We hear about cutting in the media when celebrities like Angelina Jolie, Princess Diana, and Courtney Love, to name a few, come forward. We may learn of instances of cutting in our communities, but it remains a poorly understood and difficult to treat behavior. Yet cutting is becoming more prevalent in young women.

Rachel is 16 years old. Her tall, slightly overweight body conveyed awkwardness and her learning disability only made matters worse. She required ongoing help in all of her special needs classes while her star athlete brother was accepted early decision into his first choice Ivy League college. He emanated success and high performance in all of his endeavors.

Rachel’s father, CEO of a company in London, and mother, a high- powered Boston lawyer, both demanded perfection in themselves and their children. Essentially raised by nannies, and feeling very much an outcast, Rachel kept to herself. Her rich inner world remained a secret for years. Rachel sensed her parents’ disappointment in her performance but felt helpless, as she could not find anything good about herself.

Her few friends sometimes included her in their activities and sometimes did not. Rachel spent hours alone in her room organizing her drawers and shelves and playing with her dolls. She could not sleep knowing that anything was out of place in her room.

One evening her mother took Rachel shopping. Her mother slipped into the dressing room to hand Rachel some clothes. It was then that her mother noticed the cuts on her thighs – five scars of varying degrees of freshness on her left thigh and six on her right thigh.

Rachel quickly covered up and demanded that her mother leave the dressing room. She told her mother that she was ‘scratched’ while playing with her cat.

Her mother didn’t believe Rachel and pressed further until Rachel finally confessed. She vowed to her mother that she would not cut herself again, but also insisted that they no longer talk about this behavior. Her mother agreed not to discuss the cutting as long as Rachel promised she would talk to a therapist.

Rachel’s loneliness, isolation, anxiety, lack of connection and self-loathing all contributed to her self-injurious behavior. Her cutting was not intended as a suicidal gesture, but rather as a self-destructive way of coping with complicated and painful feelings.

Rachel numbed herself to the emotional pain that she experienced on a regular basis. The pain of the cutting masked the pain in her heart. It felt better to cut her flesh and bleed, than feel the rejection and self-hatred. Cutting gave Rachel the illusion that she could control her inner world but the relief was only temporary.

According to Mental Health America and Discovery Health Report over the past decade more than 2 million people have cut themselves or inflicted self-injury. Further evidence suggests that 1 in every 200 teenage girls have intentionally cut themselves.

When left untreated, cutting and self-injurious behaviors do not simply resolve or go away. While this behavior is not addictive, it is habit-forming. Rachel continued to engage in cutting behavior to continue to find the relief she desperately needed. Whenever she felt mocked at school, failed yet another exam or disappointed her parents, she would retreat and self regulate by cutting her body.

These behaviors usually begin in adolescence and can continue into adulthood. While most girls (9 out of 10) who attempt cutting do not continue this behavior, those that do, left untreated, send themselves deeper into an emotionally tumultuous world. Treatment for cutting is designed to get at and resolve the core issues, usually regarding low self-esteem, depression, body image and self-loathing.

Only after an in-depth psychotherapy and adoption of specific behavioral and cognitive-behavioral strategies did Rachel begin to gain authentic control of her feelings and impulses. Treatment for this type of disorder typically can be quite involved and happens over the span of years.

Stay tuned for part 2 on cutting and self-injurious behavior.

I would love to get your thoughts and reactions to this post.

Abuse is any behavior that is used to control or quash another human being with fear, humiliation, manipulation, intimidation, guilt, criticism etc. Emotional abuse employs verbal and psychological tactics rather than physical ones. Sometimes it can be blatant while other times it can be quite subtle and hard to detect. Chronic devaluing and shaming gradually tugs away at the victim’s psyche leaving long-lasting, sometimes lifelong scars. The abused feels worthless and deserving of this torment. Usually the victim’s greatest fears are being lonely and unloved.

At sixteen years of age, Jenny did not understand why her father called her a “whore”, “slut”, and “tramp.” Her virginity was intact. Sometimes she flirted with boys like the other girls, but never did anything beyond kissing them. She wondered if sleeping with a boy would make her a bad person.

Her father also exhibited dramatic mood swings that left Jenny terrorized and uncertain about what would happen next. He sometimes displayed great affection towards her, but at other times, became enraged and rejected her.  Jenny’s frustration over her father’s name-calling and mood swings grew over time. She felt violated, yet was afraid to speak back to him and communicate her insecurity. Jenny hated herself for not standing up to him. Her mother also feared the father’s abuse and neglected to defend her daughter. Jenny a once bouncy, effervescent little girl, began feeling hopeless and expressed learned helplessness in her teenage years. She was losing her life force. Over time she developed an eating disorder, which became her cry for help.

Some common forms of emotional abuse:

• neglect
• rejection
• isolation
• demands/criticism
• being ignored
• threatened
• domination
• verbal assaults
• unpredictable behaviors

Because emotional abuse can so easily occur behind closed doors, it is often difficult to identify. If children are consistently exposed to emotional abuse at home, they may think the behavior is normal. An emotionally abused child has not necessarily witnessed the way a healthy home environment operates.

Some signs and symptoms of emotional abuse with children and adults:

• anxiety
• difficulty with intimate relationships
• constantly seeking approval and affirmation
• feeling different from others
• judging themselves harshly
• lying without apparent reason
• depression
• low self-esteem
• guilty feelings
• isolation
• sense of shame
• feeling unlovable
• mood shifts
• substance abuse
• self-abuse
• extreme neediness
• suicidal ideation or attempts

The cycle of emotional abuse: tension and anger increases, there is some explosive incident, followed by a reconciliation and finally a period of calm.

How do you think someone you care about can break the cycle of abuse?

Please stay tuned for Part 3 about some ways to break the cycle of abuse.