LONDON, 3 September 2003 — Paula is 12. She doesn’t get on with her parents because they dislike her friends and complain that she stays out too late. Lately, they have been having huge, ugly rows which leave Paula feeling angry and upset. She will go to her room and take the razor she uses to shave her legs out of the drawer. Then she will drag it along her wrists or upper arms, cutting deep into the flesh until her blood pours. It makes her feel better, less angry and raw.
Her friends know she does it and understand why. Several of them cut themselves too.
What is most shocking about Paula’s story is not that she regularly mutilates her body but that in doing so she is not unusual. For girls like her — and less commonly, boys — self-harm is a normal, almost banal response to emotional pain. Last week, BBC television news released the results of a survey of 50 UK accident and emergency departments, which found that 66% of staff believed cases of child and adolescent self-harm were increasing.
They reported seeing an average of 13 cases per month, with one department reporting three a day. More worryingly, most thought the age of self-harmers was falling. The average age of those treated was just 11, but children as young as six were admitted with self- inflicted injuries.
Since hospitals only see cases which require medical attention, the true number of child self-harmers must be countless times higher. Earlier this year, the Samaritans commissioned a study of teenage self-harm, conducted by the Centre for Suicide Research at Oxford University, England. After quizzing 6,000 teenagers it concluded that more than one in 10 adolescents has deliberately cut themselves at some time. Girls were almost four times as likely as boys to do so. Only 13% of self-harm incidents had led to a hospital visit.
These statistics do not surprise me. As an agony aunt for the teenage magazine CosmoGIRL!, I receive between five and 20 letters and emails each week which either mention or allude to self-harm. In most of these letters, from girls aged between 15 and 17, self-harm is not seen as the primary problem. Often it is mentioned halfway down the letter, almost as an afterthought.
One girl said she couldn’t cope with the pressure of choosing between several different sixth forms and asked me to help her decide which one to pick. Later she mentioned that the stress was making her “feel like I want to cut myself, which I haven’t done in a year”. Another detailed her experience of bullying, before revealing that her coping mechanism was to cut herself with scissors.
If, like me, you cringe at the mere thought of tearing off a plaster or pulling out a splinter, the concept of slicing or burning your own skin deliberately in order to cause injury and pain seems both abhorrent and alien. How can so many young people find it so easy to hurt themselves?
According to Dr. Michaela Swales, a lecturer practitioner in clinical psychology at the University of Wales, the answer is that self-harming is not as far from normal behavior as we might believe. “Cutting oneself is simply an unhealthy habit, not that different from drowning one’s sorrows in a few drinks, drug taking or smoking cigarettes to relieve stress,” she says.
Swales says children and teenagers who cut themselves do not necessarily have mental health problems: “There are many and varied reasons why people self-harm, but broadly there are three explanations. The first category describes young people who use cutting as a way of coping with a situation, as a way of releasing tension or changing an unpleasant emotional state. For some, physical pain is more bearable than emotional pain.
“Second, some young people use self-harm to give them a sense of control over a situation which they can’t control, such as bullying for example. Finally, self-harm is used by some young people as a way of validating their suffering. A child who has been abused may feel that nobody believes them because they don’t show any visible marks. By harming themselves they create a physical manifestation of their inner pain.”
Experts are not sure why so many more young people are harming themselves than in the past, if indeed they are. According to Joe Ferns, emotional health promotion manager for the telephone help line The Samaritans, “It’s hard to be sure if teenage self-harm really is on the increase or whether we’re just more aware of it now, looking for it and asking the right questions so we find it. Some believe that the more you talk about an issue the more acceptable it becomes to come forward and talk about it.
Young people are certainly under more pressure than in the past. Ferns believes that modern coping strategies — or the lack of them — may be to blame.
Images of self-harm are all around us, particularly in religious iconography. Pain and the spilling of our own blood are seen as ways of cleansing ourselves.
Before he vanished in February 1995, the Manic Street Preachers’ Richie Edwards famously carved the words “4 Real” into his arm as a public expression of his mental torment. Ferns says such images glamorize cutting, romanticizing the practice. “Some self-harm websites actually seem to encourage young people to experiment with self-harm,” he adds.
Ferns also worries about the effect of peer pressure on teenagers. “Our research shows a high correlation between people who self-harm and family members or friends who engage in the practice. People who have friends who self-harm are more likely to do it themselves.” This suggests that publicity about the practice — even when it is well-meaning, such as a recent storyline in the teenage television soap Hollyoaks — might actually be counterproductive.
The general perception is that we live in a more violent, dangerous society than that of the past. But statistics fail to support this impression. Perhaps the truth is rather more disturbing. In modern Britain the only real increase in violence is in that which we inflict on ourselves. If our children do come to harm it is more than likely to be at their own hands.
