It's a touchy subject but something parents need to know about. The wounds are often superficial, but the pain that prompts teenagers to do this is very deep.
Maria did not want to give her last name. She says she started cutting herself at age 15.
"I remember I went to the bathroom, I grabbed my razor, I broke it apart, I grabbed the razor and started slicing away. As I was cutting, it's like a pressure valve. The first slice I did, it's just like everything came out. I wasn't focused on my emotional anger anymore. I was focused on my pain, and I saw the blood and I just kept doing it."
Maria was sexually abused as a child. That's one of the risk factors for cutting. So is violence in the home, a family history of alcoholism, and hypercritical parents.
"The emotional pain involves the whole family. Some parents don't even know their kids have been cutting for years. Some of my patients have cut under the arms, in places their parents would not see," says therapist Irma Coto.
Coto wants parents to know cutting is not done to manipulate or to commit suicide.
Therapy for the whole family can help teens to stop, but years later Maria started again after problems in her marriage.
"It's like an alcoholic. An alcoholic, when he's very stressful he reaches for alcohol and when he's to that point that he can't even think, that's his release. Well, cutting is the same thing."
It is easier for the physical scars to disappear. Maria is still working on her emotional wounds.
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Reported by Kristy Ondo