Like someone mentioned, cutting is a physical manifestation of emotional distress. Trying to stop the behavior, hide blades etc will be ineffective. There is also the element of teens who feel a sense of belonging to the "cutting community" found on social media. You can take away the social media but that will not change the reaffirming message they have already received that cutting gives them an identity.

Usually what is behind the behavior is anxiety/anger/depression. The treatment takes multiple steps. 1) Identify the cause of the distress (Situational/family dynamics/biology/social anxiety/trauma etc..) 2) Learning how to better identify and communicate feelings so it doesn't manifest into dysfunctional behavior and 3) Identify triggers to the behavior and learn coping skills to implement when the urge arises.


This is a topic I have become very experienced in as a former middle school counselor and now a adolescent DBT therapist. If anyone has any questions you can email me at kim@ccmtherapy.com

Anonymous wrote:

Anonymous wrote:For those that btdt, do you have any prior symptoms that you observe before the cutting. Like we’re there nervous signs you missed? Eg anxiety, nail biting, picking etc. My dd is performing ok in school but at grade 10 this year, I have noticed starting from this year. She seems stressed. We are telling her to calm down but she is starting to “panic” and exhibits stress. We see her chewing pens, nail biting, And picking fingers till they bleed quite a bit. And the other day she wasn’t cutting but she was poking her Chewed part of her pencil edge (which is therefore sharp) right deep into the nail she was picking at and it was bleeding. Wondering if this is an onset that we need to see a doc.

There wasn’t anything that we “missed”. We knew our kid was suffering from intense anxiety and was also depressed. Bipolar was a diagnosis that was being considered. For ours, the first cutting episode occurred when they had been activated by an SSRI. But it was a single episode and a very deep cut done in front of the family. It wasn’t like the cutting that came afterwards. the real cutting started a few months later and was done privately. Each episode resulted in hundreds of cuts.

Honestly it sounds like your daughter does need to see a doctor. Getting in can take awhile because first you have to find one that takes your insurance and then many/most that are taking new patients have a waiting list.

Would you let her know about “queuing” for a doc. It is indeed a wait into the months. I don’t think I want her to know and then give her no help until the doc is available. That could be worse? The doctors are calling an interview with her but they also added that they cannot see anyone till months later. To other pp. yes she chews her pens too, bite her nails till they are bleeding and continues doing so. We tried redirecting but it is not working. She is also starting to talk much less and seems to be really silent more often which is scary.

Anonymous wrote:For those that btdt, do you have any prior symptoms that you observe before the cutting. Like we’re there nervous signs you missed? Eg anxiety, nail biting, picking etc. My dd is performing ok in school but at grade 10 this year, I have noticed starting from this year. She seems stressed. We are telling her to calm down but she is starting to “panic” and exhibits stress. We see her chewing pens, nail biting, And picking fingers till they bleed quite a bit. And the other day she wasn’t cutting but she was poking her Chewed part of her pencil edge (which is therefore sharp) right deep into the nail she was picking at and it was bleeding. Wondering if this is an onset that we need to see a doc.

I am a Pp who said she used to cut. I am also very anxious and will pick at my nails or face. I’m not on meds now, but in the past I’ve been on antidepressants for postpartum depression and anxiety and I did notice a huge decrease in the compulsive behaviors. I just looked at it as a nice side effect.

I used to do this. I’m not sure why. Maybe I wanted attention or as another PP said it’s compulsive like picking (which I still do). I didn’t do it for long, and I do remember the day that my mom noticed it, but I don’t remember what she did about it.

I think it’s good to be concerned but also know that I’m at least one person out there who did it, didn’t go on any meds or see a therapist or go to treatment, and I’m now just a suburban mom with two kids.

Anonymous wrote:

Anonymous wrote:My daughter pinches her skin and picks at her skin when she’s stressed. I bought her cute stress balls and I told her to destroy them when she feels anxious. I realize what you are going through is much more serious but I think sometimes just giving a kid another outlet helps.

Is pen chewing at grade 10 normal way to relief stress?

Yes it’s normal. I teach at a school and many kids do even as old as grade 12! My daughter (grade 10) does it too during the earlier part of the school year where there is more uncertainty and choosing subjects and getting adjusted. Less towards the end of the year. It is good they have an outlet and while it’s not the best habit, chewed flattened pens are far less serious than cutting.

Anonymous wrote:For those that btdt, do you have any prior symptoms that you observe before the cutting. Like we’re there nervous signs you missed? Eg anxiety, nail biting, picking etc. My dd is performing ok in school but at grade 10 this year, I have noticed starting from this year. She seems stressed. We are telling her to calm down but she is starting to “panic” and exhibits stress. We see her chewing pens, nail biting, And picking fingers till they bleed quite a bit. And the other day she wasn’t cutting but she was poking her Chewed part of her pencil edge (which is therefore sharp) right deep into the nail she was picking at and it was bleeding. Wondering if this is an onset that we need to see a doc.

There wasn’t anything that we “missed”. We knew our kid was suffering from intense anxiety and was also depressed. Bipolar was a diagnosis that was being considered. For ours, the first cutting episode occurred when they had been activated by an SSRI. But it was a single episode and a very deep cut done in front of the family. It wasn’t like the cutting that came afterwards. the real cutting started a few months later and was done privately. Each episode resulted in hundreds of cuts.

Honestly it sounds like your daughter does need to see a doctor. Getting in can take awhile because first you have to find one that takes your insurance and then many/most that are taking new patients have a waiting list.

Anonymous wrote:My daughter pinches her skin and picks at her skin when she’s stressed. I bought her cute stress balls and I told her to destroy them when she feels anxious. I realize what you are going through is much more serious but I think sometimes just giving a kid another outlet helps.

Is pen chewing at grade 10 normal way to relief stress?

Stress balls and similar also helped with mine. She was making not deep cuts during class to deal with anxiety at school and giving something to occupy her hands helped.
I think it depends on the motivation or context.