Cutters & Cutting

A cutter is a person, usually an adolescent and most often a female, who cuts herself in what is typically a private ritual. Razor blades, knives, compass points, shards of glass, or any sharp implement may be used in a self-injurious, but rarely lethal, manner.

Cutters usually do not want to commit suicide. Many talk about cutting as providing relief from emotional "pressure" they feel. Most try to hide scabs and scars left by this self-injurious behavior, and some will go to great lengths to avoid detection. Many feel guilty about their behavior. Cutters may target any part of the body for self-injury, but arms, legs, and torso are perhaps most common. In some cases, cutting is accomplished as part of a ritual, and may be associated with a certain song, incantation, or object that has special meaning to the cutter. A few cutters openly seek attention, and may even post photographs online or elsewhere. Cutting has been associated with depressive disorders, post traumatic stress disorder (PTSD), obsessive-compulsive disorder, eating disorders, and Borderline Personality Disorder (BPD).

It is difficult for most people to understand why a child might want to cut herself, or how drawing of blood might relieve feelings of stress or pressure, but cutters do derive certain gratification from the behavior. Sadie, a 15 year old girl who has cut her thighs with an Exact-O knife for nearly a year, put it this way:

When my father yells at me, I just can't take it sometimes . . . . So I go up to my room, lock the door, turn on my IPod real loud, then get my gear from my closet, take down my pants and find a place I haven't cut. It's . . . somehow, it feels good to cut, not too deep . . . and it's important to get it all in a straight line, so I have parallel lines, maybe two inches . . . and I use tissues to blot the cuts or sometime just let them scab up . . . .

The website http://www.selfinjury.com/ has posted graphic representing different motivations youth have for engaging in cutting behavior. Some youth cut to relieve the great stress they feel in their home, school, or peer group environments. The behavior is triggered by a particularly stressful life event, and leads -- paradoxically -- to a feeling of relief. Other youth feel alienated, detached, or isolated, and engage in cutting to feel "real" or alive, in the way that a tired person might throw cold water on his face to wake up. In fact, some therapists persuade cutters to use ice cubes rather than sharp implements on their skin.


Successful treatment of cutting typically involves more than dealing with the specific behavior, however, for that does not resolve underlying problems. The successful therapist must help the youth who is cutting identify stressful life situations and to develop strategies for eliminating or reducing them. The reasons for a youth feeling alienated or detached from her environment must also be explored. The youth must be encouraged to access and express difficult emotions, many of which may cause her to relive painful experiences. In some cases, and especially when abusive situations are present, a youth must be removed from her dysfunctional home environment. Collaboration between therapist and youth -- a therapeutic alliance -- is essential.

Teachers and parents often suspect a youth is cutting, or see the evidence directly. Cutting should not be ignored, or regarded as a "stage," because it signals that a child is in trouble. Rather, the youth should be addressed privately, non-judgmentally, and calmly. The adult should communicate concern to the youth, and suggest that the youth seek treatment. Teachers may also want to tell parents in confidence if they suspect their son or daughter is cutting, and offer to find help through the guidance department, school psychologist, or social social worker.