30 September 2020 (updated)

Ask Amelia: How Do I Address My Niece's Cutting?

Over the last several years, there's been a growing trend of kids and teens inflicting self-harm through cutting. Amelia Peck, LMFT, has some great advice on what to do if you notice your loved ones engaging in this behavior.

Why Do Some People Self Harm By Cutting?

Dear Amelia, We saw my sister’s family over the holidays and on my niece's arm, I saw what looked like a scar from intentional cuts. I didn’t know what to say or if it was ok to ask about it. My kids are much younger, so I haven’t had to deal with this yet. Should I say something to my sister? I’m worried she might be suicidal if she is cutting herself. - Anxious Aunt

Dear Anxious Aunt,

Cutting is a form of self-injury that has been around for a long time but had often been carried out secretly. More recently, the age of which cutting begins younger and younger, and it's becoming more common. It is often linked with a mental health issue like depression or anxiety in some form. It does not mean your niece is suicidal, but it doesn’t mean she isn’t. They are similar, yet separate issues. 

What is Cutting?

Typically, cutting is superficial cuts. There may be a desire for blood, or the person inflicting self-injury may feel a release when they see blood, often the wounds aren’t terribly serious. However, what is serious, is the thought process that leads to the act of cutting and what is under it. Many kids report a feeling of relief. Some research indicated that the mental stimulation from it is similar to the flood of dopamine someone experiences when using cocaine. 

Why Do Kids and Teens Cut Themselves?

Some kids who have a history of chronic cutting have reported abusive relationships in their history. Others connect it to shame they feel about themselves, and some even cut words into their skin. Sometimes it is a mixture of different elements that leads to this behavior. Whatever the root cause of it, therapeutic intervention can be very helpful and allow someone like your niece alternative ways to cope with whatever is leading her to self-injury. 

What Do I Say if Someone is Cutting?

Approaching this topic with your sister, friend, or your child can be very scary. Often parents worry about what the response will be when they ask. However, open communication is always the best way to address any kind of self-injurious behavior that triggers concern.

With your sister, perhaps approach her directly and let you know that you noticed the cuts on your niece's arm. In a non-judgmental way, let her know what you are there to support her and help in any way possible. She may be feeling very alone deciding how to handle the situation herself. 

When addressing it with your own child or someone you know, don’t be afraid to ask direct questions about what you notice. Even if you want to ask about suicidal thoughts or feelings, be direct. Don’t try to ask a lighter question and hope they will understand what you’re trying to say. 

What Do I Do If a Child Is Cutting?

Dealing with someone close to you cutting can be overwhelming at first. So here are four tips for you and your family to deal with the situation.

Assess for Safety.

If the child is not suicidal and does not require stitches, they probably won't need hospitalization. Make an agreement with your child, like a safety contract, and check for objects you might need to remove from the environment. Some teens who struggle with chronic cutting have their parents remove razors from the showers or other objects that are easily accessible but are common for self-injury. 

Get to Therapy.

Your teen may be able to admit to cutting and some of their feelings, but if deeper feelings are at play, the help of a professional will come in handy. Therapies like Dialectical Behavioral Therapy are very popular in treating adolescents with these behaviors. Therapists are often trained to help assess for trauma, which is often linked to self-injury. A therapist can also assess to see if someone requires a high level of treatment. Determining the level of treatment needed is important and helpful to map a path for healing

Don’t Exploit It.

Don’t hide it. Ask your teen how they feel about their cuts being visible. Some don’t mind and see it as a symbol of what they’ve overcome. Others choose to keep them covered. While there is no shame in seeking treatment of any kind, it is always good to know someone’s comfort level with information that is known about them. 

You May Need Some Help Yourself.

If you have a child or family member who is engaging in self-injurious behavior, don’t walk through it alone. It can be hard to know who to talk to about these things. Just as you are learning about this yourself, there are many others who still need to be educated. You might need your own therapist (not your child’s therapist, your own) to help you understand and work through your own feelings on the subject. Just as there is no shame in your child’s treatment, there is no shame in yours. 

If you or someone you know is self-harming, text CONNECT to 741741 for 24/7 support. If you or someone you know is suicidal, call the National Suicide Prevention Line helpline at 1-800-273-8255. You are not alone!