Kids Who Cut

The issue of self-injury has become increasingly visible in the world of adolescents and young adults in recent years. Profiled on daytime talk shows, celebrated on countless Web sites where cutters can post their painful poetry and pictures, sung about in pop songs, written into the plots of movies and music videos, revealed as part of the secret world of celebrities…self-injury is going mainstream, and is likely to remain part of the cultural landscape for the foreseeable future. We can no longer pretend this is a fringe issue that occurs only in the most extreme cases.

It’s an unusual teenager who doesn’t know a self-injurer or two. School counselors, athletic coaches, church youth workers, EMTs, probation officers…anyone who works with kids will tell us it’s happening all around us, and we can’t pretend it’s not.

There seems to be solid evidence that the problem of self-injury is not merely becoming more visible but actually becoming more prevalent. In 1998 Steven Levenkron wrote Cutting: Understanding and Overcoming Self-Mutilation, one of the first books addressing the issue of self-injury. Levenkron was seeking to introduce the world to a phenomenon he believed was beginning to become part of North American youth culture.

A highly credible expert in the field, Levenkron had clearly done his homework. His book remains a standard text in the understanding of self-injury. In the preamble to his book, Levenkron estimated that self-injury was an issue for about one in every 250 teenage girls just over one-half of one percent. His book suggests that self-injury was not an issue for guys at the time.

There’s no reason to believe Levenkron’s estimates were inaccurate. As shocking as the behavior itself was, the statistics really didn’t cause many people to stop and take notice. However, in the first few years of the twenty-first century, there was a haunting sense among those of us who worked closely with teenagers that the numbers were growing. We didn’t really have statistical support for this sense that self injury was quickly becoming a much more significant problem until Princeton and Cornell Universities published the findings of a major study done among their student bodies in 2006. Their study of more than 3,000 college students showed that approximately 17 percent (one in five girls, and one in seven guys) had self-injured at some point in their young lives. This represents an increase of epidemic proportions from the number Levenkron reported just 10 years earlier.

Furthermore, the 2006 study indicated (to no one’s surprise) that most of the people who said they had hurt themselves had done so secretly. Their behavior was a carefully guarded secret that no one knew about. It seems that most self-injury is done very privately and stays conveniently concealed under long-sleeved shirts, camouflaged behind a jumble of bracelets and bangles, or hidden away on a teenager’s thigh or tummy. Obviously, this means that when we hear numbers from school counselors, youth pastors, or others who work directly with students, we can safely assume the self-injuring kids they know represent only the tip of the iceberg. For every cutter who is identified, it’s likely there are several others who are suffering alone without anyone to offer support, encouragement, and understanding.

A hint for helpers
When we read statistics like this, it’s easy to assume every kid we know is a potential self-injurer. I want to caution you not to be paranoid but to be intentionally observant. Paranoia strips much of the joy from this delightful ministry we have of working with teenagers. Let kids know you’re comfortable talking about tough topics, communicate compassion in all you do, and help them realize you’re not perfect. You’ll find you have plenty of opportunities to talk to kids about the hurt in their lives, whether they are self-injuring or not.

Sometimes the family looks pretty good
Unfortunately, family circumstances and external appearances aren’t always good indicators of whether someone is a self injurer. While many self-injurers have chaotic family situations, there are other kids I know whose families and life circumstances seem stable and positive, yet they turn to self-harm as a way of dealing with something that’s going on inside. The chaos of divorce, poverty, substance abuse, and mental illness that defined Kelly’s environment made her self-destructive choices at least somewhat understandable. But what about those kids who come from homes that appear to be healthy and functional, yet still turn to self-harm as a way of coping?

Meet Andy, an athletic, handsome 17-year-old who is at the top of his class academically and maintains an active social life amidst all his scholastic and sports activities. When you first look at this guy, you’d never guess that over the last four years he has been regularly cutting, burning, and bruising his own body without anyone finding out. Andy came to see me only after the coach of his basketball team saw bloodstains on a T-shirt, asked some questions, and insisted that Andy needed help. As his story unfolded, I found out Andy’s dad is a successful businessman with a high profile in the community. Andy’s father is a “self-made man” who had nothing when he migrated to North America in his early 20s. Hard work and perseverance made him the success he is today. Andy’s mom is a bubbly, outgoing socialite who volunteers at the church and in the school. They live in an upscale suburb where success is measured by the size of your backyard pool. What would cause a guy living in that kind of fairy-tale environment to hurt himself like Andy does? Perhaps this journal entry will give us a bit of a clue:

"I’ll never be good enough—not sure why I even bother trying. Can’t handle feeling like a loser every day. I’m not sure I deserve to be in this family of amazing people. Maybe if he’d just show up to one of my games sometime he could be happy with me. Screw it—It’ll never happen. Who am I tryin to kid?"

Choose Your Pain
For most kids who self-injure, it comes down to managing chronic and overwhelming emotional pain through the use of self-inflicted, short-term physical pain. The “logic” is that physical pain can be controlled while relational pain cannot. The level of cognitive distortion behind this thinking may seem obvious to others on the outside. But for the young person whose emotions have reached a breaking point, self-injury is a reasonable solution to what has, in their mind, become an intolerable situation.

Listen to how 16-year-old Britney describes the thinking process:

"With each swipe of the blade or every prick of a pin I feel my pain slowly slip away, although I know it will soon return. For one moment I feel an indescribable pain pour out from deep inside. I feel all my anger and frustrations pulling away from me, escaping me. For that moment, I’m free."

A hint for helpers
One question you may find yourself asking is: “Should I confront a teenager I have reason to believe may be self-injuring?” Obviously, there’s no simple answer, because each situation is unique. The determining factor may be the quality of your relationship with that young person. In a relationship that’s based on mutual trust and respect, you already have the kind of rapport that allows you to broach topics like this. Be gentle, asking instead of accusing, and assure your young friend that your question is based in concern not judgment.

Few people have thought through an appropriate response to the discovery that someone they know and love is caught up in this painful cycle. The first time a youth worker, teacher, or coach catches a glimpse of a freshly cut arm is often a terrifying experience that leads to lots of questions. “Should I ask about it?” “Am I the only one who knows?” “What if I say the wrong thing?” And if that feels scary, imagine the fear of parents who suddenly discover their child is involved in self-injury.

Many moms and dads who find themselves in this position report feeling terrified, numb, shamefully responsible, and ultimately paralyzed. The helplessness they experience often makes them feel like victims as well. Knee-jerk overreactions can be relationally harmful and are rarely effective. The last thing these kids need is for someone to frantically tell them that they really ought to stop doing it. But ignoring the evidence is probably worse.

So what can we do? How do we point these kids to the hope and healing we long for them to experience? It should be apparent that we must not belittle the reality of these kids’ circumstances or the depth of their pain. Healing will never be achieved through our reciting pat answers and spiritual-sounding clichés. There is no room for condescending judgment or morbid curiosity.

The only way to participate in the healing journey of a young person who is self-injuring is to enter their pain through deep listening, chosen empathy, and the declared willingness to live in the mess with them. That’s something most of us can’t do on our own.

We have a great role model
The Old Testament prophet Isaiah spoke of God’s anointed deliverer who would bind up the brokenhearted, proclaim freedom for captives, and offer release from darkness for prisoners and comfort to all those who grieve and mourn (Isaiah 61:1-3).

About 700 years later, Jesus read these words during a Sabbath synagogue service to announce to his generation that this ancient prophecy would be lived out in his life (Luke 4:14-21). These vivid words, “brokenhearted, captive, prisoner, grieving” describe the world of most of the self-injurers I’ve known. Many are brokenhearted and grieving. They feel imprisoned in a desperate situation, sensing it can never be any different. They will always be vulnerable to slipping into these familiar but destructive patterns of coping. It’s a rare self-injurer who doesn’t sincerely want to stop. But they truly believe that if they were to stop the behavior their lives would quickly spin even more out of control and they’d be left with no way of managing the personal chaos they feel. That’s what I call being held captive.

What does this Old Testament prophecy about Jesus have to do with our role in the lives of these deeply hurting kids thousands of years later? If the passage refers only to Jesus’ ministry, it really has nothing to say to us. But in 2 Corinthians 5:19-20 Paul reminds us that Christ has now entrusted to us the ministry that he began:

And he has committed to us the message of reconciliation. We are therefore Christ’s ambassadors, as though God were making his appeal through us.

This passage clearly identifies us as Christ’s ambassadors, inviting us to speak on his behalf, calling people to a reconciled relationship with him. God’s desire is that we would share Christ’s heart for the misunderstood, the disenfranchised, the lonely, and the alienated. When we see deeply hurting people through Christ’s eyes and listen to them through Christ’s ears, we are in a position to respond to them with the firm gentleness and deep compassion of Christ.

This article is taken from Kids Who Cut (Zondervan) by Marv Penner. To order the book click here!