The Mirror
January 30, 2007

Cry for Help; 60,000 People Self-Harm and Kids of 7 at Risk too
By Lynn Jolly

Troubled children as young as seven are regularly cutting and slashing themselves as a cry for help, it emerged yesterday.

Up to 60,000 Irish people self-harm every year by mutilating their body or burning their flesh with lit cigarettes.

In 2005, 431 people took their own lives—35 more than the number of people killed in road accidents.

Ireland’s booze culture, drug-taking and the reluctance to talk about problems are some of the reasons behind suicide and self-harm.

While 11,000 patients are treated in hospitals across the country for self-injury, there are another 49,000 who do not ask for help.

Pieta House, a centre to help stop our spiralling self-harm and suicide rates was officially opened in Lucan, Co Dublin, yesterday.

Its chief executive Joan Freeman said: “Suicide and self-harm rates are increasing in Ireland. Self-harm is more common among young people and it is a survival mechanism. These people do not want to die. They might injure themselves by cutting and banging their heads, and they start at a young age—as young as seven. It seems to affect girls more and the average age is 13 or 14. Self-harm is a release of emotions, whether it is anger or sadness.”

The privately-funded charity, which offers free therapy to people, was officially opened by Health Minister Mary Harney.

Pieta House been working for a year to support existing psychiatric and acute hospital services.

There are also 12 psychotherapists on hand to help people in crisis.

Dr John Connolly, secretary of the Irish Association of Suicidology and director of Pieta House, said: “Although services for persons who are at risk have improved in recent years, there are still enormous gaps in what needs to be provided.”

There was outrage last year during the coroner’s inquest into the death of suicide mum Sharon Grace, 29, from Wexford.

Sharon drowned herself and her two little girls three-year-old Abby and Mikahla, four, after she could not get a social worker to talk to. She was told by the Ely Private Hospital near her home to come back during office hours.

Sharon’s angry dad Eddie Reddy said authorities “should be ashamed of themselves” because 17 months later there were still no emergency contact numbers available.

Since the 1960s Ireland’s suicide rate has increased alarmingly. In 1980, 216 people took their own lives and by 2001 there was an all-time high of 519 suicides.

Self-harm is also on the up, with 11,000 cases of parasuicide recorded.

Health experts believe the hidden scale of the problem could be as high as 60,000 cases annually.

Ms Freeman added: “More services like ours are needed because we see the person as often as possible with the same therapist.

“For anyone suffering from self-harm talking is the best thing along with things like walking, writing in a journal or playing an instrument.

The Capital (Annapolis, MD)
February 18, 2007

Cutting: Few understand why teens do it

Self-injury is a hard-to-explain phenomenon that has teenagers hurting themselves to feel better. And health experts say the problem is on the rise.

Experts say that a growing number of teens and college students are turning to self-injury to ease emotional pain and find balance. A national study found that 17 percent of students surveyed at Cornell and Princeton universities say they have cut themselves.

Salina Renninger, senior psychologist at the University of Minnesota counseling and consulting services, and Charlene Koel, a psychologist for the Anoka-Hennepin School District in Minnesota, say that the survey numbers are probably on target. Dr. Koel said it has reached “chronic epidemic” proportions in the middle schools, primarily among girls.

“Middle school is probably the worst time in your life,” Dr. Koel said. “Hormones are raging, puberty is happening and there’s pressure to conform to be in the in-crowd. … When something happens that wounds their soul, they don’t know how to deal with that.”

So they scratch, cut, bite, burn and hit themselves. They bleed, bruise and blister. And in a perplexing and alarming way, psychologists say, this brings relief.

“It’s a sick way of coping,” said Dr. Gary Blount, a psychiatrist at Allina Behavioral Health Services in St. Paul. “There’s an addictiveness to it. It makes them feel better but then it bites them in the butt. They are shamed by it.”

Students are very secretive about self-injury and usually don’t do it to get attention, but it’s a clear sign of stress—particularly among college students, Dr. Renninger said.

“School is more expensive than ever, competition is higher than ever and cultural expectations have increased over time,” Dr. Renninger said. In addition, many students never learned life skills such as balancing a checkbook, doing laundry and dealing with conflict andacademic disappointment. As a result, they feel overwhelmed.

They cope through binge drinking, excessive gambling, out-of-control spending, obsession with pornographic Web sites—and, sometimes, self-injury.

Self-injury has become one of the most requested topics at Edens Group Training Center in St. Paul, which offers training to make schools and workplaces safe and chemical-free. “It’s definitely mood-altering and a coping mechanism,” said Karen Edens, owner and founder. “The general public awareness is very limited. The denial is huge.”

Studies have shown that a large number of those who harm themselves have suffered trauma, such as physical or sexual abuse. But an emerging group are high achievers, said Barent Walsh, who has studied the issue since the 1980s and written a book, Treating Self-Injury: A Practical Guide. I have a self-injurer who was a prom queen and another who is the captain of her athletic team,” Mr. Walsh said. “The key is that they’re stressed and they don’t have the coping skills.”

Charleston Gazette (West Virginia)
February 24, 2007

Self-injury; When emotional problems turn into physical ones

High school can be a confusing time. There are certain cliques to join and certain ways to act. What happens if a teenager can no longer keep up with outside forces?

Sometimes, in order to deal with forces beyond their control, teenagers will hurt themselves to gain control over their emotions and their bodies. When people do this, they are called self-injurers.

Self-injury is not an official disorder yet, so it doesn’t have an official name. It can also be called self-mutilation, self-harm, self-abuse, self-injurious behavior syndrome or self-inflicted violence.

Whatever the name, self-injury occurs when a person purposely inflicts wounds on him- or herself. Common methods of self-injury include cutting, burning and hitting/scratching/punching oneself, but it can also include biting oneself, picking at scabs or other wounds, breaking bones, ingesting corrosive chemicals or pins/tacks or choking oneself.

If the main purpose of the act is for bodily decoration (tattoos or piercings), spiritual enlightenment through a religious ritual, sexual gratification or peer acceptance, then it is not considered self-injury.

One of the most common misconceptions about self-injury is that the wounds are failed suicide attempts. Suicide attempts are done with death in mind, but self-injury is a coping behavior that the user does to deal with emotions or events in his or her life. Just like some people try to drown their pain or sorrow with alcohol, self-injurers use a physical distraction to rid themselves of it.

When people self-injure, they generally do not strut around proudly showing off their wounds. However, there are some warning signs to look for: wearing long pants and sleeves in warm weather; having low self-esteem, relationship problems and/or difficulty handling feelings; being unable to or poorly functioning at work, school or home and having frequent injuries without being able to explain them.

Though self-injury has been around for at least 70 years—Karl Menninger was one of the first to discuss the topic—it has only recently been recognized as a widespread problem.

Armando Favazza and Karen Conterio, two leading self-injury researchers, believe that the number of self-injurers in America is anywhere between 2 and 8 million. However, an accurate statistic is hard to come by because these figures are largely based on hospital admissions, which don’t take into account the large number of self-injurers who do not need or seek medical treatment.

In 2000, researchers Holly Vanderhoff and Steven Lynn conducted a study of undergraduate students in the United States wherein 9.8 percent of the participants said they had purposely cut or burned themselves on at least one occasion. When the definition of self-injury was broadened to include hitting, scratching and head banging, the percentage rose to 32. This suggests that the problem of self-injury is somewhat common among young adults.

In recent years, a number of celebrities—including Johnny Depp, Angelina Jolie, Marilyn Manson, Christina Ricci and the late Princess Diana—have admitted to self-injuring at some point in their lives. This just shows that self-harm is a problem that can affect anyone, no matter the age, race or gender.

Self-injurers are not alone, but they should not use the fact that a celebrity has done it to justify their own self-mutilation. Most, if not all, of these celebrities have overcome their past by seeking help and no longer harm themselves.

For several years now, groups like the English-based LifeSIGNS and the American Self-Harm Information Clearinghouse, have campaigned for cities, states and nations to recognize March 1 as Self-Injury Awareness Day.

However, it is not officially recognized by any nation at this time, and New Mexico is the only state to acknowledge it. In 2006, Norwich and New London, Conn., recognized the day, leading to the state of Connecticut recognizing it this year.

As for West Virginia, there is a resolution currently pending in the House of Delegates to designate March 1 as Self-Injury Awareness Day.

If you want to help raise awareness, wear orange ribbons or clothing this Thursday. The more people know about self-injury, the more they will be able to understand and raise awareness about it.

Aberdeen Press and Journal
March 1, 2007

Living in isolation: Helping self harmers know they are not alone

The number of young people in Scotland who harm themselves by cutting or burning their own bodies is giving cause for concern. On global self-harm awareness day, Nicola Barry reports

Claire has suffered badly from depression. She used to cut herself on the arms, legs and stomach. If she didn’t have a blade, she would burn herself with a smouldering cigarette end.

In her 20s while training to be a nurse, she started self harming, always careful to conceal the cuts in her arms and legs from work colleagues.

Once Claire’s GP had signed her off sick, she was admitted to an acute psychiatric ward, where she starved a lot of the time and harmed herself with either razors or smouldering cigarette ends.

When she eventually returned to work, Claire noticed her colleagues’ behaviour towards her changed markedly.

“People would no longer give me keys to the drugs cabinet or allow me to do drug rounds by myself,” she said. “There was no specific discrimination, but there was no support either. I took the decision to leave nursing because of that.”

In Scotland, the number of young people who harm themselves is thought to be as high as those who abuse alcohol and drugs. Some use glass, others use knives, compass points or tin lids to cut themselves. Others prefer to burn themselves with cigarettes.

One in 20 calls to Childline involves either a suicide attempt or an incident of self harm.

Claire has done both, on her arms, legs and stomach.

People self harm for different reasons. Each person’s experience is unique but the act is always an indication of an underlying problem; in particular, a build-up of negative emotion. It is never a prank, never a phase one goes through, never a mere cry for help. It is done to cleanse and create release.

The feeling of isolation among people who self harm can be immense, with the act of self harm leaving the young person feeling totally excluded from society.
The UK has one of the highest rates of self harm in Europe, a total of 400 per 100,000 population, according to the Samaritans’ website.

An estimated 170,000 self-injury cases are treated in hospital each year. Many more incidents of self harm are thought to take place but are not included in any statistics because people may choose not to seek help. In all age groups, females are more likely to self harm than males.

Claire says she didn’t talk about her problems when in hospital.

“I think I would have been helped more if the nurses had talked to me about my feelings,” she said. “At times, I felt very lonely. Self harm is a big thing now,” she continued, “back then in the 1980s, it wasn’t. I imagined I was the only person in the world doing it. It became more and more severe, although I managed to stay in control most of the time.”

Many incidents go unreported since those who cause themselves injury often know how to dress their wounds and keep them hidden from family, professionals and friends.

As with so many self harmers, Claire knew exactly how far she could go, without losing too much blood and needing stitches, although she did attend accident and emergency a few times.

There, she noticed that some of the nurses could be judgmental, treating her as if they thought she was wasting their time.

Claire’s message to young people who self harm is unequivocal: “They should never imagine they’re alone out there,” she said. “Lots of people self harm.” While Claire has stopped harming herself, she is not always confident.

“It’s not that it never crosses my mind,” she said. “There are days when I could revert back but I haven’t, mainly because I have found a wonderful person to talk to.”

Nicola Thompson is self-harm development officer for Penumbra, the mental health charity in Aberdeen.

“Self harm covers such a wide area,” Nicola said. “It includes any behaviour which is damaging, such as drinking, smoking, drugs. It is just a way of coping.” However, she agreed, there was a big difference between having a glass of wine and cutting one’s arms with a sharp blade.

“Self harm is really a way of externalising one’s emotions. After all, not everyone has been brought up in a family which fosters emotional expression,” she said.

While self harm has little to do with attempted suicide, many young people who have taken an overdose say they did so in response to social problems, such as difficulties with housing, school, unemployment, debt, health or relationships. Self harm may be their only way of letting the world know how bad they actually feel.
Nicola says confusion arose between the definitions of attempted suicide and self harm because the latter used to be referred to as parasuicide.

“However, the intention is completely different,” she said. “You only have to ask someone if they meant to end their life. If they did, it was a suicide attempt. If they didn’t, it was self harm.”

Her message is one of optimism, however.

“People can recover from this,” Nicola said. “It doesn’t necessarily mean someone has a mental illness. It means they’re at a point in their lives when they are struggling. Most stop self harming and learn to cope in far healthier ways.”

Claire, now 40, says, “I never thought I would have a life again but I have and there are so many things I would have missed out on if I’d continued the way I was.”

After a decade of helping people who self harm, Pat Little, Scottish development manager with the charity Penumbra, stands out as a pioneer among those searching for a solution to this problem.

“Young people do it because of what they have been through and not to get attention,” he said. “In fact, it is largely a coping mechanism, not a means of ending one’s life. On the contrary, it actually keeps people alive.”

Pat knows that some people who self harm have had traumatic experiences, for instance, been sexually abused in the past, sacrificed by their families, by which I mean that their abuser is still at home in the bosom of the family while the wronged child has been forced to run away and manage alone.

He said: “Cutting may relieve the pressure of all that. “The person’s body sometimes represents the abuser, or, the bleeding flushes out all the badness they feel inside. Physically, the pain may be intolerable, but emotionally, it serves as a huge release. Sexually abused young people have this internal conflict. They may hate themselves and want to inflict the maximum damage on their bodies. The fact is that the rest of their life may be out of control, but here is something they can control all by themselves—how many times they cut and how far they go.”

Pat continues to be concerned at the response of some hospital staff to those who self harm, although things have definitely improved, he says.

A lack of understanding among busy casualty staff can result in a young person having to contend with a barrage of prejudice and ill-feeling. He or she is likely to be labelled “manipulative”, “attention seeking” or “hysterical”. Wounds will be dismissed as “self inflicted” and therefore “not serious”. People who self harm report hearing comments such as “don’t waste time stitching up the wound, he’ll only open it up again.”

Pat says there have even been incidences in Scotland where people have reported being stitched up in hospital without anaesthetic.

“Doctors and nurses sometimes try, unnecessarily, to psychiatrise the problem,” he said. “Consequently, they may say the wrong things, reinforcing the young person’s belief that they deserve to be punished.

“Training of hospital staff on self harm has led to a much improved response,” Pat said, “but services need to be vigilant in ensuring that this improvement continues. At Penumbra, we say these people urgently need non-judgmental, unconditional support to get them to consider alternatives and learn appropriate skills to deal with the problems life presents.”

Brighouse Echo
March 15, 2007

‘Cutting myself makes me feel better’

AS EIGHT-year-old Michelle jabbed at her legs with the pin, she started to feel better.

But once the little girl realised this took her emotional pain away momentarily, she found she could no longer stop.

Over the years, Michelle (which, to protect her identity, is not her real name) has gradually progressed from using a tiny pin to a Stanley blade to cut at her skin. Her arms, thighs, stomach and shoulders are a patchwork of fading scars which form a delicate background for the freshly-cut wounds which are just days old.

Her self-inflicted injuries are horrifying to see and bear testimony to the deep pain she lives with on a daily basis.

Michelle, who is now 45 and lives in Brighouse, approached the ‘Echo’ in the hope of reaching anyone who may be suffering in silence, to let them know they are not alone.

Earlier this month LifeSIGNS (Self Injury Guidance and Network Support) held its Self Injury Awareness Day to bring the misunderstood subject to the public’s attention.

Michelle says she began self-harming after she was sexually abused by a man in his 60s when she was just seven years old.

“He was somebody who hung around the school gates and me and my friends used to go and talk to him,” she says. “He would bring us sweets. Eventually it ended up just being me at his house and that was when the sexual abuse started.”

Michelle says the abuse continued for three years and the man threatened that something bad would happen to her family if she told anyone.

“I didn’t want him to do what he was doing to me, but I was petrified that something would happen to my family,” she explains.

Towards the end of her three-year nightmare, Michelle was seen running away from his house crying, by a neighbour who called the police.

“Officers came to the house and asked me questions,” she says. “The policewoman was really nice, I can still see her face now. I had no idea what this man was doing to me, I didn’t know what sex was at that age.”

After the police left the house, Michelle says her mother told her she had brought shame on the family.

“I was given a good hiding and I went upstairs to my bedroom and watched the police walking away, I remember wishing I could go with them,” she recalls. “I never saw the police again, other than to be told not to go anywhere near him. My parents never asked about it again and I was told never to speak about it again. They used to threaten to send me to a children’s home because of my behaviour and I remember once stealing money so I could run away.”

Feeling as if she had no-one to turn to, Michelle started going up to a local dam and sitting by the water.

“I couldn’t talk to anyone, I just coped with it myself,” she says. “I remember on many occasions sat by that dam trying to work out ways to kill myself.

“I found that sticking pins in my legs made me feel better,” adds Michelle, who has a son and a daughter in their 20s and a granddaughter. “I don’t know why, but because what he did to me hurt and made me bleed, I needed to hurt myself and feel pain.”

But after a while the pin stopped producing the desired effect and Michelle soon progressed to using a compass to gouge at her legs. She hid her scars from her family and friends, taking care to always wear clothes that would disguise them. If anybody noticed an injury she would lie and say she had fallen.

“Cutting myself gave me a release,” explains Michelle. “I had to feel the pain. I felt horrible and dirty and by bleeding it got some of it out.”

Michelle says one of her aunts told her recently that she saw her change from a happy, bubbly child to a child who wouldn’t play and just sat on a wall by herself.

Thoughts of suicide continued to enter her mind and Michelle would spend hours thinking of ways in which to end her life. When she was about nine years old she threw herself off a rope swing hanging from a tree, which hung over the dam, but she just ended up with cuts and bruises.

When Michelle moved to secondary school and no longer saw the man, her self-harming abated for a while. But she saw him again when one of her friends moved on to the estate where he lived and her pain returned once again.

When she was 14-years-old she made a serious attempt on her life by slashing her wrists with a piece of glass she found at the dam, but she panicked and managed to stem the bleeding.

Despite her horrendous childhood, Michelle met and married the father of her two children. However, when this ended in divorce due to his repeated beatings of her, she fell into a deep depression and was referred by her doctor to see a counsellor.

“The divorce really affected me and the doctor put me on antidepressants,” she explains. “When I used to see the counsellor, I didn’t tell her about my past at first, but she knew there was something else I wasn’t telling her. Eventually I did tell her, but it was hard and brought up a lot of bad memories, and although it did help, I was still cutting myself. I just couldn’t talk about it, especially the details of what he did to me; it’s too painful. That’s why I couldn’t go to court. I learned to block out what he did to me and tried to carry on as if nothing had happened,” she says. “I tried to talk to my mum about it a few years ago but she has just blanked me ever since. My father had a heart attack the next day, and even though he lived I have always felt it was my fault.”

Michelle is all too aware of the stigma, which she says is attached to self-harming.

Even now, if she goes a bit too far with her cutting, and her wound requires stitching, she refuses to go to hospital.

“I won’t go, they just look at you like a piece of trash,” she explains. “But I would rather hurt myself than someone else. Even though I have a lot of anger towards that man, I also have a lot of anger towards myself. Anything can trigger it, flashbacks, a word or a smell,” she adds. “I try and cope with it by putting a mask on, but I get to a stage where I can’t and the anger takes over, the blade comes out and I have to cut to make myself feel clean. I have even bathed in bleach to try and be clean.”

Michelle, who also suffers with epilepsy, sees a psychiatrist every few months to discuss her progress but she says despite taking medication, it doesn’t make her feel better.

She has made repeated attempts to take her life, the last one being just after Christmas.

Even though the man responsible for Michelle’s abuse is probably dead now, she never felt able in adulthood to reopen the case with the police.

“I just couldn’t, especially when you read about similar cases in the papers and there never seems to be any justice,” she says. “I hope he is dead. That man has ruined my life.”

Pediatric News
April 1, 2007

Kids and self-injury: “pain makes them feel alive”
By Timothy F. Kirn

SAN DIEGO — Cuts on the arms that are superficial and evenly spaced can be a sign of self-injuring behavior, Allyson Cordoni said at ameeting on adolescents and violence.

Typically, these cuts do not go across the arm, as with a suicide attempt, but up and down from the wrist toward the elbow or the elbowtoward the shoulder, she said at a conference sponsored by the Chadwick Center for Children and Families at Children’s Hospital and Health Center, San Diego.

Self-injuring behavior is extremely common among individuals abused as children-often sexually abused—and it is estimated that 70%-75%of cases involve cutting, with the arms being the most common location, said Ms. Cordoni, a nurse-practitioner at the Kapiolani Child At-Risk Evaluation Program in Honolulu. Repeated self-injuring behavior among adolescents is not an attempt at suicide, and the individuals who do it generally do not seek help for the behavior, she said. Unless the individuals make mistakes that send them to the emergency department, the injuries are minor and the behavior can go on for a long time.

On the other hand, if physicians see signs of suspicious injury, Ms. Cordoni recommended that they simply ask directly if the patient has self-inflicted the wounds. She finds self-harming adolescents tendto be quite open about it.

“They’ll tell me,” she said. “They are not ashamed of it.”

“They do it because they feel the pain and it makes them feel alive,” she said. “They are not trying to kill themselves. This is a physical way that kids use to help themselves cope. They don’t express themselves verbally. It is difficult for them to express themselves anyway but self-injury.”

Estimates of the prevalence of self-injuring behavior range from a2004 report suggesting that 1-2 million persons in the United Statesdo it, to surveys suggesting 16% of high schoolers report having done it and 35% of college students report having done it.

It has commonly been thought that the individual who self-injures regularly is a woman, 20-30 years old, who is middle or upper class and has serious psychological issues in her past that have not been dealt with. That notion may be outdated or never was accurate, however,Ms. Cordoni suggested.

Newer evidence suggests the behavior is only slightly more common in females than males, and Ms. Cordoni has seen individuals in her program who self-injure at ages as young as 12 years.

Regarding self-injuring by cutting, children and adolescents will use anything they can to cut themselves, Ms. Cordoni said. She had one child who cut himself with a paper clip, and another who caused abrasions with a pencil eraser. The cuts are typically on the arms and wrists, but they can be anywhere.

The second most common method is burning, done by 35% of those whoself-injure, and the third is hitting themselves or banging their heads against something, done by 30%.

To stop their self-harming behavior, individuals should have a sense of why they do it, so they can then take better control of their personal history and the feelings that lead to the behavior, Ms. Cordoni said. These individuals often hurt themselves in response to stress.

That means that the behavior is often difficult to break and one cannot simply tell the individuals to stop, because they will not.

A practice often used by experts is to make a written contract with the child. Selective serotonin reuptake inhibitors and support groups are used as well, she said.

The proper approach for a physician or other caretaker who comes across a patient who self-injures is to record the details, treat the injuries that need it, get support or attention to that person—such as a referral—and, finally, to be nonjudgmental, she added.

Buffalo News (New York)
April 22, 2007

Self-mutilation by teens raises growing alarm; Girls form majority of those who deal with problems by cutting themselves
By Dan Herbeck

Ann was only 12 years old, a frazzled girl from a middle-class suburban family, when her bizarre behavior began. She slashed herself with razor blades.

The pressures of life were squeezing her from all sides. She had just missed five months of school because of an illness and was having trouble with her studies. She was struggling to adjust to a new school where she had very few friends. And her beloved grandfather recently had died.

For reasons that she can’t fully explain, she began making short, shallow cuts on her arms and legs, drawing a few drops of blood each time.

For Ann, focusing on the physical pain made dealing with her problems a bit easier.

“After a while, I became addicted,” recalled Ann, now 16. “The bigger a problem I had, the more I would cut myself. Sometimes I was punishing myself. Sometimes I just used it to help me forget about my other problems.”

Ann is among hundreds — if not thousands — of young people in the Buffalo area who have used cutting as a coping device, psychologists and counselors say.

Officials of Crisis Services of Erie County estimate that counselors spend a third of their time on cases that involve cutting or other self-mutilation by young people.

“It is a serious and growing problem. We get calls and referrals for help from school districts all over this area,” said Sandra L. Reinhold, a child psychologist from Child & Adolescent Treatment Services of Western New York.

Although cutters are rarely suicidal, self-injury is a harmful and self-destructive form of behavior, said Reinhold, whose not-for-profit agency runs a counseling program in Buffalo for self-injuring teens.

“It’s a coping mechanism, like abusing drugs or alcohol,” Reinhold said. “It does help them to cope, but if they keep doing it for too long, it can get out of control. You can do serious damage to yourself. If it goes too far, there’s the risk of death.”

Solid statistics on the extent of the problem are difficult to obtain. Some studies estimate that up to 20 percent of high school and college students — mostly girls — have engaged in cutting or some other form of self-injuring behavior, Reinhold said. A national group called Mental Health America estimates that 2 million Americans injure themselves, mostly by cutting.

A Cornell University study conducted last year found more than 500 Internet message boards that teens use to share intimate secrets about cutting, burning and other self-injury behavior.

“Adults are uncomfortable with it and very surprised to hear about it, but the kids are very aware of it,” said Janis Whitlock, director of the Cornell Research Program on Self-Injurious Behaviors. “In schools all over the country, it’s part of their world.”

“It’s still a taboo subject with a lot of people, but we’re very familiar with it,” said Pamela Embury, coordinator of, a Web site that Crisis Services operates.

The site received more than 447,000 hits in the first three months of this year, and self-injury by young people is one of the most popular topics, Embury said.

Some of Reinhold’s patients cut themselves several times a day — at school and at home. Some do it only occasionally, in times of extreme stress.

The worst case Reinhold ever encountered was a deeply disturbed 40-year-old woman who cut herself for years. Ultimately, the woman had to be hospitalized after slashing her stomach and trying to cut off her breasts.

“That is an extreme, unusual example, but the danger of real harm is there,” Reinhold said.

Reinhold sees 37 girls and three boys in her program, and other teens are on a waiting list. They come from all over Erie County — Buffalo, suburban areas and rural areas, she said.

A wide variety of sources produces the stress that can lead to self-injury.

“It can be an honor student trying to keep up, or a very poor student who never goes to school,” Reinhold said. “It could be a kid who was molested, a girl having trouble with boys, a girl with body image problems, or someone who thinks her parents hate her.”

She urges parents, guidance counselors, teachers and others who deal with young people to watch for the following signs:

* Fresh cuts or scars.

* Constant wearing of long sleeves, baggy clothing, jewelry or wrist bands to hide scars. Awkward body posturing to hide scars.

* Frequent use of bandages, ointments or other first-aid supplies to treat cuts. Bloody tissues or broken razors found in the home.

* Unusual mood swings or spending an inordinate amount of time alone.

Ann, the suburban girl who spoke to The Buffalo News on the condition that her full name would not be published, is one of Reinhold’s clients. After cutting herself for three years, she stopped eight months ago, after her mother discovered some of her scars, became alarmed and found help.

“Once my mom found out, I broke down and told her everything,” Ann said. “I knew she was someone who could get me help. At that time, I was doing it every day. I realized I was hurting myself and people around me, and I needed help.”

A bright, energetic honor student with an engaging smile, Ann does not give the appearance of a girl with psychological problems. But she showed a reporter four light scars on her left arm and said her clothing covered many more.

Ann said she once wanted to be a fashion model, but now, because of her scars, she feels that opportunity is gone.

When she was cutting regularly, using razor blades, scissors and other sharp instruments, Ann tried desperately to hide the scars from her parents and friends. She wore long-sleeve shirts on hot summer days.

“You’re very paranoid about people finding out,” she said. “You feel like, if someone finds out, they’re going to hate you, make fun of you or think you’re some kind of idiot.”

Ann had suicidal thoughts at times, but she said she never seriously considered it and never intended to seriously hurt herself.

“Cutting gave me some relief from my problems. It gave me a euphoric feeling,” she said. “I still have urges to do it now, once in a while. But I don’t.”

Counselors from Child & Adolescent Treatment Services bring clients together to share their experiences during group discussions. They urge them to stop cutting and use less harmful “self-soothing” methods when they feel intense pressure.

“I’m finding other ways to deal with anxiety and depression,” Ann said. “I’ll call friends to talk, or I’ll listen to some of my favorite music. It’s helping. Until about a month ago, I would say, ‘I cut myself.’ Now I say, ‘I used to cut.’ That’s a turning point for me.”

Where to get help and information

Experts say young people and their parents often are embarrassed and reluctant to seek help with cutting and other self-injury issues.

“This is a problem that can be beaten,” said Sandra L. Reinhold, a child psychologist with Child & Adolescent Treatment Services of Western New York, “but it’s hard to do that without talking to a professional and getting some help.”

One of the best sources for information or help referrals is Crisis Services of Erie County. The agency can be reached at 834-1144 or (877) KIDS400, or through its help Web site,

“We can even put kids or parents in touch with a counselor, through the Internet,” said Pamela Embury, Web site coordinator.

The Web site also has information about other issues that affect young people, including school bullying, depression, drug use, eating disorders and suicide.

Embury also advises young people to go to a guidance counselor or some other responsible adult if they know of a friend who is inflicting self-injuries.

“At first, your friend might be angry for reporting you, but in the end, they’ll probably wind up thanking you,” Embury said.

Other helpful Web sites include, and, the site run by the Cornell University Research Program on Self-Injurious Behavior.

Orlando Sentinel (Florida)
May 10, 2007

Group shines light into darkest corners; To Write Love on Her Arms embraces hope and holds it out to those wandering in the shadows of depression, addiction and self-injury.
By Laura Brost

The young woman was so dependent on drugs and enslaved by depression that cutting herself became an addiction — and suicide a constant option.

Enter, by chance, Jamie Tworkowski.

Tworkowski met 20-year-old Renee through mutual friends who were nursing her back to health after she overdosed. He and his friends stayed with her, waiting for her body to rid itself of toxins — and, hopefully, of the idea that she was a failure, which she had spelled out on her arms with razor blades.

Eventually, Renee was admitted to rehab. And Tworkowski knew that her story had to be told.

What he didn’t know was how many people needed to hear it.

The 27-year-old Melbourne native posted a story about Renee’s experience on a MySpace page in March 2006, and the response was overwhelming. Today, the page has about 90,000 members, or “friends,” and has spawned To Write Love on Her Arms, a nonprofit group that travels the world to raise awareness for those suffering from emotional pain and addiction, and to point them toward help. Its message of hope has spread through the Internet and the local concert scene, with bands giving Tworkowski and his colleagues a forum for plugging their cause by addressing the crowds and selling T-shirts.

“I feel like our churches and our society haven’t really dealt with pain,” Tworkowski says. “[To Write Love] is dealing with something that you don’t really hear much about.”

Something bigger

About 17 percent of college students (20 percent women and 14 percent men) say they have committed some form of self-injury according to a study last year by Cornell and Princeton universities. One form entails cutting slits on arms or other parts of the body. Much like anorexia, experts say, this act allows the person to feel in control. Some do it to get a high, while still others hurt themselves physically to replace emotional pain.

Tworkowski says he never dreamed that his MySpace page about Renee’s struggle would draw that much attention.

“When I asked her if I could write her story, it wasn’t that there was this vision attached or T-shirts and a nonprofit,” he says. “I wrote it first for myself because it meant so much to me, and I wanted to remember it. I saw how my friends responded to it [the story], and I think after that was when the vision came for it to be something bigger.”

He soon had designed T-shirts to help pay for her rehab. The words inscribed on them — “to write love on her arms” — became the group’s name.

By last fall, the movement’s rapid growth led Tworkowski to quit his job as a sales rep for the Hurley sports apparel company. A few months ago, the group qualified as a nonprofit through Fireproof Ministries, a Christian outreach group in Grand Rapids, Mich.

To Write Love has three full-time staff members — Tworkowski, along with David and Lauren Ranzino of Melbourne. They handle merchandise, concert promotions and speaking engagements, as well as correspond with young people who message or e-mail the group about their crises.

“We’ve just been put in a really unique place as far as people trusting us with what they’re going through. And then with that, [we can] kind of relieve those fears of going to see a doctor or telling their parents,” Lauren Ranzino says.

Ranzino, 23, with a degree in pastoral Christian ministries and psychology, focuses on answering the more urgent requests for help. For guidance, she turns to Aaron Moore, a counselor at Gilstrap & Napolitano Counseling and Psychiatry in Windermere.

“It’s made very clear that To Write Love On Her Arms is not counseling or a substitute for counseling . . . It’s something that’s helping people have an honest conversation about these things and get the help that they need,” Moore says. “They [To Write Love] are working on things like awareness and encouragement and education and raising money that’s going to help people get the treatment that they need.”

Beyond billboards

Though To Write Love is not affiliated with a specific church, that’s where its principles are anchored — even if the focus is elsewhere.

“We want to spend as much time, if not more, in venues beyond the church — in club settings and bars,” Tworkowski says. “We want to meet people where they are.”

To do that, To Write Love organized a tour last November called Stop The Bleeding, which involved teaming with local bands in six cities. The staff just returned from a two-month tour with Orlando band Anberlin, which gave Tworkowski five minutes every night to speak.

“It was an amazing tour with those guys — I feel like they are exactly what I want to exemplify as a band because their organization cares about people,” says Stephen Christian, lead singer of Anberlin. “It doesn’t feel corporate; they are not a campaign that is just a big billboard. . . . It’s much more personal and much more on a people level.”

Along with speaking across the country, To Write Love plans to visit teenagers in Australia this year. Tworkowski says To Write Love will channel money to help those in need to nine groups throughout the world.

The group has raised $30,000 this year and sold about 10,000 T-shirts in the last two months. Its goal is to raise $100,000 worldwide to help those suffering with issues such as Renee’s.

And after more than a year off drugs, Renee is now working and living on her own in the Orlando area. She has spoken at several events with Tworkowski and has dreams to do more — helping her friends to fight against the evil that almost killed her.

“I always had this mind-set that there was a purpose for everything and that’s what kept me going — that I was supposed to help people,” says Renee, who spoke on the condition that her last name not be used. “I thought if only one or two people were affected by [my] story, then it was worth everything I went through. This is why I believe I am alive — is to tell people.”

The West Australian (Perth)
May 15, 2007

Shocking leap in teenage self-harm
By Kate Campbell

Perth children as young as 12 are slashing and burning themselves and taking handfuls of paracetamol in a shocking and escalating trend of self-harm, according to experts.

Alarming statistics show that since the start of last year, Princess Margaret Hospital has treated 167 children for self-harm and 90 of those cases involved teens aged 14 to 15.

A marked rise has been recorded in hospital cases, with 110 children admitted to PMH in 2004, 114 in 2005 and 134 in 2006.

Kids Helpline received more than 1000 calls in 2004 and 2005 from WA children seeking help over self-harm.

Experts stress these figures only scratch the surface of the problem, with most self-harmers hiding their secret shame and their injuries going undetected.

But some evidence also suggests the behaviour is becoming contagious within school friendship groups, with teens experimenting with self-injury in a bid to fit in.

YouthLink program manager Denise Follett said the self-harm prevalence could not be blamed on the emergence of Emos—the punk sub-cultural group of the moment.

She said deeper underlying issues, such as grief, peer problems, family breakdowns and even sexual abuse were common triggers.

“I think the professional and health community recognise the severity of it,” she said. “But I think there is still a degree to which people, including some parents, see it as a manipulative, attention-seeking ploy that young people will grow out of.”

Ms Follett said only a small percentage of the young people aged 13 to 25 she saw who deliberately hurt themselves were Emos. Making Emos and self-harm synonymous unfairly blurred a serious issue.

Many self-harmers did not want to die but those with acute behaviour who no longer experienced the same adrenaline rush were a severe suicide risk.

She estimated only 10 per cent of those who self-harmed asked for help.

Ms Follett said an element of bra- vado had emerged with peer groups sharing their self-harm exploits and teens copying the actions of others in their group.

PMH consultant psychiatrist Margaret Doherty said she had seen cases involving children as young as 12 overdose on paracetamol and bite, scratch and burn cigarettes on themselves.

Many had no idea of the potential side effects of overdosing on paracetamol, including serious liver damage.

Bristol Evening Post
May 26, 2007

Self-harm tackled by samaritans

The Samaritans has launched a new training course to help staff who come into contact with people who self-harm.

Self-harm is a problem that affects every age group. It can be difficult for staff such as teachers, social workers, medical receptionists, information advisers, guidance workers, probation officers or voluntary workers to know how to cope with situations in the best way.

Some 170,000 people are treated in UK hospitals for self-harm injuries but many self-harmers choose not to seek medical help.

Samaritans external training services co-ordinator Jonathan Moran said: “Our course will dispel the common misunderstandings about self-harm and provide those attending with the skills and confidence to respond effectively.

“The day-long course is aimed at frontline staff.”

Steve Tollerton, Samaritans external training officer, said: “Self-harm is a term often used to describe non-fatal self poisoning and self-injury but some of us harm ourselves in less obvious, but still serious ways.

“We all have times when we behave self destructively, perhaps by over working, binge drinking, over eating or starving ourselves, to avoid dwelling on our thoughts and feelings. These can also be considered self-harming activities.”

To find out more about Samaritans work place training visit, email or call 0208 394 8372.

Pharma Investments, Ventures & Law Weekly
May 27, 2007

Self-injurious behavior; Test improves prediction of self-injurious behavior

Researchers have found a better way to predict self-injurious behavior by using a test that does not rely on the individual to articulate their thoughts, but instead assesses their implicit attitudes towards self-injury. This procedure addresses a major challenge in the identification of people who engage in self-injurious behavior, because such individuals are often intentionally uncommunicative in order to avoid unwanted treatment as well as unable to articulate their feelings.

Conducted by two Harvard professors, the study was led by Matthew Nock, an assistant professor of psychology, with Mahzarin Banaji, the Cabot professor of social ethics in the department of psychology and Pforzheimer professor at the Radcliffe Institute. The paper is published in the May issue of the American Journal of Psychiatry.

“This research represents a significant advance in risk assessment for self-injury. This test measures the associations people hold about self-injury using their own behavioral responses rather than their verbal report, and therefore it has the potential to significantly improve our ability to detect and predict self-injurious thoughts in a way not previously possible” says Nock.

The study included 89 adolescents between the ages of twelve and nineteen, of which 53 had a history of non-suicidal self injurious behavior, and 36 were non-injurers that comprised a comparison group. The group was given a version of the Implicit Association Test (IAT), adapted to measure mental associations to cutting of the body in particular because prior studies have shown that cutting is the most common form of self-injury.

The IAT was computer administered with participants using key board controls to quickly associate self with cutting or not. Based on the participant’s reaction time when grouping self with cutting versus not, the test identified the strength of association between self and injury via cutting that the individual might not otherwise share with others or even be aware of herself.

In the identity test, participants grouped together words and phrases such as “Cutting” or “No Cutting” with words such as “Me” or “They.” Those who engaged in self-injurious behavior were more likely to quickly and without error group the words that that are relevant to cutting with the words related to the self such as I, me, mine, myself.

In a second attitude test, participants were asked to group together words such as “Cutting” or “Not Cutting” with words that captured the categories “Good” and “Bad.” While both groups showed an association between “Cutting” and “Bad,” the association was significantly weaker for self-injurers.

In addition to the IAT, participants were also assessed using more conventional measures of self-injury, as well as obtaining measures of demographic factors, differences in IQ, and presence of psychiatric disorders. When considered in conjunction with the more traditional indicators of self-injurious behavior, the IAT significantly improved the prediction of who was a self-injurer above and beyond what was possible using the conventional self-report measures.

“Among the most important applications of the IAT is its ability to reveal the mind’s state when it is psychologically compromised — as it is in a full range of psychological disorders,” says Banaji. “Clinical psychologists have been at the forefront of applying the IAT to improve the ability to predict and treat mental illness. Such applications show the importance of basic research in understanding mental illness.”

Eastbourne Herald
June 5, 2007

Highlighting the ‘taboo’ subject of self-harming

Self-injury is often thought of as a taboo subject that no-one wants to discuss but a new organisation in Eastbourne is hoping to change that.

SAFE UK came into fruition at the beginning of this year after Hannah Bradley and her friend Chrissie Sulway realised there was a lack of services for people affected by self-injury.

Hannah is the chief executive officer of SAFE UK and self-harmed for around six years.

The 31-year-old said, “I was quite severely depressed I would say. I didn’t cope. For me cutting and bleeding was a strategy about surviving. I felt very angry afterwards. It’s the whole other thing that it’s not talked about. For several years I was self-harming and felt I was the only person in the world doing it. It’s about learning to take responsibility for your actions and finding alternative coping strategies and finding support. That’s what SAFE UK is about. We can help people find what their triggers are. We can’t stop them self-harming but we can give them advice and support.”

SAFE UK consists of around 10 volunteers, all of whom have been affected by self-harming in some way or other.

The aim of SAFE UK is to promote public awareness of issues surrounding self-injury, help people to understand the triggers behind their self-injury and generally offer support and advice to families, friends and individuals affected by self-injury as well as offering help to frontline workers and carers.

The offices are based in Green Street, Old Town, and are open Monday-Friday from 10am-5pm, although the phone is always put on divert outside these hours should anyone call.

As well as speaking to people on a one-to-one basis, the organisation has done a series of talks in schools and carried out various workshops to raise awareness of the issue.

The organisation has already held a comedy night to raise funds and promote awareness and as well as trying to gain charity status they plan to have an awareness day and, at some point, a stall in the Arndale Centre.

Greg Rampley, chairman of the management committee, said one of the most important things is to not judge people who self harm.

He became involved in SAFE UK after a friend began self-injuring.

He said, “I saw everyone else’s reaction and there is such a taboo and lack of understanding. One of our main ethos is that they have to take responsibility for what they are doing and do they want to stop or do they just want to know there’s other people doing it? It’s OK to feel sad and hurt. We have people here who have been doing the same thing.”

Hannah added, “One of the good things in this is when you meet that person and you make that connection and there’s a chance you can make a difference, however small, even if it’s just by showing acceptance.”

Some of the team are also hoping to raise funds by taking part in the Three Peaks Challenge.

The event is taking place at the end of July and the aim is to climb all three mountains, including Ben Nevis and Snowdon in 24 hours.

If you would like to sponsor the forthcoming event, become a volunteer or find out more information please call 732061 or e-mail

The Gazette (Montreal)
June 25, 2007

Experts report surge of cutters
By Peggy Curran

A Goth girl struts along Ste. Catherine St. in a cut-off black T-shirt, bare arms revealing dozens of scars, a few the pearly pink of freshly healed wounds.

Out in the suburbs or in the university dorm, the skater boy, the soccer star and the class valedictorian have been cutting, too, perhaps wearing long sleeves to mask the tell-tale signs of self-inflicted injuries from parents and squeamish friends.

World experts who gathered at McGill University last week report an extraordinary surge in cases of non-suicidal self-injury by teenagers, apparently seeking release from the emotional distress of a detached world that is moving too fast and demanding too much.

Yet they say parents and teachers are ill-prepared to recognize this bewildering phenomenon, or know what to do once they do.

“Some people refer to it as the new anorexia,” Nancy Heath, a professor in McGill’s department of educational psychology, says of this troubling behaviour. Emboldened by celebrity cutters and fuelled by ghoulish Internet sites, the trend crosses gender, ethnic, education and income boundaries.

The co-author of a soon-to-be-published book designed to help teachers, social workers and clinicians identify and tackle a problem, Heath’s own research in Montreal schools indicates self-harm, once limited to teens with mental health problems or high school subcultures, is now prevalent even among privileged kids from stable families.

“If you talk to a teen, they will say, ‘Oh, that’s an emo thing,’” a reference to the latest evolution of extremely intense and emotionally charged teens. Yet Heath’s surveys in an urban and a suburban high school found a large proportion of those who claimed to hurt themselves were preppy, A students.

“It’s your kid, it’s my kid, it’s the kids who are going to university, achieving really well,” Heath said.

Other scientific studies support Heath findings, indicating as many as 13 to 25 per cent of youths in Canada, the United States, Britain and Australia have tried to hurt themselves, usually by cutting, burning or hitting themselves.

Recent evidence also shows that males are as likely to engage in this kind of activity as females—although males are less likely to confide in a friend or seek treatment.

“It’s scary how it has jumped,” said Wendy Lader, a Dallas clinician and author who runs patient programs and educational workshops for teachers and school counsellors.

“Even five years ago, it was less common. We are seeing a tremendous escalation.”

“There is really no doubt that it is exploding in the community at large—in middle schools, high schools and beyond,” said Barent Walsh, a Massachusetts psychologist who wrote his first book 19 years ago, when self-injury was confined almost exclusively to teens in hospitals, group homes and residential schools.

“The previous take on self-injury was that it was related to loss, abuse, abandonment, various types of trauma. That doesn’t appear to be true for the new generation. It’s not like the clinical population went away. They’re still out there, being served in treatment settings. But now you have this new, ‘healthier’ group of self-injurers. Which is odd language to use, but it happens to be true,” Walsh said.

“This generation is quite striking. I am now seeing very capable, competent young people who are excelling in school, have friends, come from relatively stable families, and yet they self-injure,” he said.

A former patient, in recovery for two years, was prom queen and captain of her soccer team.

Whatever makes them do it?

“What they will usually say is: ‘I feel just this incredible feeling of tension,’ or: ‘I couldn’t bear what I was feeling and I cut and, oh, I relax and I feel it all leave my body,’” Heath said.

One reason experts have begun working together is to try to get a better grasp on what it is about cutting or otherwise hurting themselves that makes these teens feel better temporarily, despite the physical pain.

“I call it this amorphous blob of feelings,” Lader said. “They aren’t sure what’s happening and then they injure and it helps glue them, it helps calm them and they can think more clearly.” Only this isn’t like other coping strategies, such as drugs or liquor.

“All of us will get a little high from alcohol. Or if they try grass, even healthy kids are going to have a reaction to it. Kids who are healthy who self-injure, they are going to be hurt. It’s not going to be helpful. So kids who continue to self-injure, it’s indicative of an internal problem. They are having trouble dealing with their emotions.”

Why this disturbing habit has blossomed now remains unclear. Heath and her colleagues can’t help making a link with widespread access to the Internet, where self-injury websites glorify abusive habits or show pictures of open wounds, or chatrooms provide a forum where emotionally distraught teens egg one another on.

“When youth communicate about self-injury, that’s triggering,” said Walsh, who sometimes suggests his patients limit Internet use or stick to responsible sites that provide support to youngsters ready to stop hurting themselves.

And then there are the “high-status peer models,” like Johnny Depp and Angelina Jolie.

“A few years ago, Angelina Jolie was voted sexiest woman alive. So when the sexiest woman alive cuts herself, that’s pretty intense advertising.”

Yet Walsh can’t help looking for underlying causes in the way so many of us live today, dashing madly in all directions.

“This is a generation of children where a certain portion of them are quite distressed. A lot of them are being rushed about from one healthy activity to another. After a while, too many healthy activities are unhealthy. A lot of the activities are competitive, so performance comes in.”

When the pressure becomes too much to stand, they often lack the skills needed to wind down, catch their breath and relax, techniques a previous generation might have learned informally at home.

“Parents are doing the best they can. But a lot of them are on treadmill existences.”

Lader also seeks clues in today’s “Twilight Zone” communities, where teens are at once hooked up and plugged in, yet largely detached from what is going on around them.

“Kids are not learning about themselves, their own internal processes, what they think, what they feel,” Lader said. “They are just reacting because things are so fast. They don’t sit with anger and frustration and figure out what it is and what they want to say about it. Things happen so fast.

“There are cultural changes that have created a sense of invisibility in kids, to the point where they think they need to advertise on the outside what they are thinking on the inside. I call it spicing up the cover, so somebody might read the book.” Science and Technology
June 26, 2007

Students Should Cut The Net, Not Themselves
By Brandon J. Mendels

Jun. 26, 2007 ( delivered by Newstex) — It used to be, if you wanted to “properly”express anger or frustration, you confront the source of your problems and register your complaints. At least, that.s what told in school. But a wealth of studies indicate college students aren.t dealing with their problems by getting help or finding other ways to resolve them. As a college student, I was stunned to learn that one of six of my peers opted to injure themselves intentionally rather than reaching out for help from their peers or institution.

College is a stressful time for everyone. The professors are overworked, underpaid, and in some cases under appreciated. Administrations need to operate on a budget and make their college attractive in light of the rising price of attendance. And the students have to navigate the “triangle of death”, better known as future life, current life (class and work), and social life. Sometimes a friendly ear can be hard to find. As a Resident Assistant, we’re trained to help students who may have problems adjusting or navigating through troubled waters. But the amount of students who come to us, or come to their student-counseling center pale in comparison to students who need help the most.

So what do these students do? Do they drink themselves stupid? No. That’s for the weekend. Do they medicate themselves? Half of all Americans are on one prescription drug or another, so the odds are they’re medicated already. According to the Associated Press, twenty-five percent of students who visit their counseling center take medication to deal with mental disorders. The seventy-five percent of students who don’t? Most deal with it rationally by subjecting themselves to other forms of punishment, such as watching Comedy Central, going to the DMV, or attending a New York Mets game.

But then we have that one student out of every six. You might be wondering, what possesses that sixth person to injure themselves in the first place? Did they see “The Lake House” and want to put themselves out of their misery afterward? Maybe. But research of self-injury has shown people injure themselves for escapism, depression, and to exercise control over their life when they feel they’ve lost it. The rise of self-injury may indicate a greater existential crisis among today’s college students.

This crisis is best be reflected by the growing popularity of social networking sites like Facebook. Students are flocking to them not because it.s the trendy thing to do, but because students want to feel connected to each other. Some media outlets have it all wrong with their “Generation Tech” idea. The technology usage among young adults has more to do with community than leisure because there is no longer a sense of community among today’s college students. With a growing number of transfer students, the emergence of non-traditional students, and the rise of in room entertainment has effectively choked the life out of vibrant college communities around the country. As the baby boomers and previous generations of college students will tell you, the social scene was completely different than it is now. Instead of interacting with neighbors, students camp out in their dorm talking online and surfing the Internet. And colleges have responded for the most part with silence and paternalistic measures like forcing Freshman to pass a test about the dangerous of alcohol before they can register for class.

If a student feels they have no control over their life, and no one to communicate with because their peers are all online watching sub par programming on YouTube, they’re going to do foolish and potentially harmful things to resolve their issues. While an effective resolution to this problem m ay not be clear cut, the burden is on colleges around the country to focus more on student life than construction and paternalism. Parents need to do their part and ask the right questions to college administrators while students need to lose their World Of Warcraft account and reach out to their fellow students in need. That would be a rational choice for all of us.

Columbia Daily Tribune (Missouri)
July 9, 2007

A Painful Release; Experts Seeing More “cutting”
By Janese Heavin

She wore jeans cut off just below the knees and a long-sleeved T- shirt, even though afternoon rain showers left the air warm and sticky.

Shorts and tank tops were out of the question.

“The last thing I want is for people to know,” she said. “I hate talking about it. I know people would see me in a different way and think I’m a freak.”

Unseasonable clothing, at least, hides the scars that decorate her upper arms and thighs.

For the most part, Sarah isn’t that much different than most 15- year-old girls. She struggles with math homework, likes to hang out with friends and has dreams of becoming a famous singer.

But sometimes she hates her life. That’s when the Hickman High School sophomore turns to razor blades for comfort. When anxiety becomes overwhelming, she presses the edge into her upper thigh and pulls the blade across her skin, leaving a bloody stream behind.

“It doesn’t hurt,” she said. “I don’t want to say it feels good, but it doesn’t hurt. It’s a relief.”

Sarah has asked that the Tribune change her name for this story because she doesn’t want her parents to know. They caught her cutting a couple of years ago but now believe she’s quit.

“I told them I stopped a million times, but I kept doing it,” she said. “I was just smarter about it. ... I used to use kitchen knives; now I use razor blades. They’re just easier. They’re cleaner and sharper, and you can just toss them when you’re done.”

Her friends know but rarely say anything. Sometimes they notice fresh marks.

“They’re just like, ‘Why don’t you just stop?’ And I’m like, ‘Because I can’t,’” she said. “It’s bad. I know it’s bad. I’ll get annoyed, and I’m just like, ‘I have to do this.’”

Therein lies the danger of self-injury, said Armando Favazza, a psychiatry professor at the University of Missouri-Columbia.

Although cutting is rarely fatal, it can be highly addictive, he said. “Some can cut once or twice and stop,” he said. “Others can’t stop once they start.”

More and more teenagers are seeking relief from daily pressures by hurting themselves, and cutting seems to be the injury of choice.

“We see it every year,” Hickman High School guidance director Ann Landes said. “If students did it in the past, we never really knew about it. Cutting is not something we used to see as much as we do now.”

Cutting has become more widely known since the mid-1990s when Princess Diana admitted to cutting her arms and legs. Since then, a slew of other celebrities, including Johnny Depp and Angelina Jolie, have also admitted deliberately hurting themselves.

Those celebrity confessions and accompanying media attention have turned cutting into a popular theme for songs, teenage television dramas and other mainstream markets.

“It’s a startling kind of behavior, a very upsetting kind of behavior,” Favazza said. “It’s difficult to stand around and watch someone cut themselves. It’s very unsettling. That’s why we’re fascinated by it: We can’t believe somebody would do such a thing.”

But self-injury is not a new phenomenon. The first documented incident of cutting is found in the Gospel of Mark, which tells of Jesus healing a man who repeatedly cut himself with stones.

“Cutting has been around forever,” Favazza said. “A percentage of the population has always done this. But a decade ago, most people stumbled on it accidentally.”

Although motives vary, cutters typically aren’t trying to commit suicide. Instead, Favazza said, those who cut or burn their skin often do so to counter out-of-control emotions.

“They do it because it makes them feel better,” he said. “It makes really bad anxiety go away. But the problem is it only lasts a few hours, or for a smaller percentage, a few days or, for an even smaller percentage, a few weeks. So they often have to do it again and again.”

Emily Thompson, 23, began cutting herself at age 13 after she discovered that physical pain relieved the pressures she felt in school.

“I hurt myself accidentally, and it made me feel better,” said Emily, a former University of Missouri-Columbia student who now lives in her hometown of Aurora, Ill.

“Honestly, it’s welcome,” she said. “You feel so much pain inside, to see it and to feel it physically, it’s somewhat validating, a relief. It’s kind of like being strangled—when they let go, you feel a relief. That’s how cutting was to me.”

Emily said others at her high school began cutting, too, after they found out about her habit. “I started it at my school,” she said.

Cutting, in fact, can become trendy among some teenagers, Favazza said. He knew of a “Cut of the Month Club” at a Columbia high school a few years ago.

“It can be faddish,” he said. “Some real cutters, for some reason, others find them attractive and cut to be friends with them.”

Others cut themselves for secondary gain, such as attention. “It’s also used as manipulation, a way of trying to instill a feeling of guilt or to get a response out of other people,” Favazza said. “A broken-hearted girl might do it to make the boy feel guilty or come back.”

But Favazza said cutting should never be ignored: “It might be a fad, but the danger is for susceptible people, it can get beyond control.”

Sarah’s mom noticed her scars about six months after she started cutting. “They were pissed off and grounded me,” she said.

Emily’s family had similar reactions after her mom read about her habit in her diary. She said her parents were also “pissed off,” and her sister disowned her. “They didn’t get it,” Emily said.

Parents rarely understand because they’re not informed about cutting, Favazza said. And it’s not a behavior that can be cured by getting angry or taking privileges away from the cutter.

“You can’t tell them to stop any more than you can tell a depressed person to cheer up,” Favazza said.

Parents who discover that their child is cutting should seek counseling immediately, he said: “You have to nip it in the bud.”

Emily saw a therapist who diagnosed her with borderline bipolar disorder. She now takes medication and has a list of 40 activities she can do whenever she feels like cutting herself. She now considers herself a recovering cutter and speaks about her experience to groups through the National Alliance for the Mentally Ill.

Emily urges other cutters to seek counseling, or at least talk to someone. “It’s true, some people do get mad or scared off,” she said. “You never know how someone is going to react. But somebody out there is going to know and understand.”

Sarah has yet to find that help. Although she said she wishes she could “take it back,” she has no intention of putting down the razor blades.

“I know I’m not going to stop. I’m not going to try to stop,” she said. “It’s like a drug addiction or drinking. You can’t stop. It’s part of me. It’s always going to be there.”

Hindustan Times
July 20, 2007

Self-Harming among Teens More Common than Thought
A Report from the Asian News International

Washington, July 20—A new study has suggested that teens’ indulgence in non-suicidal injury is more common than what was previously suspected.

Non-suicidal self-injury is the deliberate, direct destruction of body tissue without conscious suicidal intent.

“The findings are important because it suggests that NSSI is more prevalent among adolescents in the general population than previously thought,” says lead author Elizabeth Lloyd-Richardson, PhD, a psychologist at The Miriam Hospital and assistant professor of psychiatry and human behaviour at The Warren Alpert Medical School of Brown University.

“If this is the case—it’s essentially a wake-up call to take better notice of these behaviors in the community and learn how to help teens manage stress without harming themselves,” added Lloyd-Richardson.

Researchers decided to explore the frequency and breadth of NSSI engaged in by teens in the community because little is known about self-harming behaviour in this particular population.

“Although NSSI is commonly encountered in inpatient and outpatient psychiatric and other institutionalized settings, little research has looked at NSSI in community samples,” said Lloyd-Richardson.

A total of 633 high school students (grades 9-12) from schools in the southern and mid-western United States voluntarily and anonymously participated in the study by completing a survey administered by the researchers. The survey asked the participants whether they purposefully engaged in 11 different NSSI behaviours in the past year, and if so, the frequency of occurrence. In addition, the survey assessed the motivations for engaging in NSSI behaviour.

“We were surprised to find that 46 percent of the teens in the study reported injuring themselves in the past year on multiple occasions,” said Lloyd-Richardson.

Furthermore, 60 percent of these (or 28 percent of the entire sample) endorsed moderate/severe forms of NSSI including cutting skin, burning skin, giving self a tattoo, scraping skin, or using a pencil to “erase” skin.

The researchers note it was important to distinguish between minor and moderate/severe forms of self-injury, since severe forms of NSSI may be predictive of more serious outcomes. Minor forms of NSSI consisted of behaviours such as pulling out hair, biting self, or picking at areas of the body to the point of drawing blood. Moderate/severe self-injurers were more likely than minor self-injurers to report a history of psychiatric treatment and hospitalizations, suicide attempt, and current suicide ideation.

Results from the study also indicated that the most common reasons teens in the study engaged in NSSI included “to get control of a situation”, “to stop bad feelings”, and “to try and get a reaction from someone.”

“This suggests that adolescents are engaging in NSSI for several reasons, including both regulating their own internal emotional states and trying to manage situations in their environment,” said Lloyd-Richardson.

“Once thought of as a phenomenon only found in teens with mental health issues, the results support the notion that many adolescents in the community are self-harming as way to cope with emotional distress,” she added.

Accordingly, intervention efforts should be tailored to the individual and contribute to building alternative skills for positive coping, communication, stress management, and strong social support, the authors note.

“While there remains few proven treatments for NSSI, understanding the specific motivations behind an adolescents’ behaviour—namely to influence the behaviours of others, as well as to manage their own internal emotions as our study shows—allows for the development of an individual treatment plan that could help prevent future episodes,” she said.

In this study, no gender, race, or age differences were noted in overall NSSI rates—however, the researchers suggest that future studies examine NSSI in nationally representative samples. They also recommend exploring how NSSI and its functions may change over time, given additional exposure, as well as changes in interpersonal and intra-personal variables.

“For example, a question that arises is if long-term exposure of repeated NSSI leads to a decreased fear threshold in teens, and therefore, a greater attraction to suicide and death. The answer could lead to significant changes in how we initially treat adolescents who start to exhibit self-harming behaviour,” Lloyd-Richardson added.

The research is published in the August 2007 issue of Psychological Medicine.

The Globe and Mail (Canada)
July 20, 2007

Cuts, Bites, Burns: Teen Self-Injury on the Rise?
By David Andreatta, with a report from Hayley Mick

Latoya had no intention of harming her boyfriend when she reached for the kitchen knife while in the throes of an argument with him four days ago.

Instead, she calmly dragged the serrated edge across the fleshy underside of her left forearm, as she has done for years when the stress of the moment becomes too much for her to bear.

Then she did it again, and again, until the skin broke and blood bubbled to the surface.

“Whenever I’m upset or in pain, instead of taking it out on other people I take it out on myself,” said the 23-year-old from Toronto, whose scarred and bruised arm betrayed a decade of self-abuse.

Deliberate self-injury without suicidal intent is not a new trend. But new research suggests the practice may be more common among young people than previously believed.

According to a study published in the August issue of the journal Psychological Medicine, 46 per cent of U.S. high school students surveyed had practised some form of self-mutilation in the past year, ranging from cutting and burning to pulling out hair and hitting themselves.

“If this is the case, it’s essentially a wake-up call to take better notice of these behaviours in the community and learn how to help teens manage stress without harming themselves,” said Elizabeth Lloyd-Richardson, a professor of psychiatry at Brown University in Providence, R.I., and the author of the study.

The findings are a stark departure from other studies on self-mutilation, which have generally pointed to an incidence of between 13 and 25 per cent of adolescents. Leading researchers, however, have not always agreed on what constitutes self-injurious behaviour, in some cases limiting their studies to cutting and burning.

In the Brown study, 633 teenagers between grades 9 and 12 at U.S. high schools were asked if they had engaged in one or more of 11 different types of behaviours deemed by researchers to be self-injurious in the past year.

They included obvious forms of self-mutilation like cutting, burning, inserting objects under the skin and biting, and less overt forms like pulling out hair, picking at skin until blood is drawn and giving oneself a tattoo. Cutting, biting, burning and hitting were found to be the most prevalent forms of self-abuse.

Elizabeth Thom, who runs a counselling service in London, Ont., called Safe Abuse Finally Ends in Canada, said she was not surprised by the latest results.

She said she has seen an explosion in self-injury among adolescents, and estimates that 80 per cent of her clients are teenagers, compared with 50 per cent a couple of years ago.

“I’m seeing kids now in grades 7 and 8,” Ms. Thom said. “They feel [this behaviour] gets rid of their problems for the moment. It’s not healthy or helpful, but it takes away the pain by distracting them. That may last only minutes, but under the circumstances minutes may be all they need.”

Indeed, among the most common reasons for self-mutilation given by those polled were “to stop bad feelings,” “to get control of a situation” and “to try to get a reaction from someone.”

It was once thought that self-injury was confined to teenagers with severe mental and emotional problems, but the new research mirrors other studies in suggesting that even adolescents who appear mentally stable are harming themselves as a means of coping with anxiety.

“Certainly you still see very disturbed kids who self-harm, but then there are kids who just kind of do it when they’re upset,” said Miriam Kaufman, an adolescent health specialist at Toronto’s Hospital for Sick Children. “I’ve had a few kids who just cut recreationally.”

Ms. Kaufman said the results “seem a little high,” but pointed to differing definitions of self-harm. She estimated that as many as a quarter of her patients claim to have harmed themselves in the past year.

“It’s become a sort of group activity for some kids,” she said. “They get a real rush from it.”

Why the practice is growing now is unclear. Some experts point to websites glorifying self-injury. At the same time, there are many sites and message boards dedicated to self-mutilators seeking help.

In the case of Latoya, who asked that her last name not be used because of the sensitivity of the subject, she said she began cutting herself when she was 13 as a way of dealing with the death of her father. Over time it has become routine, she said.

“There’s really nothing going through my mind when I’m doing it. I’m just zoned out,” said Latoya, who covered her scars with a heavy long-sleeved velour sweater.

“I want to stop. It’s disgusting to look at. I can’t show my arms when it’s hot outside,” she said. “When I have a short-sleeve shirt on, people give me dirty looks.”

The Patriot Ledger (Quincy, MA)
July 28, 2007

Expert: Self-Injurers Have Choice—‘Feel or Not to Feel’
By Jane MacKay

Clinically, Wendy Lader has probably worked with more self-injurers than anyone in the world. In 1986, Lader, a clinical psychologist, teamed with Karen Conterio, founder of S.A.F.E. Alternatives, the first outpatient support group for those who engage in repetitive, deliberate self-harm behavior, to create the first structured inpatient program treating self-injurers.

Unlike many outpatient treatments, the 30-day S.A.F.E. program operates on the premise that self-harm can be transformed from a seemingly uncontrollable compulsion to a choice. Participants in the program must pledge in a contract not to harm themselves.

Deliberate and repeated self-harm is a coping strategy to deal with psychological distress—to release emotions that are too great too bear.

Self-injurers often “fear that something horrible will happen—that they’ll explode or won’t be able to stop crying or that they’ll hurt somebody else if they don’t hurt themselves,” Lader said.

“Our program is about learning to tolerate those feelings and survive.”

Part of doing that, she says, is learning to recognize and identify the trigger, and then make a conscious choice of whether “to feel or not to feel.”

Repeatedly, data from clinical studies show that self-injury is vastly more prevalent among females. But, Lader says, that might be because men are less likely to reveal their behavior to a professional, and because they have ways of hurting themselves that are regarded as simply part of “being a guy.”

“Hitting walls, playing tackle football to get hurt, playing ‘chicken’ with a cigarette” are all ways of trading emotional pain for physical pain, she said.

As many as a quarter of all college students have deliberately injured themselves in an attempt to mitigate emotional pain, and 70 percent of them have done it more than once, according to a survey conducted in spring 2005.

Most started while they were in high school—the average age of first self-injury was 15 to 16 years—and most still have not told anyone.

The survey, which analyzed responses from 2,875 students at two northeastern U.S. colleges, was led by Janice Whitlock, a professor in the Department of Human Development at Cornell University.

Lader’s 21 years of experience have revealed that as many as two-thirds of self-injurers also have eating disorders.

There is, she says, a strong correlation between the two forms of self-harm that sets them apart from other addictions.

“Most of us can understand substance abuse or addiction,” she said. Having a drink or three or taking drugs leads to a good feeling, whereas slicing one’s arm or refusing to eat are disciplined, pain-inducing acts that “healthy people can’t understand,” she said. “The first thing we learn as children is to recoil from pain.”

This leads to a morbid fascination with self-injurers that in turn lends them power over those who can’t fathom their behavior.

But incomprehension and anger are not valid reasons to abandon the self-injurer to his or her pain, Lader says.

“I really do believe that people do and can get better all the time,” she said. “I’m very optimistic.”

The Patriot Ledger (Quincy, MA)
July 28, 2007

Writing Love around the World; A Group of Friends Tries to Stop a Girl From Harming Herself and Thousands Flock to the Cause
By Jane MacKay

‘Stop the bleeding” are the words in blue on Katherine Hollien’s black T-shirt. Katherine, 14, has no scars on her arms, but the words on her shirt represent the pain of those who do—those whose scars are self-inflicted.

Katherine, of Hanover, is one of thousands of teens responding to a group called To Write Love on Her Arms. It’s a nonprofit organization originally formed in 2006 to help Renee, a teenager from Florida who sought help to stop cutting herself.

Writer and founder Jamie Tworkowski wrote about her recovery in an online essay and thousands worldwide got behind the effort and bought T-shirts like Katherine’s in support.

Tworkowski’s essay described five days spent with Renee after a treatment center rejected her, deeming her too risky. She was 19, high on cocaine, had been drinking, and was depressed, suicidal and carving obscenities into her forearm.

Tworkowski wrote: “We became her hospital and the possibility of healing fills our living room with life. It is unspoken, and there are only a few of us, but we will be her church, the body of Christ coming alive to meet her needs, to write love on her arms.”

Grassroots Effort

He hand-sold a few dozen T-shirts to pay for Renee’s treatment. One sale led to another and soon rock ‘n’ roll groups, like Paramore, wore them while performing and teens like Katherine and her friends became interested.

Katherine said she and her friend Emily Abi-Kheirs are huge Paramore fans and first saw the band wear T-shirts with the To Write Love on Her Arms logo.

Then, “we were at the Wrentham outlets and we saw a girl with the shirt on,” said Katherine, who like Emily will be entering ninth grade at Hanover High School this fall. “So we went home and Googled it. We found the Web site and we thought it was wicked cool.”

The organization’s official MySpace page lists more than 115,000 friends, hundreds of whom have posted their own messages of support and tales of struggle.

Users of the social networking site have created 16 groups dedicated to the movement that together list more than 18,000 members. A search for the phrase on Google brings up almost 4.5 million references.

And all without any coverage in the mainstream press.

Songs of Praise

Music gave the group a huge boost in May 2006 at Cornerstone Florida, an annual Christian rock festival. Hayley Williams, the 19-year-old singer of the fast-rising rock band Paramore, told the crowd to check out To Write Love, which had a booth on the grounds.

It was during this show Tworkowski said he realized To Write Love had staying power.

“After the set, it seemed the entire crowd walked straight to our booth,” Tworkowski said in an e-mail. “It was clear that something was happening.”

Hanover teens Katherine and Emily are lobbying for their favorite Boston group to join the cause.

“It’d be really cool if Boys Like Girls got into it,” Emily said.

To Write Love will also have a tent at each stop on the Vans Warped Tour, a two-month nationwide music tour featuring more than 50 bands. Attended largely by teens and people in their early 20s, the tour is an ideal vehicle for spreading the movement’s message, Tworkowski said.

Strong Message

The strength of the coolness factor notwithstanding, the movement’s story and message are what compel teens like Emily, Katherine and their friend Jessica Stacy to buy To Write Love shirts and spread news of its existence.

For Jessica, who stumbled upon the Web site through links on friends’ MySpace pages, the tales of fellow teens’ struggles had a personal resonance.

“To Write Love on Her Arms helped because I was going through that,” she said. The Web site and blogs were “a place that was safe and secure. It’s not an adult saying, ‘This is wrong.’”

That feeling of safety and security is important for the treatment and recovery of a self-injurer, said psychologist Wendy Lader—but it’s not enough.

“There’s still a feeling of alienation because the other person doesn’t understand the depth of experience” of the teen struggling with depression, suicide, drug abuse or self-injury, said Lader, who co-founded the treatment program S.A.F.E. (Self Abuse Finally Ends), in 1986.

S.A.F.E. is one of seven organizations selected earlier this year by To Write Love to be regular recipients of money raised through donations and sales of merchandise.

“We want our audience to know where these needs are being met,” Tworkowski wrote in the e-mail.


Emily, Jessica and Katherine have all been inspired by the movement to help others.

“I want to be into activism when I grow up,” Jessica said.

Emily wants to “do something with music.” She has already composed a few pieces. Or she would like to become a psychiatrist.

Tworkowski’s way with words has struck the strongest chord with Katherine, who would like to earn her living as a writer.

After describing their goals, the girls muse upon the possibility of pooling their specialties to really make a difference among those in need. At 14 years old, they realize it will be a while before they fulfill their dreams, but that doesn’t dull their enthusiasm.

It’s enthusiasm like this that Tworkowski hopes will help to open the door to conversation about a reality that’s bigger than people think—or maybe want to know.

“More than half our audience struggles with depression and self-injury,” Tworkowski wrote in the e-mail. “That suggests this is much more than a T-shirt phenomenon. These are people living in dark places.

“A friend of mine told me there’s no such thing as suicide prevention. This is an attempt to prove him wrong, to say that love can change a life,” Tworkowski wrote.

The Columbian (Washington)
August 14, 2007

A Personal Pain
By Erin Middlewood

Katie Nance wore long sleeves and stacks of bracelets to hide the evidence of her self-destructive compulsion.

She still tugs her sleeves over her hands and favors colorful bracelets, but there’s not much left to hide. The scars on her wrists have healed.

Now the Vancouver teen concentrates on staying busy. She’s involved in her church’s youth group. She takes antidepressants. All to help her fend off a strong urge to cut herself.

“If it ever crosses my mind, I put it out of my mind. I put it out of my mind because if I think about it, I’ll end up doing it,” the 14-year-old said.

Misconceptions about self-destructive compulsions are common. The urge to cut or harm oneself is not rare as some might think, and it’s not confined to teenage girls who dress in black.

Self-abusers who deliberately and repeatedly cut, scratch, hit or burn themselves make up an estimated 4 percent of the population, according to S.A.F.E. Alternatives (Self Abuse Finally Ends). By that estimate, Nance is one of about 16,000 Clark County residents who hurt themselves on purpose.

“We used to think it was mainly female and upper class,” said Wendy Lader, president of S.A.F.E. Alternatives, based in Illinois. “Now we know that’s not true.”

Self-injurers hurt themselves to drown out bad feelings or to feel something at all, but it’s not necessarily a behavior leading up to suicide.

“Some are cutting because it keeps them from suicide,” said Sue Eastgard, director of Washington’s Youth Suicide Prevention Program in Seattle.

It’s hard for healthy people to understand why someone would want to hurt himself.

“It doesn’t have an effect on healthy people. It just hurts,” Lader said. “People who do it more than once must be getting something out of it.”

Self-injury often begins in adolescence, but it can continue for years if not treated.

Katie started hurting herself when she was in the sixth-grade.

“I knew people who cut. They talked about how great it was to relax,” Katie said.

Her experience illustrates that self-injury is “a highly contagious behavior,” Eastgard said.

“In the last 10 to 15 years, we’ve received many more calls about self-injury than we’ve ever had. Schools are frantic, saying, ‘We need education.’”

Katie began hurting herself using steak knives and other relatively dull implements and progressed to pocket knives and razors.

“My friends noticed,” Katie said. Eventually, someone told her guidance counselor. When her parents found out, they felt alarmed, but it also helped explain some of Katie’s mysterious behavior.

Colleen Nance, Katie’s stepmom, said she searched for information and treatment.

“Besides school counselors, there’s not much help for this,” Colleen said. “It was very difficult to get anyone to have a sense of urgency.”

Colleen said some medical professionals dismissed Katie’s cutting as an attention-getting behavior.

But many self-abusers are secretive. Those who are flagrant about it are the attention-seekers, Eastgard said.

“This is where contagion is gigantic,” she said.

Therapists discourage support groups for those who injure themselves because participants trade tips on how to hurt themselves.

Eastgard tells worried adults not to focus on the self-injury but instead what motivates that behavior. She suggests asking self-abusers what problem they are trying to solve as a way to address the underlying issues.

Lader agrees it’s important to respond. “If someone is doing this and they’re not getting attention,” she said, “what else will they do?”

Colleen said it was difficult to know how to best help -Katie: “Do you do a strip search every day?”

“When my dad checked my arms, I did my legs,” Katie said.

Katie found grief counseling the most helpful. When she hit middle school, she started feeling the loss of her mother, who died when Katie was 5 years old. Katie also received treatment for depression and anxiety. She says she rarely gets the urge to cut herself now.

When she finished middle school in the spring, she gave her exit-project report on self-injury. She didn’t talk about her own experience because the report was supposed to be objective. But she has advice for others in her situation.

“Stop while you’re ahead. Once you get into it, you crave it,” she said. “Get help right away.”

Tips for Parents

- If you notice your child has injuries and you suspect they are self-inflicted, don’t react with criticism, shock or horror. Remain nonjudgemental. Say something like, “I notice you have cuts on your arms.”

- Understand that self-injury is a coping mechanism.

- Validate the emotions that might have triggered the behavior. You could say, “I’m worried less about the cutting than what you were feeling when you cut.” If the answer is, “No one sat with me at lunch,” then focus on those feelings of isolation.

- Seek help from a counselor or doctor.

- For more information, contact the Youth Suicide Prevention Program at 206-297-5922 or

The Mirror
September 13, 2007

Your Life: Amy Winehouse’s Scarred Arms Are Proof of a Shockingly Common Habit—Figures Show One in 10 Teens Admit They Regularly Cut Themselves. Here, Your Life Investigates Just Why People Self-Harm
By Charlotte Haigh

A my Winehouse grasped the shard of glass from the broken mirror and calmly slashed at her stomach with the jagged edge.

It wasn’t the first time the troubled 23-year-old singer has deliberately hurt herself—Amy admits she began self-harming at the age of nine.

But this incident was more shocking than most... she did it during a magazine interview in June.

Owen Wilson’s recent suicide bid followed three days of bingeing on drugs and cutting himself. And in her new autobiography Gail Porter talks about how she used to slice her skin with a razor blade.

Sadly, these celebs are not alone. Research by the Samaritans ( found one in 10 adolescents has deliberately hurt themselves.

Why Do It?

“There is a misconception that it’s attention-seeking, but most people who self-harm do it secretively,” says Mary Hillery of Lifesigns, a support network for people who self-injure. “It is their way of dealing with emotional distress.”

Self-harming can be a way of expressing anger or frustration, getting relief or distraction from pent-up feelings or even an attempt to get out of feeling “numb”.

It is sometimes confused with suicide attempts but, although it is an unhealthy way of expressing difficult pent-up emotions, some self-harmers feel it actually prevents that outcome.

Who Does It?

Self-harm is most common in young people, but it’s not just a teenage problem.

“Some adults have started in their teens and continue to use it as a coping strategy in times of stress,” says Mary. “And some begin self-injuring for the first time in their 40s or 50s.”

Once thought of as a female problem it’s now known to affect men and boys, too. While some self-harmers have suffered traumatic experiences such as sexual or physical abuse, for others it is linked with depression, anxiety and stress.

Here we look at the signs someone you know might be self-harming and where to go for help.

A Danger to Themselves

Arms and legs are the most common places to find self-inflicted injuries, perhaps as these are the easiest places to hide scars. Sufferers may do it daily, weekly or it may be an occasional act when stress is overwhelming. Types of self-harm can include...


This can start with someone digging into their flesh with their fingernails and may progress to scissors, razorblades or knives. Some self-harmers keep a tool especially for it.


Another common form of self-injury, often carried out with matches or lit cigarettes. Or someone might deliberately scald themselves.


Bangs and bruises are easy to disguise as an accidental injury. “Young men may be especially likely to hit themselves or break their bones, so it can look as if they’ve had an accident or fight,” says Dr Andrew McCulloch, chief executive of the Mental Health Foundation (

Hair Pulling

Some people pull out their hair or eyebrows as a form of obsessive compulsive disorder. But when hair is pulled out impulsively to cope with overwhelming feelings, it falls into the category of self-injury.


Taking too many pills or ingesting poisonous substances—but not with the intent to kill yourself.

Taking Risks

“Self-Injury also refers to abusing your body with eating disorders, excessive drinking or drug taking, or reckless driving,” says Mary. “Men are more likely to use this risky behaviour rather than cutting.”

Heavy drinking and drug abuse often go hand-in-hand with self-harm.

How You Can Get Help

Self-Harming is a sign of serious emotional distress and can be life-threatening. It may be difficult to stop if you don’t have other coping strategies, so the first step is understanding that you need urgent help.

If it’s difficult to talk to friends, family or your GP, visit online support network

The Mental Health Foundation has a booklet, The Truth About Self-Harm, to order a copy call 020 7803 1101 or email

It was Like an Addiction

IT support worker Sophia Gill, 28, from Teddington in South West London, says:

I was 14 when I started cutting myself. There was no specific reason. I was angry with myself for being down—I told myself I didn’t have real problems, so I didn’t express my feelings, which just built up inside me.

One day, in frustration I grabbed my sister’s disposable razor and cut my hand. I’d never heard about self-harming, it was completely instinctive. It gave me an instant feeling of relief from all that pent-up emotion. I started cutting my arms every time I felt like that, and moved on to using knives and scalpels. It was like an addiction—I had to do it more of ten and deeper for the same relief.

Nobody knew until I tried to kill myself at 15 and I saw a child psychiatrist. It helped but there was no quick answer. At 23 I was still self-harming. I had scars all over my arms.

Then at 24 I started writing a book about my experiences, which let me express myself in a healthy way.

I don’t cut myself regularly any more. I scratched myself after a car crash in February, but that was the first time in a while. I don’t regret any thing, it’s made me who I am.

Spot the Signs

It can be hard to tell if someone is selfharming. If you suspect they have a problem, don’t get angry or accusing, or try to take charge—many self-harmers feel their behaviour is the only thing they can control.

Simply say you’ve wondered if anything’s wrong and encourage them to talk to someone. The tell-tale signs might include:

Stars Who’ve Self-Injured

Dame Kelly Holmes talked about cutting herself in 2003, when the athlete became depressed after being injured during training. She said: “I’d locked myself in the bathroom and turned on the taps so nobody could hear me crying. That’s when I saw a pair of scissors. I picked them up, opened them and started to cut my left arm.”

Angelina Jolie self-injured in her early teens. She was “trying to feel something... I really hurt myself.”

Christina Ricci also self-harmed in her teens. She says: “It’s like having a drink. But it’s quicker... It made me calm.”

The Olathe News (Kansas)
September 19, 2007

Schools Educate Students about Self-Harm
By Arley Hoskin

Self-inflicted cuts can turn internal scars into external wounds. And this form of self-injury might be more common in Olathe than parents think.

“Anyone that doesn’t cut doesn’t understand it,” said Megan Hankins, Chisholm Trail Junior High School health teacher.

Hankins discusses cutting and other self-injury behaviors in her seventh-grade health class.

“It’s definitely a way to feel some kind of emotion,” Hankins said.

According to Focus Adolescent Health Services, about 4 percent of the U.S. population uses some form of self-injury to deal with stress.

“Self-harming is usually a response to difficult circumstances in a child’s life,” psychotherapist Annie Erickson said, who works with children ages 6 to 17 at Marillac, a psychiatric treatment center in Overland Park.

“In this area, I have found there is quite a number of children who do self-harm.”

Adolescents who cut or burn themselves gain control over external pain. Erickson said this technique makes teens feel in control of internal circumstances as well.

“It’s a way for them to control feelings of helplessness and powerlessness,” Erickson said. “They are in control because they are cutting.”

Self-injury has many forms. Instead of cutting, some teens use a curling iron to burn their skin or an eraser to rub their skin until it bleeds. Erickson said anything that causes pain when taken to the extreme, such as tattoos, piercing or exercise, can be a form of self-injury.

Gabriela Torres, an Indian Trail Junior High School freshman, said depression caused one of her friends to turn to cutting.

“She didn’t think crying was enough, so she started cutting herself,” Torres said.

Torres said her friend usually cut herself on the upper thigh, where people could not see the scars. She added that she knows other teens who cut to fit in with peers.

Teens of every demographic self-harm, experts say.

“A lot of people think only females self-harm, but that’s not true; males self-harm,” Erickson said.

Erickson encourages adults to take these teenage behaviors seriously. She recommends professional help in most instances.

“There are some children who can stop cutting on their own.” Erickson said. “For the most part, they need assistance in helping with their anxiety and working through their emotional difficulties.”

Sacramento Bee (California)
September 28, 2007

Skin, and Deeper: Some Teens Manifest Their Feelings in What Experts Call an Epidemic of Self-Injury
By Alison Roberts

The self-injury club for teens is not all that exclusive. Joining can almost seem trendy.

“There’s an incredible amount of kids who deal with these issues,” says a 16-year-old junior at a local high school who knows all about membership.

“Cutting is definitely the most popular. I did some of that, but that wasn’t my preference,” she explains. Instead, she usually engaged in bruising herself, sometimes banging her wrist against hard objects. Or, she scraped herself. She says she no longer hurts herself.

The Bee is not naming her because of her age.

A new study—whose results were published in the August 2007 issue of Psychological Medicine—found an astonishing 46 percent of students in grades nine through 12 had engaged in some sort of non-suicidal self-injuring behavior more than once in the previous year. These behaviors included what were classified as “minor” acts, such as pulling out hair or pushing an object under a nail.

Even more alarming was the 28 percent of students who reported more serious self-injury, including cutting, burning and self- tattooing. The study found no significant difference in rates of injury by sex, age, socioeconomics or living situation. White teens were significantly more likely to engage in self-injury than African American teens.

“I was surprised at the rates; and it’s not just kids in the grunge scene wearing black,” says psychologist Elizabeth Lloyd-Richardson, an assistant professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University in Providence, R.I. She was the lead author of the study, for which more than 600 students were surveyed anonymously.

A 2005 study, also using anonymous surveys, found a lower but still high rate of self-injury among college students. In that study, undertaken by Cornell University researchers, 17 percent of college students reported engaging in self-injurious behavior at least once. Of those, 36 percent said no one else knew about it. Most reported stopping within five years of starting, and most started between the ages of 12 and 15.

Exactly how much self-injury has increased is not known, but most researchers believe it has grown, along with a kind of acceptance.

“It does seem like it’s something that people don’t frown on quite as much,” says Lloyd- Richardson. Since her report was published, she has heard from many young adults who said cutting was common in their high schools.

Cornell University researchers, in a write-up of the college survey study, point to the addictive and contagious aspects of self-injury, with its documented tendency to “follow epidemic-like patterns in institutional settings.”

They suggest the same phenomenon may well occur in schools.

Locally, self-injury is almost as hot as texting among teens, according to Kelly Richardson, a psychotherapist in Folsom who works with adolescents. (She also writes a weekly teen-advice column in The Bee. See Page J3.)

“I think that cutting is an epidemic with teenagers,” Richardson says. “It’s very accepted. I’ve had people say, ‘Oh, she’s a cutter,’ like it’s no big deal.

The therapist says she didn’t see much evidence of self-injury until the past six to seven years. She thinks word of mouth has something to do with its rise.

In her practice, it is predominantly an issue for young women. Carving a boyfriend’s initials on the hand is fairly common and open practice. But for some, cutting grows more habitual and more furtive.

“Kids who are really into cutting start getting better at hiding it,” Richardson says. They may start cutting the bottoms of their feet or the insides of their thighs.

It can go hand in hand with pretty serious troubles, including eating disorders and depression.

“I don’t think you should overlook it. Even if a teenager says it’s their first time doing it, my recommendation is, I think you need to get it evaluated by a professional,” Richardson says. “You want to make sure it doesn’t grow to ‘Oops, I accidentally slit my wrist.’”

For those who are depressed, the experience is often described as something that relieves pain. The 16-year-old student who spoke of her experience knows it’s hard to comprehend.

“I understand how awful it sounds, someone hurting themselves,” she says. “But you can only cry so many times; the pain needs to come out somehow. As soon as you cause pain, right after that the effect is, like, peace.”

In her experience, it was a matter of middle-school experimentation initially, perhaps considered because she had a friend who was a cutter.

“I tried it once, and then I was hooked,” she says. “It’s something I definitely enjoyed doing, and it was something to look forward to.”

She says it was about a year ago that she stopped hurting herself.

“I decided I’m not doing this anymore because it is kind of addicting,” she said. She says she has seen some of that same addiction at work among those who are into piercing or tattooing.

Richardson says the acceptance of so-called “body modification”—referring to piercing, stretching, scarification, tattooing and the like—may be related to the declining stigma of self-injury.

“I don’t know if there’s a connection between the kids who cut and the kids who pierce, but there is this acceptance of mutilation of the body,” she says.

John Rush, a professor of anthropology at Sierra College, points out that there is a long tradition of bodily mutilation as part of human ritual.

Rush himself has gone through extensive tattooing and written books on the topic, including Spiritual Tattoo: A Cultural History of Tattooing, Piercing, Scarification, Branding and Implants, published a couple of years ago, and a new book, The Twelve Gates: A Spiritual Passage through the Egyptian Books of the Dead (North Atlantic Books, $26.95, 328 pages).

In an e-mail on the topic, he pointed to our basic, abiding need for ritual, particularly for initiation rites that bring us into a group. There are many traditional initiation rites that leave scars (from cutting, circumcision or other acts) as they mark the joining of an individual to a group, often at a transition from childhood to adulthood. Such rites often involve a certain amount of pain, which, Rush wrote, may “represent a sacrifice of the individual to the group.”

You can find what seems like a reflection of the yearning for ritual online in many self-described “tribes,” virtual communities dedicated to body modification and variations, including suspension, in which people hang from hooks embedded in their flesh. Many of the Web sites include lengthy discussion of the spiritual side of such practices.

Rush says self-injury—even when it’s done privately—can be part of a ritual process that is not pathological, but rather reflects a healthy search for a way to mark significant personal transitions.

When we change our view of such behavior, we might be able to harness the impulse in a more healthful way, he suggests.

“A ritual could be completed with the help of a surgeon; nurses could act as priestesses, and family and friends could be present as the community,” Rush wrote.

Priscilla Niessink went to a tattoo artist just before her 20th birthday as a kind of indelible rite of passage that celebrated her aspirations and her European heritage.

“I got the Dutch writing of ‘explore, dream and discover’ (‘onderzoek, droom, ondekken’)—because I’m ambitious and totally driven,” says Niessink, who grew up in Rocklin and just started attending California State University, Fullerton.

She says the self-injury of breast-augmentation surgery she has seen her peers suffer through seems much more cringe-worthy. And her tattoo gives her a chance to connect with others.

Among the young and frequently modified, you can rely on encountering the getting-to-know-you question, “Do you have any tattoos?”

“You say ‘yes,’” Niessink says. “And then you can share your story about how you got it.”

More Information

The Web site of the Cornell University Research Program on Self-Injurious Behavior in Adolescents and Young Adults has a wealth of readable and useful information. Find it at