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"If only I had encountered someone with visible scars who could share their experiences when I began self-harming, it might have changed my perspective. Living with scars has profoundly impacted my life — I haven’t visited the beach in years or worn a bathing suit in public. Last summer, despite the sweltering heat, I wore sweaters daily, hiding my scars from the world."
Jaime, a 17-year-old, is one of many teenage girls who engage in self-harm by cutting their skin on various parts of their bodies, including their arms, backs, and stomachs.
Jaime’s struggles began at age 12 when she developed a negative self-image. She resided with other self-harmers at Vista Del Mar in Los Angeles, the country’s pioneering residential program focused on treating adolescent girls who self-injure.
Research on this topic, though limited, indicates that approximately 2 to 3 million Americans engage in self-injurious behaviors.
The number of self-injury cases is increasing. Health-care professionals note that instances of self-harm have doubled over the past three years. As teenage life grows more complicated, therapists anticipate this trend will persist.
"I think it’s reached epidemic levels — it’s even affecting middle school students now," states Andrew Levander, clinical director of the self-injury treatment program at Vista Del Mar.
"When asked if they know someone who self-harms, nearly everyone raises their hand — it’s that widespread. Every therapist either has a case or knows a colleague who does."
The Question Remains: Why...
...Would someone intentionally inflict harm on themselves?
"In simple terms," explains Levander, the creator of Vista Del Mar’s treatment program, "self-harm functions as a coping strategy. It provides instant relief from tension, stress, and depression, akin to self-medicating with a drug."
Who's Doing it?
Jayney Goddard, president of the Complementary Medical Association in the U.K., states: "Individuals harm themselves for various reasons, often feeling isolated and ashamed of their behavior."
"Frequently, self-harm serves as a means to cope with intense emotions, and many experience a profound sense of relief after the act," she adds.
In fact, many who self-harm describe the act as making them feel "alive," notes Levander. "The reality is, it allows them to feel something, and none of us can endure being emotionally disconnected for too long."
"It’s challenging for most people, including myself, to comprehend the idea of intentionally using a razor blade on one’s skin to achieve relief. It’s hard to imagine how such an act could be beneficial," Levander explains. "From my perspective, self-injury doesn’t necessarily make people feel better; it simply helps them feel less terrible."
Various Forms of Self-Harm
Self-harm manifests in numerous ways. Conditions such as anorexia, hair-pulling, and burning often accompany cutting. Health-care experts emphasize that these behaviors are attempts to exert control over one’s body.
The breakdown of self-harm methods is as follows: cutting, 72 percent; self-hitting, 30 percent; hair-pulling, 22 percent; bone breaking, 10 percent; and burning, 5 percent.
Most self-injurers are female. A 1986 study outlined the typical profile: a woman in her mid-20s to early 30s who has been self-harming since adolescence. She is often middle- or upper-middle class, intelligent, well-educated, and has a history of physical or sexual abuse or grew up in a household with at least one alcoholic parent.
Why Are Women More Affected?
Experts suggest that women tend to internalize anger, whereas men are more likely to externalize it. Additionally, societal norms encouraging men to suppress emotions might make it easier for them to manage overwhelming feelings internally.
A study on self-injurers revealed that women are often diagnosed with 'transient situational disturbance,' while men are more frequently diagnosed with borderline personality disorder.
The same study also found that male self-injurers receive more serious attention from medical professionals compared to their female counterparts.
Causes of Cutting
What Triggers Self-Harm?
A 1991 study on individuals who self-harm revealed that childhood experiences such as sexual abuse, physical and emotional neglect, and unstable family environments were strong indicators of the frequency and intensity of cutting behaviors.
"The study highlighted that the earlier the abuse occurred, the more severe and frequent the cutting. Sexual abuse survivors were the most prone to self-harm. Neglect emerged as the most significant factor predicting self-destructive behavior, suggesting that while childhood trauma initiates such behaviors, the absence of secure emotional bonds perpetuates them. Those who lacked feelings of being loved or valued as children struggled the most to control their self-destructive tendencies."
Cutters often inhabit a world that feels distant and isolating. Beyond the physical scars, the emotional pain runs so deep that extensive therapy is often required to address the root causes driving their self-injury.
Jaime encapsulates this reality: "I feel like I’m very different from my peers at school because they haven’t experienced what I have. But no one knows that — I keep most of my life private."
