Cutting and Self-Harm: Cry for Attention or Something More?

girl hiding face“Self-injury is an expression of acute psychological distress. It is an act done to oneself, by oneself, with the intention of helping oneself rather than killing oneself. Paradoxically, damage is done to the body in an attempt to preserve the integrity of the mind.” —Sutton and Martinson, 2003

Self-injury is a serious phenomenon that affects millions of adolescents. Current prevalence estimates of non-suicidal self-injury (NSSI) among middle school and high school students range from 15% to 20%, and some studies estimate rates even higher than that.

It can be difficult for family members, friends, and even professionals to understand what causes young people to hurt themselves, or to know how to respond. Discovering that a child or adolescent is engaging in self-harming behaviors can be frightening. It is not uncommon to feel panic, worry, or even disgust when you suspect or discover this type of behavior. Having accurate information is an important first step for parents, teachers, and other helping professionals who may be the first line of defense when adolescents engage in non-suicidal self-injury.

What’s the Difference Between Self-Injury and a Suicide Attempt?

Non-suicidal self-injury (NSSI) describes the intentional injury to or destruction of one’s own body tissue, most commonly through cutting, burning, or self-hitting. Sometimes parents wonder if cutting and other self-harming behaviors are simply a cry for attention. If that’s true and someone needs attention that badly, then I can’t imagine a more appropriate response than to give it. Instead of looking at it as a bid for attention, though, try thinking of it as an attempt at communication.

Cutting and other forms of self-harm should always be taken seriously. Most individuals who engage in non-suicidal self-injury do so in secret and go to great lengths to hide the behavior from others. Most often, NSSI is performed as a way to regulate or modulate strong, painful emotions. Sometimes, NSSI is also described as a way for individuals who feel numb to “feel alive.”

NSSI should not be construed as a failed suicide attempt. NSSI is an attempt to live with or manage painful feelings—unlike suicide, which attempts to permanently end pain by ending one’s life.

NSSI should not be construed as a failed suicide attempt. NSSI is an attempt to live with or manage painful feelings—unlike suicide, which attempts to permanently end pain by ending one’s life. It is important to note, however, that although they serve different functions, NSSI is associated with an increased risk of future suicide attempts, and therefore should never be taken lightly.

Signs to Watch For

It is important for parents, teachers, and other helping professionals to learn to recognize the signs and symptoms of self-injury. A few things to watch for include: wearing long sleeves even when it is hot outside; a pressing desire for a lot of time alone; and, of course, unexplained, or suspicious cuts, burns, or bruises.

Sometimes, individuals who engage in self-harming behaviors may appear to be clumsy or have frequent accidents, and use these incidents to explain self-inflicted injuries. Adolescents who experience depression or anxiety, have difficulty solving problems, or who tend to feel things deeply may have an increased risk of turning to NSSI as a method of coping.

What to Do If Your Child Is Cutting

How you respond matters! If you suspect or discover that your child is cutting or engaging in other self-harming behaviors, it is important to seek help from a qualified mental health professional. A professional will begin with an assessment and may recommend family or individual therapy, or a combination of both.

Early intervention is best, so don’t wait to get help. Treatment can be effective at both reducing the behaviors and addressing painful emotions.

Reference:

Sutton, J., & Martinson, D. (2003). Because I hurt: Understanding self-injury & healing the hurt. Oxford: How To Books.

© Copyright 2015 GoodTherapy.org. All rights reserved. Permission to publish granted by Betsy Smith, MEd, LPC-S, therapist in Bellaire, Texas

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • 24 comments
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  • Lisa N

    Lisa N

    August 5th, 2015 at 6:19 PM

    Self-injury doesn’t just affect young people or adolescents…

  • dearbliss

    dearbliss

    August 5th, 2015 at 10:34 PM

    Speaking from experience it does. Youth are under so much pressure and under so much stress because everyone is busy chasing the dollar. Just because you have no experience with it doesn’t mean it doesn’t exist.

  • dearbliss

    dearbliss

    August 5th, 2015 at 10:35 PM

    Correction, I missed the just… ignore please.

  • Mrsp0331

    Mrsp0331

    August 7th, 2015 at 3:42 PM

    I agree 100%. The majority of my experience with self harm was as an adolescents, as an adult I still find myself with the want or yearn to harm myself in certain situations. While I have developed new ways to help myself get through those feelings, they are not entirely gone (and occasionally acted upon). I think it would be important for this article to recognize that adults should be included in this discussion as well

  • Sita

    Sita

    August 5th, 2015 at 6:31 PM

    It can also be from un diagnosed migraines.

  • anuki86

    anuki86

    August 7th, 2015 at 6:55 PM

    i used to burn and i used to do it when emotional pain was so untolerable that physical pain was a short break from my ugly reality. as soon as i got away from the situation, i had no desire to hurt myself any more. thanks for the article, it verified my feelings.

  • Alix

    Alix

    August 8th, 2015 at 12:48 AM

    couldn’t agree more with Lisa N….It is certainly not just young people that affected by this……

  • Sally H.

    Sally H.

    August 8th, 2015 at 4:56 AM

    This cannot go ignored. It is all a call for love. Speak to your kids. Validate that their reality is real to them.

  • Tina

    Tina

    August 8th, 2015 at 10:24 AM

    I know why people cut them selves, and you don’t have to be young to do it. At least I know why I did. Because there was so much pain inside, it was the only way to release it. Watching the blood from my arms, help me release pain. It was like I could take a deep breath without pain for a moment.

  • Samrue

    Samrue

    November 5th, 2017 at 4:50 PM

    I know what you mean that’s why I make my nose bleed it gives me something else to think about..it is oddly relaxing I don’t do it often but when I do..I have been under a lot of stress

  • nessa3

    nessa3

    August 8th, 2015 at 2:01 PM

    I never cut until I was much older…and you dont hear anyone addressing that….they only talk about teen cutters.
    I cut because I cant express the emotional pain inside, and the self hatred.

  • Mary

    Mary

    October 27th, 2015 at 6:18 PM

    Me too. I seem to only manage for six months then I give in.or give up fighting the urge.

  • Daniel

    Daniel

    February 23rd, 2017 at 8:18 AM

    Wow, so true! One year ago I almost accomplished to be clean for two years, but one month away I endured an specially bad day and I did it again. I have been doing it again once (up to seven times per session, though) every three or two months, and I think that Im stuck again in this irregular patron xD.

  • Joanne B.

    Joanne B.

    August 9th, 2015 at 7:49 AM

    When I first started noticing this in my daughter I though this is just something that some teens do when they are seeking out attention.
    I felt like she didn’t really care how she got the attention just as long as we were paying attention to her.
    I wish that I would have taken it more seriously sooner because we have now been through her running away, addiction, and an actual suicide attempt.
    I am not sure if it is always the same but for her this was just a harbinger of more things to come and I beat myself up every day thinking that if I had done something sooner that her life and mine could be so much different now.

  • nessa3

    nessa3

    August 9th, 2015 at 3:04 PM

    so sorry…..I cant imagine your sorrow.

  • lazydaisy

    lazydaisy

    August 9th, 2015 at 3:05 PM

    even when there is a lack of understanding there still has to be empathy for what this child is feeling and an urge to help them stop, right?

  • Joanne B.

    Joanne B.

    August 10th, 2015 at 1:01 PM

    Thanks nessa3. A big thing for me has been learning to forgive myself too, so working on that daily.

  • Mary

    Mary

    October 27th, 2015 at 6:36 PM

    Cutting helps.release the emotional pain for a minute then the shame and guilt and other self.hatred thoughts come from doing it which twisted way makes want to do it again, or actually attempt suicide. Wish I never started way back in my 25 and then stopped for ten yrs and started again after my husband died.

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    October 27th, 2015 at 8:04 PM

    Thank you for your comment, Mary. We wanted to provide links to some resources that may be relevant to you here. We have more information about self harm at https://www.goodtherapy.org/therapy-for-self-harm.html and additional information about what to do in a crisis athttps://www.goodtherapy.org/in-crisis.html

    Warm regards,
    The GoodTherapy.org Team

  • Karen

    Karen

    March 28th, 2016 at 6:19 PM

    Thanks for the article. From age 5-6 I pulled the skin off the bottoms of my feet until they bled. Also, I bit finger and toe nails untl they bled. I lived in a home where both parents were alcoholic. I found alcohol and many acting out behaviors. Sober since 1983, all have been dealt with. My question is about my 4 yr old grandson who bites his finger nails and also chews off his toenails till they bleed. Neither parent abuse alcohol. I think it’s a loving and supportive home. I can’t help but wonder if this is an early sign of trouble. Brennan is sweet, a bit shy and seems happy. His older brother bit his finger nails a while and stopped. No toenails. I also bity toenails into the quick so naturally I have concerns. Thanks so much. Karen

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    March 29th, 2016 at 8:13 AM

    Dear Karen,

    The GoodTherapy.org Team is not qualified to offer professional advice, but we do encourage you to reach out. If you would like to talk about this or any other concern with a mental health professional, feel free to return to our homepage, https://www.goodtherapy.org/, and enter your zip code into the search field to find therapists in your area.

    Once you enter your information, you’ll be directed to a list of therapists and counselors who meet your criteria. From this list you can click to view our members’ full profiles and contact the therapists themselves for more information. You are also welcome to call us for assistance finding a therapist. We are in the office Monday through Friday from 8:00 a.m. to 4:00 p.m. Pacific Time; our phone number is 888-563-2112 ext. 1.

    Kind regards,
    The GoodTherapy.org Team

  • Bob

    Bob

    March 28th, 2016 at 8:35 PM

    Self injury takes on may forms, NOT just cutting as emphasized here. My 19 yo daughter is on a self injury bought right now. She went to college was raped and now is doing anything and everything to punish herself. She is drinking, taking drugs till she passes out. Having sex with anyone at any time, – not cutting, abusing food, diets, health, etc. She’s obviously in major pain. We’re trying to seek help as I type

  • The GoodTherapy.org Team

    The GoodTherapy.org Team

    March 29th, 2016 at 8:15 AM

    Dear Bob,

    The GoodTherapy.org Team is not qualified to offer professional advice, but we do encourage you to reach out to find help for your daughter. If she would like to talk about this or any other concern with a mental health professional, feel free to return to our homepage, https://www.goodtherapy.org/, and enter your zip code into the search field to find therapists in your area.

    Once you enter your information, you’ll be directed to a list of therapists and counselors who meet your criteria. From this list you can click to view our members’ full profiles and contact the therapists themselves for more information. You are also welcome to call us for assistance finding a therapist. We are in the office Monday through Friday from 8:00 a.m. to 4:00 p.m. Pacific Time; our phone number is 888-563-2112 ext. 1.

    Kind regards,
    The GoodTherapy.org Team

  • Adolf

    Adolf

    March 20th, 2018 at 12:57 PM

    how do i know if somewone cuts like a friend but icant see it

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