Thank you for your continued notes of appreciation for this weekly digest on what’s happening in my practice. One of the goals with this is for us all to learn from one another- you are not alone, your kid is not the only one, and there is much we can do to support one another with the ups and downs of parenting. Some topics are harder than others- this is another common and difficult one to discuss.
Kayla is a 14-year-old girl who I had been working with for a few months when she told me she had something to share. She looked nervous so before she said anything, I reassured her that whatever it was, she was not alone and that we would work through it. While looking down at the floor, she said, “I have been cutting for a while now…my parents don’t know.”
Ugh…not another one… that is what I thought in my head. I see so many middle and high school-aged kids who cut, both boys and girls, and it’s such a complex matter. Sometimes they do it in private, sometimes they do it with friends, sometimes they post it as a suicidal cry, but always they tell me that it “feels good.” Or at the very least it helps them feel something.
After Kayla shared what was going on and we talked for a bit, I encouraged her to allow her parents in and that we could discuss it with them. After some initial hesitation, she agreed. When her parents joined us and she told them they just looked at me, horrified, and asked, “But why?”
I explained to them all that cutting is typically a desperate attempt to deal with difficult feelings. It has become a part of the Millennial generation’s way of coping with strong feelings, pressure to succeed or relationship challenges. Though self-mutilation, as it was referred to when I was being trained, has been around since at least the late 1800’s, it has gained popularity in part due to YouTube and social media outlets where kids post their wounds and share their pains. I would go so far as to say that is is nearly socially acceptable among this generation due to how common it is.
Kids cut their body with razors, metal ends of pencils, needles, glass, knives and safety pics to name a few. They tend to start on their arms and then move to thighs, sometimes the back and then the abdomen. Some kids do it deep enough to leave significant scars and some do it lightly enough to barely leave a mark. Usually, this is not a suicide attempt.
Over the next few weeks, the interventions that I suggested to Kayla were reducing her cutting by a bit but not stopping it. I processed this with her parents and provided them with some education around the topic. I referred her to a clinician who runs a specialized group for adolescents who engage in self-harm. The model uses a treatment method called Dialectical Behavior Therapy (DBT). DBT is one of the most successful treatment interventions for intentional self-harm behaviors and teaches people to focus on self-regulation, relationship skills and stress management techniques.
After about 8 weeks in that program, I started seeing Kayla again. She was doing much better and was able to apply what she had learned into our work together. Just like other unhealthy forms of dealing with stress such as alcohol and drugs, Kayla found it difficult not to cut again when her stress levels increased. One in 5 children is estimated to have engaged in cutting. I encourage my clients that if they know someone who is cutting, urge them to seek professional help. Professionals need to help in this situation, this is too heavy of a burden for other kids to have to manage, which is often the case in late night texts and posts.