The Arizona Republic (Phoenix)
January 9, 2008

Workshop Spotlights Teen Self-Injury
By Rachael Quattrini

The non-profit Arizonans for the Protection of Exploited Children and Adults is presenting a free workshop Monday, “Understanding the Dynamics of Adolescent Self-Injury.”

Lisa Ferentz, a social worker nationally known for her work with teens and self-injury, will present the workshop from 6 to 9 p.m. at Alleluia Lutheran Church, 8444 W. Encanto Blvd., Phoenix.

Ferentz is an adjunct instructor at the University of Maryland School of Social Work and has been run her own private practice for 24 years. She’s written on the topic of adolescent self-injury for several journals.

An estimated 1 million to 2 million people in the United States intentionally and repeatedly engage in self-injury as a coping strategy, according to the non-profit’s executive director, Janet Olson.

Frequently the injuries are done in secret, dismissed as accidents, or go unnoticed, meaning many teens and adults never receive the help they need.

“It can be anything from cutting, scratching, bone-breaking, using objects on their bodies,” Olson said.

Kids inflicting injury on their own bodies usually starts in early adolescence, peaking between the ages of 18 and 24. The most common factor leading to self-injury is stress in their lives.

“It’s not suicide. It’s to cope with the world in order to survive,” Olson said. “They’ve discovered this is a coping strategy to deal with it.

“It’s so hard nowadays to be a teen. There’s so many pressures, and sometimes they don’t have coping methods built up to handle it,” Olson said. “They need some extra help.”

Teens can feel anxious before they hurt themselves, and experience relief immediately afterwards. Once that passes, however, teens can feel sad and embarrassed, or feel like they can’t talk about it.

“It’s like other kinds of addictions. Once you get started with this coping strategy, it’s hard to stop without getting help,” Olson said.

The good news is teens can reduce the behavior and extinguish it.

Techniques to reduce the stress that leads to self-injury can include alternative behaviors, calming strategies, learning to self-nurture and learning to communicate. Tips and alternate coping techniques will be presented at the workshop.

Arizonans for the Protection of Exploited Children and Adults was created in 2003, and has been working with teens since 2004. The group offers support for teens recovering from self-injury, as well programs dealing with anger management and stress reduction.

If You Go

What: Adolescent Self-Injury Workshop.

When: 6 to 9 p.m. Monday.

Where: Alleluia Lutheran Church, 8444 W. Encanto Blvd., Phoenix.

Information: Free. For more information or to register, 623-247-6026.

Tips for Parents

Parents can become angry or confused when confronted with a child’s self-injuring behavior. Here are some tips.

* React in a calm, non-judgmental way. Staying calm helps avoid creating extra stress for the child.

* Talk to them about it. Be open and receptive when they are ready to talk.

* Determine what the stressors are. Knowing what they are can help you develop strategies to get them away from those stressful situations.

* Find help. Psychologists and counselors can help. The non-profit provides information and support groups:

Source: Arizonans for the Protection of Exploited Children and Adults

The Asheville Citizen-Times (North Carolina)
January 23, 2008

Local Schools Battle Trend of Self-Injury in Teens
By Ashley Wilson

For Jessica Ketterman, it all began when she was 10 or 11. Some friends asked whether they could carve her then-boyfriend’s initials into her back. The pain, she found, was a temporary release from the emotional turmoil she was going through.

Soon, cutting herself became a habit. She cut herself every day and sometimes more than once. Her favorite spots were her arms. Her favorite tool: a thin, double-sided razorblade that she bought at the dollar store 15 for $1.50.

“It felt like when you’re really, really stressed out and you keep it all in,” said Ketterman, now 17. “Then you have a nervous breakdown, and it’s really bad at that point, but afterwards, you feel 10 times better. It’s like a bursting balloon that gets filled up, and it bursts and then afterwards it’s better.”

With the help of Buncombe County Schools’ Student Response Center and the motivation to stop for her daughter, 2-month-old Lillie, it’s been a year since Ketterman last cut herself. Over the course of three years, she slowly went from cutting every day to once every couple of months. It got worse again before it got better, but now Ketterman rarely gets the urge to harm herself.

Ketterman’s story is not the only one. More and more local students are intentionally harming themselves. It goes across all levels and exists in all schools, said Kathryn Reynard, a member of the response center.

“I think mainly what it boils down to is this overload of emotions and teenagers being teenagers. They are trying to take care of this emotional overload immediately,” she said. “They turn to this other way. They don’t have to go out and buy it. They just have to get something sharp.”

The response center was created three years ago as a kind of emergency team to work with students who are not making adequate progress in school because of discipline issues, failing grades, substance abuse, mental health issues, bullying or harassment. One team member is assigned to each of Buncombe County’s six school districts. Self-injury is one of the things they deal with in all schools.

As Many as 2 in 10

Across the world, research has found that 15-20 percent of all teenagers have self-injured at least once, said Nancy Heath, a professor at McGill University in Montreal and a member of the International Society for the Study of Self-Injury.

“Whether it’s in the States, whether it’s in Canada, whether it’s in Turkey, you are finding 15 percent of the kids admit to this behavior at least once, and most of them are doing it a number of times,” Heath said.

The 3-year-old society is made up of 15-20 researchers, clinicians and advocates from different areas of the world all interested in the area of self-injury.

The practice takes on many forms, although cutting is most frequently discussed. Other forms include burning, hitting objects, biting, head banging and punching.

“I actually self-injured myself since I was little,” Ketterman said. “I would hit stuff and mess up my knuckles a lot when I was younger. I would walk on the side of my feet where it would hurt. I would bite myself and hit myself. Not in front of my mom, but I would do it in my room.”

Most researchers agree that the reason most teens self-injure is to deal with an overflow of negative emotions. A small group of children use it as a form of communication or do it for social reasons to get others to understand their pain. An even smaller group does it to manipulate.

“This is, basically, a coping strategy,” said Wendy Lader, a clinical psychologist and co-founder of S.A.F.E Alternatives. “When kids are feeling too much, oftentimes they don’t know what to do with those feelings. They may not be able to communicate it, and this is true for even very bright kids. They don’t know what to do with feelings, and they want to stop them, and self-injury is a way to stop uncomfortable feelings.”

S.A.F.E Alternatives is an organization based in Texas and Illinois that includes outpatient programs, a day hospital, therapist referrals and educational resources to try to end self-injurious behavior.

Lader deals mainly with females. Self-injuring is most prevalent in girls, although many males do it, too. The practice typically begins to form in middle-school-aged children, but it has been seen at younger ages as well.

Increase in Visibility

Although it is not new, self-injury is getting more attention as the subject is discussed on TV shows, sung about in songs, written about on Web sites and depicted on movie screens. Princess Diana and Johnny Depp are among the celebrities who have publically admitted to self-injuring, and it was the topic of a “Family Guy” episode.

“When we first started looking at it, a lot of people didn’t know at all,” said Heath, who began research in 1999. “They thought I was talking about a suicide attempt. Now as soon as I say cutting or burning, they say, ‘I remember that on ‘Oprah’ or that in ‘Girl, Interrupted.’”

The increased attention has negative and positive effects. More people are becoming conscious of it, making it less taboo to talk about. At the same time, as more teens hear about it, more may be tempted to try it as an option to deal with their emotions.

“I think it could go either way,” said Jon West, a counselor with the student response center. “Positive for us is more teachers are becoming aware of it. The more we can get in and help kids, the better. But also when kids hear it in the music and hear it in the songs, the music is making it a trend.”

How to Help

When Ketterman’s mom found out about her self-injuring, she grounded her. That only made the situation worse and forced her to hide it more. To get through to Ketterman, it took someone who would not punish her, but be real with her.

That someone was West. He got Ketterman to open up about her cutting and helped her find other ways to cope with the overload of emotions she was feeling. Ketterman now considers West and Kristin Rhinehart, a counselor at Enka High, her closest friends.

“I think I just tried not to judge her and accept her,” West said. “Give her options and just say, ‘OK, these are things you can try, but ultimately it’s your decision,’ and not take that away from her. Try to make her be the one to decide: Do I use these options? Do I cut? How do I deal with it?”

Punishment is rarely the correct response to deal with a child who is self-injuring. Neither is ignoring or overacting, West said. Parents and teachers who suspect a child is self-injuring should reach out to the child and be straightforward with him or her.

“Try to let them know you are there when they’re ready,” he said. “If they want to go to see someone, you will go with them. Let the person who is cutting be the one who decides when it is going to happen.”

The response center is trying to equip the community with the proper tools to help children who are self-injuring. Almost all of the staff in Buncombe County’s 41 schools have been trained, along with the school resource officers. The group has also done presentations for the Department of Social Services, local health clinics, nurses and volunteers.

Moving On

Journaling, drawing, listening to music, writing poetry and just talking helped Ketterman stop cutting. Now that she has Lillie, she said, her focus is taking care of her daughter. She is raising the girl, her child with a previous boyfriend, on her own.

Her next step is getting her GED and taking classes in Asheville-Buncombe Technical Community College’s Veterinary Medical Technology program. She hopes to work with an animal rescue team.

“It can get bad, but it does get better,” Ketterman said. “You can make it better, even when it seems like you can’t. I never thought I would get to be happy, and I am very happy now.”

Abilene Reporter-News (Texas)
February 10, 2008

Why Self-Injury?
By Brian Bethel

About 4 percent of the U.S. population uses physical self-injury as a way of dealing with overwhelming feelings or situations, often using it to speak when no word will come, according to

The most common behaviors are cutting, burning and headbanging, violent head movements to music. Other forms of such behavior include carving, scratching, branding, marking, biting, bruising, hitting and picking/pulling skin and hair.

Teens who self-injure may go to great lengths to hide wounds and scars, and many consider the self-harm to be a shameful secret.

But it provides an outlet for those who have difficulty talking about their feelings.

Several risk factors predispose youth to self-destructive behaviors, including low self-esteem, negative peer groups and low school engagement or educational aspirations, according to “High Risk Behaviors Among Youth,” by Maria R. de Guzman and Kathy R. Bosch.

Further risk factors include poor parent-child communication, low parental monitoring and a lack of family support.

Outside the family, variables that might put a child at risk for negative behaviors include a negative school climate, poor neighborhood quality, low socioeconomic status and poor or no relationships with nonparental adults, according to the report.

University Wire
February 15, 2008

Campaign addresses cutting
By Kyle Mills, Technician, N.C. State

Because February is considered to be the most prominent month for cutting, students are partaking in a global event called “Love is the Moment.”

The event is part of the “To Write Love on Her Arms” campaign, a movement started by a non-profit of the same name.

Several N.C. State students are writing “love” on their arms Feb. 13 and 14 to show their solidarity against self-injury.

According to the TWLOHA official Web site, more than 121 million people suffer from depression worldwide. It is also estimated that over 20 percent of teenagers will deal with depression at some point in the years between 13 and 19.

“On the day before Valentine’s Day, as well as the day of, teenagers are supposed to write the word ‘Love’ on their arms to show that cutting is not the way to go,” Natalie Brooks, a sophomore in animal science, said.

Brooks said she heard about the campaign during the last week of January through Facebook.

“I thought it was just another Facebook application, but when I read into it and took another look I found that it was something that I was passionate about, so I spread the word,” she said.

According to Brooks, the campaign hit close to home for her because she had personal experience with self-injury and understands how severe the issue is.

“Someone close to me was cutting and kept it a secret for almost one year,” Brooks said. “I saw no reason as to why she would do this.”

Zack Tondera, a sophomore in civil engineering, said he understood why cutting would increase around Valentine’s Day.

“February is a month that revolves around love, which is hard to deal with sometimes,” Tondera said. “Also, the weather is not the greatest in February.”

Tondera didn’t participate in the campaign because he said he was unsure of its effect but said if it did have an impact, he would consider participating the following year.

“I would write ‘Love’ on my arm if I knew it was going to make an impact, but as for this year, I’m not sure. Hopefully it will grow into something more popular,” Tondera said.

Some students say they see this month as affecting cutting more than others due to media influence, however.

“A lot of times, the media presents it as taboo if you don’t have a loved one, or a significant other on Valentine’s Day. This can cause peoples’ self-esteem to drop really fast,” Brooks said.

The non-profit originally began as a story Jamie Tworkowski wrote about his friend Renee, who was a drug addict and cutter, according to the Web site. After Renee was denied access to a drug treatment center because they didn’t have detox, Tworkowski and his friends took her in and had a kind of five-day rehab until they could get her into an actual rehabilitation center. His story chronicled those five days, and the non-profit grew from the story and its cause.

Music was a big part of the original story and the five-day rehab, because Renee loved music, and now TWLOHA has the support of numerous bands including Paramore and Switchfoot.

The non-profit also tries to further its cause with the selling of t-shirts and other merchandise. According to the Web site, 25 percent of all proceeds go directly to treatment and recovery through partner organizations. The rest of the income goes to support the organization and the services it provides the community.

“It’s awesome that something like this has grown into something as big as it is,” Brooks said. “With the help of t-shirts and bands, I suppose the word will get across.”

“The publicity this situation receives from these bands is very helpful,” Tondera said. “It’s helpful that the bands are popular with the targeted audience, and they tell a great message.”

In many ways cutting, and depression in general, are something that are highly under-addressed by students, according to Brooks.

“We as a society need to help these people who do these sorts of things to know that they are not outcasts from society,” she said. “We need to help them know that it’s not something they should be ashamed of, but rather [to] go and get help for.”

Daily Times (Salisbury, Maryland)
February 26, 2008

March 1 is designated as Self Injury Awareness Day

Self-injury (usually abbreviated SI) is known by many names—self-harm, self-mutilation, self-inflicted violence and much more commonly, cutting.

SI Awareness Day is March 1.

SI is a serious and real problem facing society today. If someone comes to you or if you discover that someone you know self-injures, would you know what to do?

Don’t react with anger or disgust. Self-injurers generally need support from those around them, not condemnation.

Don’t try to blackmail them or make them feel guilty for what they’re doing. Punishment and forced hospitalizations are usually unhelpful, and can make the self-injurer even more secretive and more reluctant to seek help about their behavior.

Instead, offer the person a listening ear and (when he or she is ready) assist in finding that person the help he or she needs (that could mean a ride to the hospital for stitches or helping to find a good therapist). Talk with the self-injurer about the SI and be supportive.

Another great source of support is, a community of self-injurers who gather to support one another.

Support the self-injurers in your life (surely there is more than one) by wearing orange on March 1—Self Injury Awareness Day—or by wearing orange and white if you are currently SI or are recovered from SI.

For more information or support, check out, or e-mail me at SelfInjuryAwareness@

Columbus Telegram (Nebraska)
February 26, 2008

Self-mutilation a problem among Columbus teens
By Julie Blum

Feeling confused and lonely like an eternal emptiness was always present, she coped with her feelings the only way she knew how—she cut.

Using razor blades and other sharp objects, she repeatedly inflicted harm on herself.

“I started cutting when I was in the ninth grade. When I first started cutting, my intentions were to hurt myself so it would take the pain away, so that it would numb (the) inside,” a local 11th grader wrote about her struggle with self-injury.

The thought of purposely hurting oneself to the point of bleeding and bruising seems shocking and horrific. But self-injury is occurring more often, especially among youth.

Columbus isn’t immune.

Carol Sheffield, program director at Youth For Christ Columbus, said she is seeing more and more young people coming into the office who abuse themselves.

“The numbers are rising. There are probably more because it takes so long to build that trust with them for them to tell us,” Sheffield said.

Self-injury also is known as self-abuse, self-mutilation, deliberate self-harm, parasuicidal behavior and non-suicidal behavior. It is intentionally harming oneself most commonly through cutting, scratching, burning, ripping or pulling of the skin and hair, bruising or breaking bones.

Sheffield said she has seen the gamut of self-injury forms at her office.

“It’s heartbreaking when you see kids who are hurting themselves to control the world around them,” she said.

Jill Colegrove, owner of Colegrove Counseling Center in Columbus, said such behavior is a coping mechanism for those who don’t know how to deal with their emotional pain. Some are feeling so overwhelmed that they injure themselves to feel in control.

“The common theme is a lot of depression and anxiety. A lot of people are feeling emotional pain. They don’t know how to deal with it. (Self-mutilation) is a sense of relief,” Colegrove said.

Others feel emotionally numb and hurt themselves as a way to feel something. When they self-injure they can see the physical wound and the blood, and that makes them feel alive again, Colegrove said.

Several teens who have sought out help at Youth for Christ wrote testimonials about their struggles with self-injury. Though some said they don’t know why they started, they continue to do it because it helps them release anger, and it is a way to punish themselves.

The act of hurting oneself is an addictive behavior and one more commonly found among adolescents. Some research suggests it is more common among females and in sexual abuse victims.

Most who do self-injure do it on areas of the body that can be easily covered, like arms, wrists, legs, inner thighs and lower abdomen. Only a small percentage of those who deliberately hurt themselves are suicidal.

“Self-mutilation is really scary because accidental suicide can happen. They can go too far,” Colegrove said.

Though Colegrove said self-injury has been around for a long time, people are more aware of it and have more knowledge of it now because it is being talked about.

Getting to the root of the reason people harm themselves and developing new, healthier ways to cope takes time. Treatment in therapy can take months or years, Colegrove said.

“It’s similar to alcoholics who have the urge to drink. They (those who injure themselves) will want to revert to that,” she said.

People who do self-injure often are ashamed of it and keep their wounds hidden.

There are signs that parents can look for in their children, according to the S.A.F.E. Alternatives (Self Abuse Finally Ends) Web site. Indicators can include unexplained cuts or bruises on their child, and their child is always covering their arms and legs with long-sleeved clothing and pants, even during warmer months.

Children who have trouble expressing emotions like sadness, fear and anger, and have low self-esteem also are at higher risk for self-injury. A presence of an eating disorder or possible substance abuse also can increase the risk.

It can take someone a long time to confide in another person about harming themselves. It is important, Colegrove said, if you are the person being confided in to respond calmly and not to be judgmental.

“People who aren’t familiar with it typically freak out. Those people that are self-mutilating will personalize that reaction and say, ‘See, there is something wrong with me,’” Colegrove said.

One 11th-grade girl, who started cutting herself when she was 13, said that is one of the reasons she doesn’t tell anyone she is hurting herself.

“I tell people that I’m not cutting anymore, but I am. If I tell people that I still cut they’ll look down on me. I like to think I’m a good person, and I want other people to think I’m a good person, too,” she wrote.

Colegrove said it is important for parents, teachers and counselors to be aware of self-injurious behavior in order to address it.

“I think it is one of those behaviors that you will see come and go in spells for a while. The more we can educate people and identify it and the resources available, the more we will watch it become less common instead of more,” Colegrove said.

Charleston Gazette (West Virginia)
March 1, 2008

Self-Injury Awareness Day; It Became an Addiction
Teens Discuss What Led to Cutting, How They Stopped
By Molly Page, South Charleston High School

Editor’s note: Because of the sensitive nature of this story, the names of the teens interviewed have been withheld.

Today is Self-Injury Awareness Day. Self-injury continues to be a growing problem across the globe, particularly among teenagers. What causes people to burn, cut or otherwise mutilate themselves? Several area students discussed why they started self-injuring and what made them stop.

“The whole reason I started cutting was for self-punishment,” said one teen. “I felt worthless, and I would guilt myself all the time. I started getting into bad drugs like cocaine.”

He no longer cuts because he said he has realized “that people aren’t worth it.” A simple phone call led him to this realization.

“I was laying in bed and someone had called and made me really mad. I just realized, ‘What’s the point of listening to these people anymore and letting them get to me?’” he said.

For this teen, confiding in a friend helped him stop cutting. “I would usually call a friend and talk to them or go over to their house. I have a really close friend who knew about [what I was doing], and he said he’d do anything to help me. He let me come over whenever I needed to, and that was his way of helping me.

“People need to learn that there are ways out of it [cutting] and other ways to deal with problems,” he said.

Another teen who used to cut said she began because “I was depressed and I didn’t like life. My dad was abusive, and I had really low self-worth.”

“Everything was happening at once,” she continued. “My great grandma died, and my boyfriend broke up with me. I felt like cutting was the only way to get rid of the pain. I also started smoking weed and cigarettes, but the pain, no matter what, was still there.

“I finally quit because I realized it was pointless, and I wasn’t getting anything out of it at all,” she said. “Life is going to go on no matter what, and cutting isn’t going to help it any.”

Family played a big role in her recovery, she said, and friends even more so.

“My family kind of came back together, and my friends snapped me back into real life. They showed me that I don’t really need to do that because it’s not worth it. It all kind of happened pretty quickly.”

She said she relied primarily on her friends to help her recover. She didn’t seek any professional help because she felt that it wouldn’t have been beneficial to her.

“You don’t feel like you’re going to get enough support from them because they’re like every other doctor—they’re seeing several other people at the same time; they’re just doing their job,” she explained.

With her friends, though, they all worked together to help each other overcome their problems. “We kind of felt like we needed to get help and to try to help other people who did it,” she said, adding that her friends have been what has kept her strong and kept her from returning to self-injury.

“[Cutting] really isn’t worth it,” she stressed.

The next teen who spoke about her experience is a best friend of the previous teen. The two helped each other get through their self-injuring ways.

“I started to cut because of my mom. We fought all time,” she said. “I had really low self-worth and hated the way I looked.

“Sometimes, things would come back in my mind from the past—stuff about how my parents used to fight—and they would haunt me. It would be all I could think about all the time.”

“Finally I realized doing it was stupid, along with smoking weed and cigarettes. I knew it wouldn’t get me anywhere. My friends helped me quit, and I helped them—like a big support group,” she concluded.

For other teens who might be in a situation similar to hers, she suggested, “Tell your friends about it and let them help you. And whatever is causing your problems, try to solve that and face those problems.”

She said she hasn’t thought about cutting herself again since she stopped, but she has a plan should those thoughts ever return. “I still think cutting’s stupid, but if I would think about it, then I’d just sit there and blast my music.”

The last teen, who has been cutting herself for more than four years, hasn’t been able to completely stop.

“I started back in 2003 after my grandma died because after we lost her, we lost our whole family. Everyone started disowning each other and stopped talking to each other, so cutting was a way for me to release that stress.

“I stopped back in August of 2003 because I met someone who has become a really close friend, but something happened and I started again. Once again, I used it as a way to release stress.

“For me, injuring myself was my way of talking about my problems,” she explained. “I didn’t have anyone to talk to, and it was like my arm was a journal and the knives were my writing tools.

“After awhile it became an addiction,” she admitted. “I was looking for any reason just to cut. I started wearing long-sleeve shirts in the summer to hide my cuts and became really depressed.

“I have been cutting for four years, and I don’t know when it will ever stop. It’s like a drug; once you start you just want more and more.”

Currently, she has stopped cutting. As with the other teens interviewed for this article, she is not seeking any professional help for her problem. She said that when she feels the need to cut, she tries to block those urges by writing journal and blog entries.

“It was a way to numb the pain,” she said of cutting, “but it stops working after a while and you’re left with all of these scars from the past.”

When asked why she continued to cut if she felt it was no longer helping her, she said, “I continued to do it because it became an addiction and a habit. It was like my drug.”

All of these teens tried to use cutting, as well as drugs and alcohol, to get rid of their pain and found that it didn’t help. They realized that no matter what they did to themselves, it wouldn’t help the situation they were in.

If you cut and need help stopping, talk to friends, trusted adults or a therapist. They might help you more than you think.

There are also many Web sites that offer support for those recovering from or trying to stop self-injuring. Some of these include, and If you are feeling the need to self-injure, you can also call 1-800-DONTCUT, a national self-injury hot line.

Wales on Sunday
March 2, 2008

‘I got an adrenalin rush and soon I cut myself every day’;
EXCLUSIVE Ex-self-harmer sets up help group
By Catherine Evans

Standing alone in the dark on a deserted hill, 18-year-old student Bethan Jones pulled back her sleeve and ran a pocket knife across her arm.

As the blood flowed, she felt her worries ebb away. But the scars remained.

On the outside, Bethan appeared to be a popular, happy teenager and conscientious student.

But for years Bethan hid a secret shame—she was self-harming.

As the rest of the nation celebrated St David’s Day yesterday, the former English and religion student at Bath University spoke to Wales on Sunday about her painful past and her plans to setup the first self-harm support centre in Wales.

“Not many people know that March 1—as well as being St David’s Day—is Self Injury Awareness Day,” said Be than, who works at the DVLA in Swansea.

“I’m working on a new registered website to offer help and support to others whose lf-harm. Irun the Scar Tissue website—which helps more than 450 people to prevent self injury. But what I really want is to set up the first self-injury support centre inWales.”

Now26and living in Cwmdare in the south Wales valleys, Bethanstill doesn’t fully understand why she started to cut herself.

“When I cut myself for the first time it scared me half to death. I honestly don’t knowwhy I did it. I had a penknife that I carried around to clean my horse’s hooves and I used that to cut myself. I got an adrenalin rush from it and soon I was cutting myself every day,” she said.

Bethan, who suffers from clinical depression, hid the scars on her arms from her parents by wearing long-sleeved tops—even in the height of summer.

“Sometimes, I probably should have gone to hospital for the cuts I had. But it’s a taboo subject and I was afraid of what people would say. I didn’t want anyone to know what I was doing.

“It’s hard to walk around with your arms in plasters. I didn’t tell my parents until I was 23. They were very supportive. If parents think their child is self-harming, they should let them know that they are there for them to talk to,” she added.

After the recent string of tragedies in Bridgend, Bethan said there is more need than ever to address teenagers’ problems.

It was her own failed suicide attempt that forced her to get help.

“I overdosed on anti-depressants and that’s when my family found out about it andI finally tried to get help,” said Bethan.

“People think self-harmers are freaks who are just crying out for help, but that’s not the case at all. There needs to be far more education about it. I want toget the message out to other people that there are other alternatives and that there are people you can talk to.”

Thanks to the support offered by the Scar Tissue website, Bethan no longer turns to self-injury in a crisis.

“I don’t self-harm anymore, but if something goes wrong I still feel like I need to do it. But now I think of other things I can do to get past that feeling. I’m getting much better,” she said.

If you are self-harming or are concerned about someone you know, contact Bethan at or

The Herald (Glasgow)
March 3, 2008

Why Services Are Failing the Adults Who Self-Harm; No Support System Exists for Older People Who Self-Harm, and the Scale of the Problem Is Still Not Fully Understood.
By Rebecca McQuillan

‘The hospital staff only see the injuries and they treat me as someone who cannot cope. I’m holding down a job that I do well and looking after my children. I have friends and am part of my community. But that gets disregarded.”

Self-harming: it is often seen as an issue affecting teenagers. But a new survey being released today by the charity Outside the Box makes clear that women and men over 25 also injure themselves, including people aged in their sixties, and some have been doing so for more than 20 years. Often they are working and caring for others, and specialist support services for them are non-existent.

Drawing on responses from adults who self-harm, and the friends, relatives and professionals who care for them, the Outside the Box report highlights the need to raise awareness and understanding of the issue among the public and health professionals.

Self-harming, inflicting injury on oneself, is “a way of expressing deep emotional feelings or problems that build up inside,” according to NHS Direct.

The most readily recognised form is cutting the skin, but it can take several others. Smoking too much, and binge-eating, drinking or misusing drugs to excess, can be seen as types of self-injury.

Outside the Box, which supports people and groups who tend to be marginalised, including people with mental health problems, produced its report after speaking to women aged 30 to 50 who self-harmed or were worried about friends who did, and wanted information about other older people in the same situation. The survey, which was online and confidential, received 84 responses, including 46 from people who self-harmed or had done so in the past. Of them, three-quarters were aged 25-44 and the remainder were older. Most were working and 41 of them were women.

Past research has shown that there is a higher prevalence in the lesbian, gay, bisexual and transgender community. One-third of the people who took part put themselves in this category.

One of the most striking findings was that the overwhelming majority of people—38 out of 46—had been self-harming for more than five years and more than half for more than 10 years. Seven people had been harming themselves for more than 20 years.

A number stressed that their behaviour was not about suicide. One said: “I self-harm because I do want to be alive and sometimes hurting myself is the only thing that helps me hold on and stay alive, stay in the world.”

Perhaps surprisingly for a behaviour that is often seen as secretive, most respondents said at least one or two people among their family and friends knew about their self-harming, though not all felt their relatives were supportive. What came across loud and clear was that many considered their self-harm to be a mental-health issue, though not necessarily linked to mental illness. “I don’t think self-harm is a psychiatric issue but it is definitely a mental health issue,” said one.

It is more easily defined as a “behaviour” than a diagnosis in traditional terms, says Charlie McMillan, director of research, influence and change at Scottish Action on Mental Health. “Professionals see it in different ways: some see it as a coping strategy, some as a cry for help, some as an indication that something is not right and we need to work with the individual involved. There are a number of ways of interpreting self-harm. The important thing is to listen to the person concerned: it may be that they are depressed or anxious; they may see it as a coping strategy—there will be no one rule for all.

“What we hear time and time again is that the thing that helps people the most is being listened to, being heard and treated with respect and dignity. From there, you can lead on to a discussion about how you deal with it.”

That is very much in keeping with the views expressed by the survey respondents. Most decribed positive experiences with their GP or A&E department, but a significant number said they had not been treated well.

For example, one said: “The A&E consultant of my local hospital has been great and made arrangements to make sure I get continuity of care. He also stated that it did not matter how many scars I already had, each injury should be treated as carefully as possibly to promote good healing and reduce scarring”; while another said: “Staff were rude and I heard them saying that they are sick of ‘people like that’ wasting their time.”

The respondents stressed that they didn’t want to be judged, but to be treated with respect, and felt a greater understanding of selfharm among health professionals would improve matters. They also called for more support and information for the families and friends of people who self-harm.

Anne Connor, chief executive of Outside the Box, confirms that within existing specialist support services for people who self-harm in Scotland, the maximum age for referrals is typically 21 and in a few cases 25. She says that, in short, there are two priority areas where progress is needed. The first is simply recognising the reality. “Self-harm exists. Don’t freak out about it, it’s there. That being recognised in itself makes it so much easier for people to talk about it.

“The second thing is that services should respond to people in a sensitive way. What is clear is that some people are getting wonderful caring support while others are not.”

The last word goes to one respondent who was asked how people should be treated by GPs or A&E staff: “Calmly, and with respect.”

The Straits Times (Singapore)
March 22, 2008

They Cut Themselves to Cope with Hurt; Teenage Girls Are More Likely Than Boys to Practise Self-Mutilation, Say Counsellors

Alone in her room, 15-year-old Stephanie searched for a clear landing between the livid, red scars criss-crossing her left forearm. There was none.

Sighing, she placed the blade of her penknife at the base of her elbow where a wound had barely healed and dug in.

Immediately, blood spurted out and numbness set in.

Stephanie cuts herself whenever she feels ‘emotionally unstable,’ usually after quarrels with friends.

‘When I forget to buy things which they’ve asked me to, they get angry with me and I feel frustrated. That makes me want to cut so that I can feel better,’ said the Secondary 3 student from an all-girls school. Her parents divorced when she was five and she lives with her mother.

Sometimes, her body becomes her emotional canvas on which she carves words like ‘angry,’ ‘hurt’ and ‘frustrated’ with her blade.

Like Stephanie, many teenage girls are using self-mutilation as an outlet to cope with emotions they cannot handle, said counsellors.

Besides cutting their skin with sharp objects, other popular ways of self-injury include pulling at the skin or hair, burning parts of the body with wax or bruising themselves.

Counsellors and social workers noted that the trend of self-mutilation is prevalent in all-girls schools.

Denise, 16, said that in her Normal (Academic) class of 42 girls, she knows of at least five others who cut themselves. Watching them in action piqued her curiosity.

She said she first cut herself in the classroom after being badmouthed by friends.

‘I borrowed a penknife and cut a few lines,’ she said, adding that she felt calmer afterwards.

No one tried to stop her.

A social worker at Denise’s school confirmed this.

Out of every 10 students she has counselled there, about seven were practising self-mutilation, said Mrs Rachael Lim of Care Community Services Society.

‘I suspected that many students were doing it. Almost every time I talked to a student, she would have issues about self-harm. It got a little scary,’ she recalled.

The numbers dropped tremendously to about three out of every 10 troubled students last year after counsellors conducted sessions with the girls to discuss the dangers of self-mutilation.

‘We helped them to explore alternatives to cutting and introduced more positive coping skills like music and sports,’ she said.

Counsellors and social workers noted that more teenage girls than boys take to cutting themselves.

According to Ms Eileen Chua, assistant director of Lakeside Family Centre, this is because boys express themselves in other ways. They usually take out their hurt and frustration through sports or smoking and drinking.

Another reason is girls’ susceptibility to peer pressure, said social worker Joyz Tan from Fei Yue Community Services.

‘It used to be that when you had a problem, you’d share it with me, we’d talk about it and that’d be it,’ she said.

‘But now, when they know that their friends cut themselves and they see their scars, they think the way to cope with problems is to cut.’

Ms Melissa Lim, centre director of Students Care Service (Yishun), termed this group ‘copy-cutters’.

One of them is Shuling, 15, who tried to emulate her fashionably dysfunctional friends, then got hooked.

‘It’s harmless fun. I like to see the blood flow. When my skin splits open, I feel like a paper being torn,’ she said.

Many believe they are hurting no one but themselves. But there are instances when the cuts get too deep, the bleeding won’t stop, or the wounds get infected and the girls end up in hospital.

Also, cutting to relieve tension can be addictive.

Consultant psychiatrist Daniel Fung, who is chief of child and adolescent psychiatry at the Institute of Mental Health, likens it to getting a runner’s high.

‘When there is pain, the body releases a natural anaesthetic agent called endorphins. These are hormones which reduce the pain and make you happy.

‘If you keep cutting, you’ll get addicted to the whole process,’ he warned.

Doctors also warned that if girls are not taught healthier ways to vent their frustrations, they may continue to turn to self-mutilation as a coping mechanism even in adulthood.

‘They feel so much pain on the inside that they need to feel it on the outside, so it ends up as physical wounds which they can see, feel and touch,’ said Dr Geraldine Tan, a psychologist at Mount Elizabeth Medical Centre.

‘It’s a reminder that they’re okay.’

Dr Tan added that teens who display their wounds are crying for attention and parents must act quickly. She advised parents to look out for tell-tale signs such as the frequent use of plasters and ointment.

Ultimately, the only way to help self-mutilators is to be there for them with a listening ear, she said.

Xiuping, 19, used to cut herself two years ago whenever she quarrelled with her boyfriend.

She stopped after being reassured that others care for her.

‘Nowadays, I’d find friends to share my problems with. If they’re busy, then I’d find something else to do, like read or do housework,’ said the Institute of Technical Education student.

It has been three months since Stephanie last cut herself, but the scars on her forearm are still visible. She now knows that the relief from cutting is only temporary.

‘Although I feel a bit better after cutting, I know the scars will remain there forever,’ she said.

Names of the girls have been changed to protect their identities.
August 27, 2008

Dionne McMillan, 22, from Edinburgh, self-harmed for about 10 years and tells the BBC news website about her experiences.

Dionne McMillan has not self-harmed for about two years.

I first self-harmed was when I was about 10 years old. I just couldn’t cope with life – I’d been in care, I’d been moved around from pillar to post so much that I had no stability in my early years. That led to me having the problems I have now and have had for the past 10 years.

Self-harming gave me a release from the tension and stress that I’d been feeling and gave me a chance to escape from reality for a little while.

I didn’t know what self-harm was at the age of 10, I wasn’t copying anyone. When you talk about self-harm, people always think it’s about cutting yourself, but there are so many ways to do it. For me it started with the tablets I took out of my grandparents’ cupboard. Then I accidentally cut myself while peeling potatoes. That led to me starting to cut myself because I felt that with losing blood, all the bad feelings were leaving me as well.

Once you start self-harming, it’s like a drug, it becomes addictive and it’s very hard to stop. I self-harmed for 10-and-a-half years but after four years it was discovered, at a PE class in school. One of the teachers saw my arms, asked what it was about and got psychiatrists in. When that happened, everything was taken out of my control and that was the one thing I didn’t want because I felt self-harm gave me control over my life.

After it was first discovered, I continued to self-harm for more than six years. It became more and more dangerous, to the point where there were a few occasions when I was very close to death. If it hadn’t been for medical intervention I wouldn’t be here now.

I only stopped because I fell pregnant with my son. I no longer viewed my body as my own – I couldn’t damage it because I needed to keep myself safe for this baby that was growing inside me. So it was a decision that I made to end it.

‘Safety blanket’

People in my position should speak to someone, whether it’s a friend, teacher, parent – anyone. If self-harm had been more talked about when I was younger, I think I would’ve been able to seek help a lot quicker. I don’t think I would’ve got as bad if I’d had the early intervention when I first started.

Once you start self-harming, it’s like a drug, it becomes addictive and it’s very hard to stop. It’s been about two years since I last did it and I’m not completely safe from it. I think about it every single day because self-harm wasn’t just a coping mechanism for me – it was like a safety blanket which meant I could deal with the world around me. I know there could be a day where I will return to it. But I will fight that as long as I can because my son needs me and that’s my inspiration. I get ongoing support, but for me I don’t think having the professional help is what’s going to keep me going – I’ve got to do that – no-one else can do it for me.