A topic that came up in one of my recent supervisory sessions involved self-injury, specifically a client who engaged in repeated cutting. The phenomenon of self-injury, particularly cutting, has its roots in the mid-1980s, where it was commonly linked to individuals with histories of childhood trauma or severe depression. For those with trauma, cutting often serves as a means to escape psychological pain by inflicting physical pain. In cases of deep depression, it acts as a reminder that they are still alive, with the sight of blood serving as proof of their existence.

Around the early 2000s, I observed what seemed like a minor epidemic of cutting behaviors among teens. During this time, cutting often served as a socialization or identity function, a way for teens to connect with one another. While the prevalence of such behaviors has decreased somewhat over the years, self-injury, particularly cutting, remains a persistent issue among both teens and adults.

For many who engage in these behaviors, there is often a connection to unresolved trauma or an inability to cope with overwhelming stress. In some cases, particularly among teens and young adults, self-injury becomes a way to signal to others that they are in crisis and in need of help.

For parents, addressing this issue can be challenging, as many teens are reluctant to share. Many cut in places that are not visible, such as areas covered by clothing, making it difficult for parents to detect the behavior. In some cases, I have observed clients switch from cutting to other forms of self-injury, such as drawing excessively on themselves or burning their skin with erasers, without others noticing.

Regardless of the specific behavior, parents should take any reported or observed self-injury seriously and either seek help or contact the teen’s therapist as soon as possible, even if the marks appear superficial. Parents should also be aware of subtle indicators, such as a teen wearing long sleeves in the summer, shavers going missing, or broken plastic items found in the teen’s room.

When approaching this sensitive issue, I advise parents to respect the delicacy of the situation, considering the shame and guilt often associated with self-injury. In more severe cases, parents might consider enrolling their teen in a self-injury day treatment program or consulting with a psychiatrist. Linden Oaks Hospital in Naperville/St. Charles is one option for those seeking more intensive care.