Is cutting on the rise? I don't think I knew of a single friend affected in my teens, but my DD is constantly worried about a couple of friends who self-harm.

Anonymous wrote:7:56 PP here:

I would ask questions about what the punishment is for? What is the "crime" they committed worth hurting themselves. Pay particular attention to perfectionism and unrealistic expectations they hold themselves to that they wouldn't hold others to. Find out if there are substitutes for cutting. Talk about the self-punishment as a pile-on...a way that makes them feel worse not better and the shame, guilt, embarrassment might be enough. I am so sorry that you are going through this. As you can see on this chat, how common this is. I know it is alarming but self-harm does not equal suicidality and something needs to replace the impulsive behavior before it is removed completely. It seems really backwards but for some kids cutting or self-harm IS the coping skill. It's an unhealthy coping skill but it might be the thing that is holding them together. Freaking out and pulling it away too quickly without support in place can be devastating. So work with a therapist to replace it, learn distress tolerance skills, and to understand the why and what of the reasons your child is in pain

It is exactly this. Completely unfounded perception of failure due to unrealistic expectations.

7:56 PP here:

I would ask questions about what the punishment is for? What is the "crime" they committed worth hurting themselves. Pay particular attention to perfectionism and unrealistic expectations they hold themselves to that they wouldn't hold others to. Find out if there are substitutes for cutting. Talk about the self-punishment as a pile-on...a way that makes them feel worse not better and the shame, guilt, embarrassment might be enough. I am so sorry that you are going through this. As you can see on this chat, how common this is. I know it is alarming but self-harm does not equal suicidality and something needs to replace the impulsive behavior before it is removed completely. It seems really backwards but for some kids cutting or self-harm IS the coping skill. It's an unhealthy coping skill but it might be the thing that is holding them together. Freaking out and pulling it away too quickly without support in place can be devastating. So work with a therapist to replace it, learn distress tolerance skills, and to understand the why and what of the reasons your child is in pain

Anonymous wrote:I am moved by the compassion and good suggestions on this thread. Unusual for DCUM. I am a therapist who works with adolescents and young adults and think that you got really good advice. I often think about cutting as falling into one of the following categories:
1. Because the emotional pain is overwhelming and cutting lets some out physically--distracts or calms
2. To feel something at all (when emotionally numb)
3. As a form of self-punishment
4. To feel the endorphin and adrenyline rush following the injury as a way to feel better

I find it is helpful to find out which of these is the reason why someone cuts. It can be more than one, but it usually falls into one bucket or maybe two. It helps give us a language to talk about the self-injury as well as figure out ways to replace the cuting, hitting their head, pinching, etc

NP. DD did it as self-punishment (option 3). Any insight?

I am moved by the compassion and good suggestions on this thread. Unusual for DCUM. I am a therapist who works with adolescents and young adults and think that you got really good advice. I often think about cutting as falling into one of the following categories:
1. Because the emotional pain is overwhelming and cutting lets some out physically--distracts or calms
2. To feel something at all (when emotionally numb)
3. As a form of self-punishment
4. To feel the endorphin and adrenyline rush following the injury as a way to feel better

I find it is helpful to find out which of these is the reason why someone cuts. It can be more than one, but it usually falls into one bucket or maybe two. It helps give us a language to talk about the self-injury as well as figure out ways to replace the cuting, hitting their head, pinching, etc

Anonymous wrote:As someone who was placed in in-patient as a fourteen year old (and a couple of times as a young adult), I don't recommend inpatient. Most in-patient programs simply house patients and try to stabilize them to where they can do outpatient treatment. I consider it appropriate for folks who are suicidal or homicidal or about to truly crash and burn their whole life. It sounds like this is not that. And I have not heard good things about DMV area inpatient options.

She needs an excellent therapist, an excellent psychiatrist, and all of the support you can give her. Family support is huge -- the knee jerk reaction to mental health problems is always "therapy!" and "medication!" Those two approaches are critical, but when people think that treatment will "fix it" they become sorely disappointed and frustrated. It won't. It will help. Hopefully a lot. But it doesn't make the problem disappear. Not like an antibiotic for strep throat.

Best of luck. Please take very, very loving care of that DC -- even when it is the most challenging thing in the world.

This is good advice, OP. I second it, as a parent who was in your spot three years ago with my then 12yo.

We found a good therapist for her who helped our daughter manage her triggers and compulsiveness better. My child has not needed to be medicated at any point, but I trust that her therapist would have recommended a psychiatrist, etc. if that had been necessary.

FWIW, my kid, now 15, is doing much better. Just more comfortable with who she is in the world, and finding a good outlet on sports. Which is to say: you’re ay a scary place right now, it’s a journey, and it can definitely get better.

All the recs about therapy here are good. Also think about helping her be active (do active things together) and help her develop new ways of seeing herself as someone to be proud of, who has something to offer. Get her involved in doing something that she can feel good about, that helps other people, or helps her contribute to family and friends. Cutting is about stress and shame, and often about feeling out of control.

Our DD did the same at age 13. It was scary and stressful. For her, It was a combination of losing friends, the stress of going to MS and the arguments DH and I were having. Therapy was great for her, and she found a different sport …where she made new friends (it was the friends not the sport that was positive). I also started being a lot more present, DH and I stopped arguing. It’s difficult and sending you good thoughts and virtual support!

Therapy worked wonders for our kid. Kid is relieving pain or escaping pain — eg cutting to feel more or cutting to feel less. Therapist was helpful in getting them to explore other outlets. And in calming us down in the process. Hang in there.

Cutting is a symptom. It is a way to refocus and temporarily relieve unbearable pain or anxiety. Try to get at what is bothering her and support her. Is gonna take a while. Avoid inpatient if you can. It’s stigmatizing and cutting is not a suicidal gesture.

My son was a cutter and the only time he needed services in the ER was when he needed 10 stitches; you don’t want to send her to inpatient treatment over this, and they probably wouldn’t admit her. My son eventually quit and found other coping mechanisms. He did therapy and is on Zoloft, but I can’t say I credit either one of those with being the fix for the problem. It’s really hard to witness this as a parent. Hopefully it is a phase that passes for your daughter too.

Another recommendation for DBT. It’s expensive and time-consuming, but it breaks the cycle of depression/anxiety and self-harm. A proper program will include a parent group, and you will learn how to avoid dysfunctional patterns of communication with your child and how to validate the pain they are feeling, and how to help them find other ways to be present with and process difficult emotions.