts on your arm”/ “Honey, Bella’s mom called to tell me you’ve been cutting yourself.”

Then, make sure your daughter understands that you are her ally and not an enemy intruder, from whom she must hide:

“Even though I’m very concerned, I want you to know that I love you and am committed to helping you with anything you’re struggling with.”

Follow up with:

“Can you talk to me about this?  I would like to understand things from your perspective.”

Your teen may or may not open up to you about the behavior.  If she does, breathe and regulate your own emotions so she can feel safe bringing you into her vulnerable secret.

If she doesn’t, don’t push too hard and instead let her know you will try again the next day, after she’s had a chance to settle her feelings.

Follow up by again gently but directly approaching her for discussion:  “Honey, I realize how difficult it is to you to talk to me about this.  I assure you, YOU and your well being are my interest.  I’m always with you and never against you.”   Be the Dalai Lama of composure while she exposes her secret coping behavior to the light of your love and compassion.

This is no time to let your anger out.  Process that with a friend or your own therapist.  Consider having a few sessions to get support if you don’t go to therapy already.

As you listen to your daughter, don’t worry about saying anything brilliant or resolving anything.  Just thank her for sharing and let her know she deserves to find healthier ways of coping.  You will help her.

Seek Help

Upon first hearing of cutting, many people assume it has something to do with a suicide attempt or suicidal feelings. While some girls who self-cut may have suicidal thoughts and feelings, for many, self-cutting is a separate and unrelated behavior:

“I cut to feel better!  Not to kill myself.”

This being said, it is possible for cutting behavior to escalate, creating risk of harm from cutting too deeply or infection.  Additionally, if a self-cutting girl becomes suicidal, she is at risk.

“I told my mom about my cutting when I got scared.  My impulse was to cut deeper and deeper and I got freaked out that I’d end up killing myself.”

Whether a teen who is self-cutting is also suicidal or not, this is a perfect time for therapy!  In therapy, the teen girl can learn about her internal life of emotions and how to respond to her emotions in healthy and productive ways!

In time, cutting will fade as her “go-to” and she will instead do things like:  express herself  verbally, write in a journal, use exercise as a way to move her emotions and her body, use self reflection as a way to appreciate and explore the range and nuance of her feelings.

Teen girls who are resistant to therapy can be guided toward at least a few sessions when you say something like:

“Taking care of your emotional health is every bit as important as taking care of your physical health.  Cutting yourself is a way you are handlingstress or difficult feelings and I want you to see a professional so that you can learn other ways to express and take care of yourself.”

Requesting her participation in at least 5 sessions gets resistant girls in the door.  If the therapist is good and knowledgeable about teens, she will likely agree to more sessions and derive benefit from the self-exploration.

Lifestyle Review

Girls who self-cut often have lifestyles that are too stressful, or lifestyles that lack healthy balance. If your daughter is doing too much, she will need your help and support in trimming her time commitments. 

Replacing commitments with rest, fun, family time, and social time reaps big rewards for stressed out teens.  They need these things for their healthy development.

If your daughter is doing too little, sucked into too much screen time or has too much time to get into trouble, she needs more to do.  Give her a choice but make sure she adds meaningful activities to her schedule such as yoga, kick boxing, an art class, jewelry making, martial arts, a writing group, some kind of volunteer work, or whatever aligns with her interest.

Remember Molly?

“Learning different ways to cope was huge for me and that was my focus in therapy.  Why do kids learn about physics and history but not about how to deal with being a person?  Everyone has to deal with having feelings but no one is taught how to do that.  At this point, I can’t believe I cut myself to feel better.  And I never even felt bad about it at all.  Now, I live a really healthy, balanced life and I have lots of ways of taking care of myself.  For girls who cut themselves, I just say parents need to be very compassionate and realize that those girls need love and help to find better ways to deal with stuff.  Like I did.”