Cutting starts with emotional damage

Teenage girls who cut — inflict superficial wounds on themselves, usually with a razor — are driven by deeper, emotional wounds.

Without good coping skills, they cut as a way to deal with intense, difficult issues in their lives.

Baton Rouge mental health professionals say they’re hearing reports from school counselors of an increase of girls cutting themselves — a behavior that occurs at all income levels and in all types of family situations.

“It’s definitely increasing, not just at the middle school, but in elementary,” said Laura H. Choate, LSU associate professor of counselor education who recently published “Adolescent Girls in Distress.”

While there aren’t statistics for this area, “nationally, 17 percent will self-injure themselves” a figure that includes men and women, said Tiffany Thibodeaux, a local licensed professional counselor.

“Boys are more likely to beat themselves or punch walls over and over,” she said. “Girls cut.”

“They do feel guilt and shame about it,” Thibodeaux added. “They can’t think of anything else to do.”

There can be many reasons behind the behavior.

Many teens who cut themselves have been sexually abused, the experts said. Others feel isolated, suffer from low self esteem, are being bullied or are suffering stressful situations at home or in school.

Termed non-suicidal self-injury by healthcare professionals, cutting becomes a coping behavior when a teen cannot adjust to her situation.

“It’s how they cope with depression, anxiety and stress,” said Thibodeaux, who treats girls ages 13 to 17 struggling with the issue.

“A lot of them don’t want to cut. It’s not their ultimate goal. They do want to feel better,” said Dr. Amy Dickson, assistant professor of psychiatry at the LSU Health Sciences Center, New Orleans.

“It can be feeling a lack of control in their life: ‘I can’t control my circumstances now (but) this is something I can control,’” said Amanda Chapoton, licensed professional counselor with Brandon P. Romano, Psy.D, and Associates.

Dickson said for another group of adolescents and teens, cutting is almost an “in” thing, a way to be cool. That trend, she said, appears to be declining in the New Orleans area.

Getting help

It’s vital for the person who cuts “to find a therapist that is familiar with trauma and is comfortable with the issue of cutting,” Chapoton said.

The youngster needs to trust and respect his or her counselor.

Thibodeaux tells parents: “Let them come two times (to see a particular counselor), and if they don’t connect, find someone else.”

“For these kids, it’s very important to have a positive view of counseling,” she said.

A type of cognitive behavioral therapy called dialectical behavior therapy is helpful in treating the behavior, counselors said.

Choate said the therapy includes:

Learning to identify patterns of behavior that lead to cutting and how to interrupt them.

Being mindful of how one is feeling.

Learning to decrease intense emotions.

Developing distress tolerance, with self-soothing

Learning social skills and assertiveness.

While it’s frightening for parents to learn their child is cutting, education about it can be a vital bridge to healing.

“One of the things we really encourage parents (to do) is to come from a place of concern, ‘We’re going to get you help,’” Chapoton said.

Counselors offer these thoughts for parents:

Cutting is considered non-suicidal behavior.

“It’s not an attempt to commit suicide. It’s the opposite,” Choate said, adding the child sees it as a way to keep living.

If a parent learns a child is cutting, get help with a counselor who treats the behavior and with whom the child can trust and connect with.

Focusing on the cutting doesn’t address the underlying emotional issues. Even if parents believe their daughter has stopped cutting, without therapy, the emotional issues behind the cutting remain.