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Princess Diana shocked the world when she revealed she intentionally cut her arms and legs and had thrown herself down a flight of stairs on more than one occasion.

After that interview thousands of self-injury survivors called or wrote the media in response to that interview in just the United States alone.

Dianne, Age 30, Canada

"I hurt myself for different reasons, depending on my state of mind. I do it sometimes as a way to get relief from the pain I am feeling inside. Other times I do because at the time I feel I deserve to be punished, or I am angry at myself, but really I think someone else. Other times I do it to "shout out" to the world that I need help and here is the proof. I am an incest survivor, so I think that it's some of the pain that I have had to live with trying to escape my body.



Skin cutting
Banging or hitting body parts
Interfering with wound
Hair pulling (trichotillomania)
Ingestion of toxic substances
or objects.

Chrissy, Age 17, USA

"I cut myself because I feel so much pain inside that I need a way to release it all. Cutting acts as an outlet for that l pain, I guess, somehow. It feels like it's all running out of me when I see myself bleeding. I know that probably sounds gross to most people who don't do this."

Self-harm (SH) or deliberate self-harm (DSH) includes self-injury (SI) and self-poisoning and is defined as the intentional, direct injuring of body tissue without suicidal intent. Older literature almost exclusively refers to self-mutilation. ~ From Wikipedia, the free encyclopedia


Suicide is not the intention of self-harm. Self-harming behavior may be potentially life-threatening depending on the severity of injury. There is an increased risk of suicide since Self-harm is found in 40–60% of suicides. But those who self-harm generally are not suicidal.
Self-harm is often a response to profound and overwhelming emotional pain. Those who self-harm cannot seem to resolve their “pain” in an emotionally healthy way so they use it as a coping mechanism to provide temporary relief from anxiety, depression, stress, emotional numbness, or a sense of failure or self-loathing. There is also a positive statistical correlation between self-harm and emotional abuse. Self-harm may become a means to manage pain, in contrast to the pain of abuse they may have experienced earlier in life over which they had no control.


ESSORTMENT – Information and advice 

Tattoos and Body Piercing: Adolescent Self-Expression or Self-Mutilation? 

Recommended Reading
“A Bright Red Scream: Self-mutilation and the Language of Pain” by Marilee Strong
ISBN 0-14-028053-7
Includes a treatment and informational resources section.


It is estimated that one in every 200 girls in the U.S. between 13 and 19 years old, or one-half of one percent, cut themselves regularly. Those who cut comprise about 70 percent of teen girls who self injure.

In the U.S. up to 4% of adults self-harm with approximately 1% of the population engaging in chronic or severe self-harm. The rates of self-harm are much higher among young people with the average age of onset between 14 and 24. The earliest reported incidents of self-harm are in children between five and seven years old. (

There appears to be an increased risk of self-harm in college students. 9.8% of the undergraduate students in the U.S. surveyed indicated they had purposefully cut or burned themselves on at least one occasion in the past. When including head-banging, scratching oneself, and hitting oneself along with cutting and burning, 32% of the sample said they had done this.

Kids generally start cutting during their teenage years but may begin cutting as a pre-teen. Kids who cut are not going through a phase. They may adjust as they mature but typically need help to stop cutting. Cutters do not cut to attract attention since they are typically secretive about their cutting and cut in areas that can be concealed with clothing. Cutters are also found in every income level and every social stratum

Treatment visits for teens that self injure continue to increase. Numbers are expected to grow as life becomes more complex for teenagers. Directors at self-injury treatment programs refer to self-harm as an epidemic that reaches even into middle schools.


Profile of a Typical Cutter

A female in her mid-20's to early 30s, and has been cutting herself since her teens. She is intelligent, middle or upper-middle class, and well educated. She is from a home where she was physically and/or sexually abused and has at least one alcoholic parent.

Age of onset is typically from 10 - 16 years old with a major change in the teen's life (e.g., parents divorce or death). There is typically a history of family violence, abuse (verbal or physical), or sexual abuse and intense feelings of fear, hurt, anger, rejection or abandonment, feelings of loss and or need for control.

Substance abuse is considered a risk factor and cutters typically have poor problem solving skills and are impulsive. Those with borderline personality disorder, clinically depressed, phobias, or conduct disorders have increased risk. Up to four times as many females as males self-harm. There is difficulty getting info on male self harmers since males may engage in different forms of self-harm which could be easier to hide or explained away. Men typically burn and hit themselves while women typically cut and burn themselves.


• Don’t react with anger
• Don’t deny the problem
• Don’t assume this is a "phase" your teen will outgrow
• Don’t blame yourself (unless you know you deserve it)
• Don’t ask why they are cutting
• Don’t try to hide sharp objects. It won’t work.

• Admit you and your child need help
• Take the problem very seriously
• Understand this is not just attention-seeking behavior
• Be completely supportive and immediately seek treatment for your child

Gender and Age Differences

The highest rate among females is in the 13–24 age groups. The highest rate among males is in the 12–34 age groups. ~ World Health Organization

There is no difference in motivation for self-harm in adolescent males and females. For both genders there is an incremental increase in deliberate self-harm associated with an increase in consumption of cigarettes, drugs and alcohol. There is a statistical correlation between self-harm and emotional abuse.

Gender and Age Findings


A study in 2003 found an extremely high prevalence of self-harm among 428 homeless and runaway youth (age 16 to 19) with 72% of males and 66% of females reporting a past history of self-harm. In 2008, a study of young people and self-harm saw the gender gap close, with 32% of young females, and 22% of young males admitting to self-harm. Studies indicate that males who self-harm may be at a greater risk of completing suicide. Common triggering factors are low self-esteem and having friends and family members who self-harm. Females are more likely to explain their self-harm episode by saying that they had wanted to punish themselves.


In the United Kingdom, 5.4% of all the hospital's self-harm cases were aged over 65. Rates for males and females over 65 in the local population were identical. Over 90% had depressive conditions, and 63% had significant physical illness. Less than 10% of these patients had a history of self-harm. The study suggested that older people who self-harm are at a greater risk of completing suicide. Sadly, 1 in 5 elderly who self-harm continue on to end their life

Prison Inmates

Deliberate self-harm is prevalent in prison populations. The typical motive for prisoners is that they wish to avoid physical confrontations and may resort to self-harm as a ruse to convince other prisoners that they are dangerously insane, that they are resilient to pain, or they want protection from the prison authorities.


Common Reasons for Cutting

They find it soothing
They want to feel pain on the
outside instead of the inside
They are making an effort to cope
with feelings
They do it to express anger
towards themselves
They do it to feel alive and real

~ ~ ~

Is Cutting A Mental Disorder?

Self-harm is listed in the Diagnostic and Statistical Manual of Mental Disorders as a symptom of borderline personality disorder. Patients with other mental disorders may also self-harm, including those with depression, anxiety disorders, substance abuse, eating disorders, post-traumatic stress disorder, schizophrenia, and personality disorders. Self-harm is also apparent in high-functioning individuals with no underlying clinical diagnosis. Cutting is used as a coping mechanism which provides temporary relief of intense feelings such as anxiety, depression, stress, emotional numbness and a sense of failure or self-loathing.

Motivations of Self-Harm


Environments where parents punish children for expressing sadness or hurt
Abuse during childhood, bereavement, and troubled parental or partner relationships
War, poverty, and unemployment may also contribute
Some with developmental disabilities such as autism engage in self-harm, although this may be a form of self-stimulation
Some self-harm to draw attention to their need for help and to ask for assistance in an indirect way
Some attempt to affect others and to manipulate them in some way emotionally
Those with chronic, repetitive self-harm often do not want attention and hide their scars carefully
Some cutters say it allows them to "go away" or dissociate, separating the mind from feelings that are causing anguish.
The physical pain acts as a distraction from the emotional pain
The paradox is to harm oneself to obtain relief
For some the relief is psychological. For others relief comes from the beta endorphins released in the brain
Endorphins act as painkillers, induce pleasant feelings, and act to reduce tension and emotional distress
Many report feeling very little to no pain while self-harming and, for some, deliberate self-harm may become
a means of seeking pleasure


What else should I know?

Those who self-harm sometimes describe feelings of emptiness or numbness (anhedonia), and physical pain may be a relief from these feelings. A person may have feelings of detachment from self, detached from life, numb and unfeeling which may trigger a need to feel real again. As a coping mechanism, self-harm can become psychologically addictive because it works to block stress. The patterns sometimes created by it, such as specific time intervals between acts of self-harm, can also create a behavioral pattern that can result in a craving to fulfill thoughts of self-harm.

Self-injury is usually kept secret, and the "cutter" often feels deep shame and guilt. Many who self-injure wear long pants, long-sleeved shirts, and turtlenecks even in warm weather to conceal the marks they've left on their bodies. Many self-harmers fear being discovered.

Cutting is the most common type of self-injury. Cutters use whatever they can find to make repetitive slices on their arms, legs or other body parts. Many people who self-injure say cutting helps them to feel alive and/or have a sense of control. Most say their incidents of self-injury are triggered by stress and anxiety. Self-harm is most common among people who have been sexually abused as children, molested as children, or are survivors of incest. Self-harm can be traced back to a serious assault on one or more of our five world views

World Views / Core Values

Our belief in a just and fair world
Our value in trusting others
Our need for self efficacy / self esteem
Our need for safety
A belief in God or some supreme being

How Our World Views and Core Values are Affected

Self-harmers believe what was done to them was not just and fair
It is difficult for them to trust others
An assault on self efficacy and self esteem can result in insecurity and self loathing
They may believe they will never be safe
They may have no interest in God because God did not (or does not) protect them from their abuser

What to Look For

80% of self-harm involves stabbing or cutting the skin with a sharp object. Self-harm methods may include burning, self poisoning, alcohol abuse, self-embedding of objects and forms of self-harm related to anorexia and bulimia. The locations of self-harm are often areas of the body that are easily hidden and concealed from the detection of others.
It may be accurate to define self-harm in terms of the intent, and the emotional distress that the person is attempting to deal with. They may give verbal and/or behavioral suicide type clues that indicate that they are distressed. It may be accurate to define self-harm in terms of the emotional distress that the person is attempting to deal with.

Common Triggers for Cutting


Being rejected by someone who is important to them

Being blamed for something over which they had no control

Feeling inadequate

Real or imagined guilt over some incident


Parents who discover their child is cutting typically are shocked and immediately blame themselves for failing as a parent. Therapists say that parental self-blame is NOT helpful. Cutting is a behavioral sign of a deeper underlying problem. The goal should not be to get your child to "stop cutting," but to treat the deeper problem so your teen develops more mature coping skills and no longer feels the need to self-injure.

Talk to your doctor or your local public health department to find a mental health treatment program that can help. Understand that treatment probably won't simply be a matter of medication and/or a few visits with a therapist. Understand that treatment often includes medication combined with individual and family therapy over a sustained period of time. Understand that a therapist may use psychotherapeutic drugs during treatment.

Don't assume that your child is "okay" once he or she is in treatment and making progress. Understand that setbacks are not uncommon. Understand that episodes typically become less and less frequent the longer a teen is in treatment. Provide a card that allows sufferers to make emergency contact with a friend or a counseling service.


Suggestions for Self-Help

Hold an ice cube in the palm of your hand as an alternative to cutting
Wear a rubber band around your wrist or ankle that can be “snapped” to induce a sharp sting
Try journaling, taking a walk, participating in sports, exercise, or being around friends when you have the urge to harm yourself
Get rid of objects used for self-harm to make it more difficult to find a way to harm yourself
Tell somebody - a sibling, a friend, a parent or relative, anyone you can talk to
Overcome your shame by admitting your problem
Let a mental health counselor help you identify what triggers your cutting behavior
Ask for help from your parents, a medical professional, a school counselor, or any adult you trust and tell them you want to stop cutting
Stay with it; breaking your cutting habit will not be easy
With treatment, you can learn more healthy way to deal with stress and negative emotions


 © 2002, Ron Richardson



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