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August 16th, 2007

A Prescription for Parents

How do you know when your child at college needs help

 
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CUTTING

Cutting is a general term for a variety of self-injurious behaviors. If you have never been a cutter, it will be hard for you to understand why your son or daughter would want to intentionally harm him- or herself, but over two million people in the United States do just that. More than 70 percent of self-injurers are women, mostly between the ages of 11 and 26, and they come from all races and social classes. And according to my own observations the numbers are on the rise among the college-age population.

A Secret Act

Kids involved in cutting look quite normal and fit in with their peers. They are generally good students and are actively involved in the school activities. Most are ashamed of their self-inflicted injuries and are very secretive about the practice, so they often injure places that can be easily hidden by clothing, such as the arms, upper chest and upper thighs.

Their methods of injury are varied:

  • Cutting is the most common expression of this disorder. The person will use any sharp object including a razor, box cutter, knife, broken mirror, or even the flip top off a soda can to cut the skin, making a shallow cut just deep enough to draw blood.
  • Burning is also a popular method of self-injury. In this case an item such as a lit cigarette, a piece of hot metal, a lighter, or a match is used to burn the skin.
  • Scratching is a simpler method that involves using the fingernails to scratch at the skin until a wound is opened.

Why?

Self-injury is a coping mechanism. It is a way to deal with life and the emotional pain it can bring. Often the first episode of self-injury is triggered by some event that causes much tension or stress (and we know there are plenty of such events during the college years). Many of those who self-injure say they do it to release pain. Fear, anxiety, anger, isolation, sadness, loneliness, or emotional pain builds up inside until they feel like they’ll explode without some form of release—self-injury serves that purpose.

Others self-injure for exactly the opposite reason: They are numb inside and feel no emotion, so they appreciate the raw pain of injury; finally, they can feel something. In these cases, cutting can be a way to be temporarily distracted from real feelings.

“The scariest statistic that I have encountered is from American College Health Association data reporting that nine percent of all college undergraduate students seriously think about suicide.”

Some who self-injure feel a strong need to punish themselves for some perceived wrong. This is frequently the case with victims of child sexual abuse who believe on some level that the abuse was their fault. Filled with self-loathing and alienation they have an intense desire to do themselves harm.

Cutting can also be a symptom of an underlying psychiatric disorder such as depression, obsessive-compulsive disorder, Gilles de la Tourette syndrome, psychosis, borderline personality disorder, kleptomania, trichotillomania (hair pulling), eating disorder, or body dysmorphic disorder.

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The Author : Dr. Richard Kadison
Dr. Richard Kadison is the Chief of Mental Health Services at Harvard University
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