Often when parents seek therapy for teens who are struggling with depression or anxiety, they are also looking for therapy for cutting. Cutting is when someone is takes an object such as a knife (dull or sharp), scissors, a paper clip or another sharp object and cuts themselves with it to create a painful but releasing sensation. Cutting falls into the category of self-harm behaviors, which also includes biting, skin picking, burning, scratching, banging, hitting body parts and hair pulling.
There are many reasons teens cut. In my therapy practice, I’ve seen teens cut because they’re angry, anxious, sad or feeling unsafe. Overall, though, cutting is a form of the teen saying they don’t have the words or outlet to express what’s going on internally. It represents a conflict and a release–the act of cutting can release and calm the emotional and physical pain teens are feeling. Often, this release helps temporarily, but eventually, their feelings and physical uncomfortableness comes back. They need to cut again to find that release.
In the New York Times article “Why Teenagers Cut and How To Help,” Jessica Lahey terms this inability to express emotions and experiences as “emotional illiteracy.” This means the teen doesn’t have the language to express themselves, so instead, it gets bottled up and expressed by cutting. But, cutting is also isolating, which is why it under-expresses teen’s emotions. By under-express, I mean it only allows for a momentary release of the teen’s pain, depression, anxiety, anger, frustration, loss, and trauma.
That is why, in order to address cutting, parents, therapists and other adults have to help teens express their feelings and needs. Cutting happens more than parents, teachers and others with teens think, and what is often missed in these discussions is how cutting needs to be talked about with the teen to teach them how to articulate their internal and external experiences without self-harm.