Teen girl
Photo: © 2009 Jupiterimages Corporation
Night after night, Dr. Drew Pinsky talks with teenagers on his call-in radio show Loveline. Teens ask for help with a variety of problems and, almost every night, call to confess they've been cutting themselves. Dr. Drew says cutting is a very serious problem, and if parents of cutters don't take notice, their children could be scarred in more ways than one for the rest of their lives.
Erin E. White: What is cutting?

Dr. Drew: It is an attempt at bodily mutilation, usually with a sharp object, and is rarely with the intent to harm. In other words, they're not trying to kill themselves. They're actually trying to get a certain emotional release from the experience of the pain.

EW: Who is typically drawn to this type of behavior?

Dr. Drew: It's a sign of severe psychiatric pathology, however, because it has become so widely discussed, kids are copycatting and kids are picking up on this as an option. So, we've seen it more in recent years. The people who are drawn [to cutting] are a mixed bag; it is primarily people that are severely disturbed. I think the most common population would be trauma survivors.

People who have had severe childhood traumas lack the ability to regulate emotions and, as a result, gravitate toward whatever primitive means they can come up with. It is not the average healthy 16-year-old that is cutting herself when she gets a bad grade on a math exam. It is a kid with real problems. If a kid shows up cutting, they have to see a doctor. This is a sign that something is very wrong.

EW: Are females more likely to engage in cutting?

Dr. Drew: Yes, in a sense. I have an aphorism that colleague of mine taught me, which is: "Men act out, and women act in." As such, men go out and do violent things, while women tend to perpetrate violence against themselves.

EW: Is cutting a cry for help?

Dr. Drew: It is not a cry for help. People are ashamed of cutting, and they hide it. They usually [cut] in places that are covered by clothing, they do it on their thighs on the inner surface of their arms and they'll carefully hide it. Often, parents don't know about it for years.

The health risks of cutting

EW: What are some of the health risks involved when someone is cutting herself?

Dr. Drew: Obviously, going a step too far: getting an infection, permanently altering your body anatomy in some way, rupturing a tendon or severing a nerve. Permanent scaring too. But, it tends to be a relatively low-risk behavior. Again, they're not trying to hurt themselves; they are trying to get a release from unpleasant emotions.

There are sort of two predominate styles of cutting. One is kids who are severely traumatized and [these kids] tend to have something we call dissociation. They kind of disconnect from their feelings; they sort of feel out of body or like the world is kind of a dream they are walking in. Or they actually black out or feel like they are hovering above their body and they get these sort of outer body experiences, and that is called dissociation. Some kids like the feeling of dissociation because it is a relief, and they will actually induce dissociation through cutting.

Others hate dissociation and try to bring themselves back by feeling something through cutting. It is kind of an interesting dichotomy in terms of who is cutting.

Kids who are addicted will frequently cut as a way of releasing endorphins. Once they stop drugs or stop sexually acting out, all of a sudden they start starving themselves and cutting. It is sort of a common syndrome we see today. Cutting, starving, sexually acting out and doing drugs—that is sort of the combo that is out there in these teens who are basically traumatized.

EW: Why are there so many traumatized kids out there?

Dr. Drew: We have a pandemic of childhood trauma. The amount of trauma is spectacular right now, and it is perpetrated at the hands of important people in those kids' lives. On the radio right now, that is all I am talking to is trauma survivors. All I treat at the hospital is trauma survivors. I just wrote a book about trauma survivors. It is the issue of our time. In trying to solve the problems of trauma, kids are gravitating toward whatever the culture offers them.

What to do if your teen is cutting

EW: What if you find out your child is cutting?

Dr. Drew: If you have a child who is cutting, you have to get professional help. It is a gigantic mistake to try to do this alone. This is a sign of severe psychiatric pathology. The cutting may settle down, but that child is going have further problems going forward. It is a sign that you need help now. You will pay now or pay later, and it will be worse later.

EW: You talk with kids who cut all the time on your radio show. What do you say to them?

Dr. Drew: I tell them, "You've got to tell an adult!" Because no one is aware of it. And I tell them, "This is a sign that there is something very wrong, you need help immediately, you've got to tell an adult, someone at school, tell your doctor, tell somebody so help can be brought to you so you can get some ongoing care, because this is not going to get better in a couple of days."

EW: Are adults cutting themselves too?

Dr. Drew: It is primitive, so kids who are not fully developed are more prone to it. It is something people grow out of—the cutting gets better. It is rare in only the most severe cases that somebody cuts well into adulthood, but it is a sign that you are in real trouble. It might be as simple as an evaluation that you figure out the child is severely depressed and the depression is treated. Whatever it is, something is very wrong, and you need treatment.

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