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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Young People and Self Abuse

Allan N. Schwartz, LCSW, Ph.D. Updated: Jun 14th 2006

A study was published this June 2006 that reported that one in five students at two Ivy League universities engaged in self mutilation. The study pointed out that the problem is more wide spread than what is happening at the Ivy League schools. It is estimated that some 14% of young people engage in self injury. In addition, the largest majority of self mutilators are women. Surveys show that 55% of all self abusers are women. Some but not all of the men are bisexual or are dealing with sexual identity issues. Self injury begins as early as 14 years of age but the largest percentages occur between the ages of 17 and 22 years of age. Most people do not seek help for their injuries and, in fact, try to hide their scars are marks from others because of the shame they feel about what they have done. Many methods of self harm are used ranging from scratching the skin until it bleeds to self cutting with a sharp knife. These actions are in marked contrast to suicide attempts although any person can misjudge and inflict an unintentional life threatening injury.

What Causes Young People to Self Mutilate?

This is a complicated question with few concrete answers. Several things are known about the issue of self abuse:

Self abuse can be used the in the same way as the abuse of a substance: it is an attempt to numb feelings of emotional pain from having been traumatized.

Examples of trauma that may cause a young person to self abuse range from being the victim of incest to having been physically and emotionally abused as a small child.

In some cases the self abuser feels so extremely alienated from life that physical pain is the only way they seem to feel alive.

The pain resulting from cutting oneself may result in feeling of relief.

Self cutting may be an attempt to communicate feelings that are too over whelming to put into words or to actually tell anyone else about.

Inflicting pain on oneself is an attempt to exercise some sense of control over ones life, much like the anorectic self starves to gain a sense of control.

Self injury is not an attempt to manipulate other people or to gain sympathy. To reiterate, those who injure themselves maintain strict secrecy, do this in isolation and feel intense shame about this behavior. The victim wears typically wears long sleeve shirts and blouses and full length pants and jeans in order to hide scars.

These young people suffer from low self esteem, depression and feelings of helplessness. Many are shy and withdrawn although extroversion is no guarantee that the person is not self injuring.

Associated problems with self injury are often eating disorders, especially bulimia nervosa with its cycle of extreme binge eating and purging followed by intense feelings of shame and self hate. In some cases the sufferers do begin to engage in drug abuse. In fact, poor impulse control along with anxiety and self hate accompany all of these problems.

It is important for family and friends to be warm and supportive when and if they become aware of the problem. Scolding, hostility and rejection will only worsen the situation. Psychotherapy along with medication to relieve depression is usually the best approaches to this problem.

While it is possible to recover from this illness, for some, it does persist into later adulthood.

What are your experiences and opinions about this serious problem? Your responses are encouraged.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

Anonymous Self Abuser - Allan N. Schwartz, PhD - Oct 28th 2009

Hello Anonymous,

I strongly urge you to enter psychotherapy. You are a young person of 19 years of age and deserve a chance to live your life to the fullest without all of that suffering.

I recommend that you find a good clinical psychologist for individual therapy and that you enter group therapy. The type of therapy I recommend Dialectical Behavior Therapy because that could teach you to handle your stormy emotions in healthier and less depressing ways than harming your body.

Best of Luck,

Dr. Schwartz

hmmm...where to start - - Oct 28th 2009

hmmm...where to start. i'm 19 i'm anorexic i cut i hit i punch i use inanimate objects to hurt myself. it happens when i'm mad or upset and i can't really control it i just need to get it out and so i engage in this behaviour. i don't really know why or how stop it.. i hate myself to the extreme if i could dissappear willing i would, i would like to be free of this life in all honesty and there is nothing to live for.everywhere i turn there are people taking advantage of me or just ingnoring me completely. i don't really want anyone to know what i'm doing have been doing, but i want to not be depressed all the time and hate myself. it gets so bad i wish i could just i dunno i guess switch lives with someone or go back in time and tell my parents they made the biggest mistake of a life time having me. i would like to spare us all the pain and guilt. thanks for listening i guess...

First Self-Abuse at Age 58 - Donna Hart - Aug 13th 2009

I recently moved to be with a man who I had a long-distance relationship for 1 1/2 years. I left a very postivie environment and life. This was after I ended the relationship and he asked me to move in with him, promising to be a better partner and to work toward a life together.

When I moved in, he immediately became abusive -- from verbal to eventually physical. I won't go into details, but it was horrific. I felt I had left so much and invested so much in this decision, that I needed to make it work. In the beginning, I also made excuses for him: a sad childhood and diabetic mood swings. He's can also very manipulative and charming -- on a sociopathic level as I have now realized with help from my counselors.

One night he left to go on a date -- as I very painfully discovered in his e-mail. I don't remember doing it, but I severly cut my arms and legs. I was horrified. I'd never understood self-mutilation. Another night, after he physically hurt me, I cut my legs, though much less severely. He said he watched me do it.

The first question the doctors asked was how old I was when I began cutting. At age 58, this was my first time.

Have you ever heard of anyone self-mutilating at this late stage in life?

father of a self abuse teen - - Jul 7th 2009

I was awaken this morning to my youngest son telling me my 16 yr old  had cut himself again. He has been in therapy for a little over a year, and hadn't cut himself in the past year.

What I cant understand is last night  he was cheerful, joking, talking about selling his car and getting a mustang he always wanted, then about 2:30 am he drinks a bottle of tequila he had apparently hid somewhere, and proceeded to cut both arms and his hip.

what can we do, or what shouldnt we do to support him in this problem? im at my wits end and my wife is headed for a nervous breakdown over this.

How long does this usually go on for?

perplexed by my own mind - perplexed - Oct 29th 2008
I have issues with anxiety, and it seems that the same cycle happens over and over. I start out feeling ok, then a period of unnatural euphoria ... followed by worried thoughts, stomach aches, and if something happens out of the ordinary or is stressful during this period images of cutting myself flash in my mind.  I don't usually follow through with it because I'm married and if I cut myself it would become obvious immediately to my husband. I understand and deal with it as a symptom of depression, and at that point I really start focusing on myself and my behavior before I explode at work, at home, whatever.  I just find it very odd that images of a blade running down my skin and bleeding is something that I can't get out of my head in this state. For me I guess it would serve as relief and release, and maybe control.

messed up.... - Day. - May 14th 2008

I cant even pin point my problem, its just too many things, ive been through too much an now im just left feeling worthless....i used to cut myself cause i felt overwelmed with everything that was going on in my life an it was the only thing that brought me together after i would fall apart, but some how i got passed that and stopped for 2-3 months... but i got sucked back in somehow... an its for such a silly reason i think but i cant stop, i just feel ugly an disgusting, i pick and at every imperfection on my body now, im told constantly that im beautiful but i cant see it, not at all, i just see everything bad about my image and personality, i always feel alone like im losing everything and everyone around me....

i dont tell anyone cause everyone thinks im better, i dont want everyone to think im going back to my old ways. i just feel like no one will understand how im feeling this time its like a whole new level. i just feel alone,ugly,unwanted,sad,angry,used, its just rediculious as to how many mixed emotions are overpowering me...

self-abuse - LP - May 10th 2008

Growing up I learned how to turn off all my feelings. So much abuse so much a child I just endured it...I didn't know there was any other way. I learned how to be numb. I used to cut myself to that I could feel something...anything. No one knew. even now, I am an adult and no one knows. Why am I remembering all this stuff now? I thought I was past it.

words cant even begin to help THEM understand - - Oct 20th 2007
Confusion may sound as close as i can get to explaining my it that is so many..or none at all..souless,unforgiven,broken..I always seem to attract twords chaos..i need hatred..i only feel alive in the darkness..i feel comfort in pain..and familiarity in in the confusion and misery..i seek out lost souls myself..drugs,drinking myself into misery ..its all my private crucifiction..words carved into my skin is my i stay in comunication with myself..i dont want to feel but i never want to skin is all i can depend on ..its all i know will be with me and connect with me for my life..i commit temporary suicide with chemistry..i find it funny when peole say they drink to forget..or numb the pain..i use to abuse be the embodiment of what i am..TO FEEL anger revel in self loathing and disgust..

Pain through blood and tears - Red - Jun 15th 2007
I started cutting myself again after stopping for years.  Then I had a nervous breakdown. Tried to do all this stuff and help others and become a success at work.  After a while I just go worn down and had to admit myself into a hospital.  I think that I am so confused about what life even's not at all clear, is it?  Cutting is a way of figuring out one's self without the intervention of others.  It is very personal and acute.  It is not just about pain, but about self revelation; explaining life when it makes no sense - when it feels like living on Mars.

Thankfully I grew out of this pattern - - Oct 28th 2006
As a teenage girl, I used to inflict pain upon myself often. I was raised in a highly strict religious environment. I was alienated from my peers through home school, because my parents feared the public school system. I feared the wrath of a puritan-like god. But I could not ignore the desire to touch my own genitals. I incorporated the pain into my masturbation rituals, probably because I felt so wicked for having sexual urges. I had fantasies of rape and torture, and I acted out the torture part. I drew blood on my breasts by using sharp objects. I burned my nipples with matches. I whipped myself with various objects. And I wrote degrading phrases and words all over my body with black permanent markers. I hated myself. This behavior continued until I was about 19 years old. This is the age when I left the church of my birth, stopped believing in a deity, and began my new life of freedom. I am not completely healed yet (I'm 23 years old now). I still have problems embracing my sexuality. I feel degraded by pornography and sexy commercial ads. I feel undesirable and ugly. I feel no enjoyment during sex with my partner of 4 years. He does his best to understand my problems, and he encourages me to learn more about it so I can "fix" myself. This is why I am here in the net, reading and learning. To those who are still in the cycle of self-abuse and mutilation, I urge you to be patient with yourself. There is hope and healing for you. Good luck.

helpless - - Oct 15th 2006
Sounds a lot like me - I'm desperate for some control over my own pathetic existance of a life, I can't communicate what I so badly want to say, I can't put it into words, and I feel like such and outsider and so different from the rest of the world, at least hurting myself will "ground" me in some way. People have tried to help me. I've also been yelled at, scorned, ostracized and I must do everything I can to keep anyone from realizing what I do. It's been a long time, and I've given up. There's no hope left in the world. Someone sucked it all up.

confused - - Jun 15th 2006
Well interesting that you hit how I feel bang on, interessting how some Dr.'s know so much and others so little. I wish I could have found a Dr that could help me sort all these feelings out. As much as I hate all this I am very stuck in it all and it is like I have nothing else to lean on if these issues are gone. I am very much afraid but more so embarassed and so I feel like it is not worth the hassle. I don't even know how to ask for anything because I don't know what will help. How confusing. I read about this issue and it sounds so common and sounds like the help is easy to access but in reality it is not so easy for someone so afraid. I wish that I could be more open. I hope that others have a easier time getting the help that they need.

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