One concerning thing that I find myself working with a decent number of folks on is cutting. It seems more common than I would have thought, especially in adolescents and young adults. It's not a new phenomenon, but it does seem to be happening more now because kids are hearing about it and trying it out for themselves. While overall it is still a socially unacceptable practice, I think there likely is more acceptance of it with adolescent peers. I haven't gotten the impression that it is considered "cool", but I think there is less stigma around it in the younger population.
Cutting is something I have never been inclined to do. In order to better understand it, I've had to do research and also get information from folks I work with who do it. Cutting typically IS NOT simply a cry for attention. Most of the time when folks do it, they do it on a part of their body that is relatively easy to conceal (arms, upper legs, sometimes abdomen) because they don't want other folks to find out. If it isn't a cry for attention or help, then why do people do it?
I almost didn't include this image. It's hard to look at. However, this topic is hard to talk about anyway, and this is the main reason people do it. Although it seldom lasts long, individuals who cut swear that it takes away their mental/emotional pain, even if only for a minute. Physical pain (of any sort) causes the release of endorphins in our bodies that act to reduce pain. When an individual causes physical pain and then goes through the healing process for it, they feel better and are able to temporarily ignore their emotional pain. A cut or cuts may represent the emotional pain they experience, but are easier to manage. It can also give people some sense of control over the pain in their body. Finally, a physical cut is something that can be seen, it is real; although emotional pain is absolutely as real, because we can't see it it may feel less real to some people.
Cutting is generally not a suicide attempt. However, it is still a risky practice and so one we want to stop and prevent. Cutting may result in scarring that will be present the rest of the life, and most people really don't want that. While I have heard people state that they want the scars to remind them of what they have been, in most cases this isn't a permanent sentiment. More importantly, cutting can result in unintentional injury, sometimes of a serious nature. A cut that accidentally goes too deep or hits a major vessel can become an emergency situation.
Treatment for cutting involves identifying and implementing alternative coping skills. While we absolutely should communicate to people who are cutting that it is not a healthy practice, and parents absolutely can limit access to devices to cut with (although, honestly, if someone wants to cut they will find something - in a pinch paper will do the trick), people will not stop until they have other ways to deal with their emotional pain. I don't believe punishment for cutting is appropriate, other than taking away objects they can use which may include personal property like pocket knives. Folks who cut should be approached with care and compassion, and psychotherapy is the best treatment. For those of us who don't understand it, cutting can be a really scary practice. Fortunately, it is a practice that can be halted with supportive therapy.
