Teen Girls: A Crash Course

Conflict, communication, and connection with your daughter

Cutting to Cope Part Two

How to identify, respond, and seek help for cutting behavior in teenage girls.

Molly Cuts Herself to Feel Better

In Part 1 of this series, you met Molly, a high performing 16- year-old in her junior year of high school.  On the outside, Molly looked like she had it all together.  On the inside, Molly struggled with feelings of anger and sadness.  She used self-cutting as a way to feel better.   

“It started as an impulse. Of course I knew a lot of girls who cut so the idea came to me and I started with a paper clip.  I ran it along the inside of my arm until it made a mark.  Then I went deeper until I made myself bleed.  It was totally engrossing and I can’t explain why but it made me feel better.  I graduated to straight edge razors and, at the time, it seemed perfectly fine to me.  It was a little secret compartment of my life where I had all the power and control.” 

What to Look For

Molly’s mom found out about Molly’s self-cutting one day upon encountering her daughter emerging from the shower.  Even though Molly chose to cut on her belly and upper thighs as an attempt to keep her behavior an absolute secret, a chance meeting in the bathroom revealed her behavior.

Like a lot of parents, Molly’s mom was shocked and horrified.  The encounter triggered a heated interaction that left both parties stunned and wary of one another.

While Molly was committed to keeping her behavior a secret, I have heard other girls say that they test people to see if they will notice the cuts.  “My friends noticed right away and confronted me, but I think my parents looked the other way.”

Indeed the parents of this teen girl later shared, “We suspected something was going on but didn’t know how to handle it.  The idea of self-cutting is foreign to us and so how do we approach a topic we can’t fathom?”

In other cases, parents find out about the cutting through the peripheral support system. Teachers, coaches, friends of the teen or parents of the teen’s friends learn of the behavior and call it to the attention of parents:

“Thank God my daughter’s coach talked to me about Brandi’s cutting. I was really upset but had time to get myself together before talking to Brandi about it. I got her in to a counselor right away.”

The way a teen dresses, especially when it represents a change, can serve as a red flag for self-cutting:

“When my tank top wearing Hanna began wearing long sleeves everyday, no matter what the weather, I knew something was off.”

Cutting paraphernalia can also tip parents off to the secret:

“At first I didn’t put 2 and 2 together. I would see paper clips partially opened in the bathroom or an exacto knife out on my daughter’s desk. I didn’t really think much of it.  Then, I heard a reference to self-cutting on a television show and it hit me. I needed to have a conversation with my daughter.”

Understandably, when parents learn about the behavior, emotions run wild creating a huge risk for a bad interaction. You can avoid that!  In fact, your response could be the best thing that’s happened to your relationship with your daughter since you put glow in the dark stars on her ceiling.

How To Respond 

Believe it or not, you have your own Pause Button and you can push it.  The last thing you want to do when you find out or suspect your daughter is self-cutting is to hurry into any interaction. 

Instead: 

Pause.  Breathe. Restabilize.

This is tough because learning your child is hurting herself, on purpose, to feel better is as jarring as a dunk in an Alaskan ice pond. Parents feel an icy horror and panic that is hard to direct productively.

A solid rule of thumb when it comes to shocking news is to pause and focus on stabilizing yourself first. If you allow your feelings about the shocking news to propel you into an interaction, it will surely go badly.

Pausing allows your brain to recover and begin working properly.  Pausing allows you to move out of your brainstem (fight/flight/freeze) and into your pre-frontal cortex, the thinking part of the brain.

To further restabilize yourself, you can:

  • Take time to process the information
  • Take time identify and acknowledge your feelings
  • Talk to supportive friends
  • Consult a professional on the subject
  • Prepare your approach to your teen

When confronting your teen, it is crucial to be gentle, direct, and concise.  Name what you see, suspect, or have been told without inundating your teen in too many words or your emotions:

“Honey, I see cuts on your arm”/ “Honey, Bella’s mom called to tell me you’ve been cutting yourself.”

Then, make sure your daughter understands that you are her ally and not an enemy intruder, from whom she must hide:

“Even though I’m very concerned, I want you to know that I love you and am committed to helping you with anything you’re struggling with.”

Follow up with:

“Can you talk to me about this?  I would like to understand things from your perspective.”

Your teen may or may not open up to you about the behavior.  If she does, breathe and regulate your own emotions so she can feel safe bringing you into her vulnerable secret.

If she doesn’t, don’t push too hard and instead let her know you will try again the next day, after she’s had a chance to settle her feelings.

Follow up by again gently but directly approaching her for discussion:  “Honey, I realize how difficult it is to you to talk to me about this.  I assure you, YOU and your well being are my interest.  I’m always with you and never against you.”   Be the Dalai Lama of composure while she exposes her secret coping behavior to the light of your love and compassion. 

This is no time to let your anger out.  Process that with a friend or your own therapist.  Consider having a few sessions to get support if you don’t go to therapy already.

As you listen to your daughter, don’t worry about saying anything brilliant or resolving anything.  Just thank her for sharing and let her know she deserves to find healthier ways of coping.  You will help her.

Seek Help

Upon first hearing of cutting, many people assume it has something to do with a suicide attempt or suicidal feelings. While some girls who self-cut may have suicidal thoughts and feelings, for many, self-cutting is a separate and unrelated behavior:

“I cut to feel better!  Not to kill myself.”

This being said, it is possible for cutting behavior to escalate, creating risk of harm from cutting too deeply or infection.  Additionally, if a self-cutting girl becomes suicidal, she is at risk.

“I told my mom about my cutting when I got scared.  My impulse was to cut deeper and deeper and I got freaked out that I’d end up killing myself.”

Whether a teen who is self-cutting is also suicidal or not, this is a perfect time for therapy!  In therapy, the teen girl can learn about her internal life of emotions and how to respond to her emotions in healthy and productive ways!

In time, cutting will fade as her “go-to” and she will instead do things like:  express herself  verbally, write in a journal, use exercise as a way to move her emotions and her body, use self reflection as a way to appreciate and explore the range and nuance of her feelings.

Teen girls who are resistant to therapy can be guided toward at least a few sessions when you say something like:

“Taking care of your emotional health is every bit as important as taking care of your physical health.  Cutting yourself is a way you are handling stress or difficult feelings and I want you to see a professional so that you can learn other ways to express and take care of yourself.”

Requesting her participation in at least 5 sessions gets resistant girls in the door.  If the therapist is good and knowledgeable about teens, she will likely agree to more sessions and derive benefit from the self-exploration.

Lifestyle Review 

Girls who self-cut often have lifestyles that are too stressful or lifestyles that lack healthy balance. If your daughter is doing too much, she will need your help and support in trimming her time commitments. 

Replacing commitments with rest, fun, family time, and social time reaps big rewards for stressed out teens.  They need these things for their healthy development.

If your daughter is doing too little, sucked into too much screen time or has too much time to get into trouble, she needs more to do.  Give her a choice but make sure she adds meaningful activities to her schedule such as yoga, kick boxing, an art class, jewelry making, martial arts, a writing group, some kind of volunteer work, or whatever aligns with her interest.

Remember Molly?

"Learning different ways to cope was huge for me and that was my focus in therapy.  Why do kids learn about physics and history but not about how to deal with being a person?  Everyone has to deal with having feelings but no one is taught how to do that.  At this point, I can’t believe I cut myself to feel better.  And I never even felt bad about it at all.  Now, I live a really healthy, balanced life and I have lots of ways of taking care of myself.  For girls who cut themselves, I just say parents need to be very compassionate and realize that those girls need love and help to find better ways to deal with stuff.  Like I did.”

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For more information about Dr. Lucie Hemmen and her practice, you can visit her website at www.luciephd.com or join her on Facebook at www.facebook.com/luciephd

 

Lucie Hemmen, Ph.D. is a clinical psychologist and author of the book Parenting a Teen Girl.

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