I’ve been in youth ministry for more than 20 years and have come to realize that there is no end to the steady stream of kids who experience deep pain in their lives and resort to cutting (and other destructive behaviors) as a means of coping. Every time I talk with a young boy or girl who is cutting, I am overwhelmed with empathy for them and the pain they experience in life. Here’s what I’ve learned about it and what to do when kids are cutting. Cutting is the most common form of self-injurious behavior. It is not to be confused with attempted suicide. It is a way many people, especially young teens, cope with deeply intense and traumatic emotional pain or pressure (abuse, relationship problems, severe anxieties, etc.). For some, the pain of cutting temporarily relieves or distracts them from the constant presence of the emotional pain. For others, it is a way of expressing feelings of deep anger, rage, desperation, emptiness. etc. In some cases, the teen has been so overpowered by trauma that they feel emotionally numb to all other feelings and the pain of cutting is the only feeling that they have that lets them know they are “alive.” Unfortunately, it is a dangerous, compulsive behavior that can become addictive, can lead to severe infections, permanent scarring, nerve damage, and even unintended fatal bleeding. Teens who cut have not developed the coping skills necessary to deal with the intense emotions they are experiencing. Or, perhaps, the coping skills they have developed are simply overpowered by the severity of the situation. Because cutting is so deeply related to larger, deeper, more intense emotional realities and is so addictive, professional therapeutic help is most effective. If you are encountering teens who cut and are at a loss for what to do, here are a few steps that I practice.
1. Affirm them for talking about it.
The hardest step for most teens who cut is the first step…talking about it. You absolutely must affirm them for courageously taking this first step. It’s the right thing to do. It’s the healthy thing to do. It’s the biggest most important step to getting better.
2. Love them unconditionally.
Resist the urge to be judgmental about why they cut. Don’t even question their intentions for talking with you about it. Even if you’re weirded out by it…even if you think they’re just seeking attention…take it seriously and love them unconditionally. Unfortunately, their reality is far too often one where love and acceptance is conditional or even absent.
3. Ask lots of questions.
Before you start giving advice; even before you start preaching Christ…ask them lots of questions. You must first seek to understand them. Let them tell their story. Ask about their cuts. Where? How many times? How deep? How often? Ask about the feelings they get when they cut. Ask about the feelings they get that make them want to cut. Ask about the situations, thoughts, or memories that lead to those feelings. Ask about how they feel about themselves after they cut. Ask them who else knows? Do their parents know? What do they say about it? Do any friends know? What do they say about it? Ask if they have talked with a counselor about it and if they’re getting any help with it.
4. Inform their parents.
If it was your child that was hurting themselves like this, you’d want to know. Right? You must inform parents within 24 hours of discovering it. You have an ethical and a legal obligation to let them know. You are at risk of a law suit and losing your job if you don’t. Besides, good youth ministry is not working with kids to the exclusion of parents. It’s working in partnership with parents and supporting them for what’s best for their child.
5. Refer to a professional therapist or school counselor.
You’re probably not a professional therapist. You might be really good with people but you don’t have the training needed to handle this type of thing. So don’t fool yourself and think that you alone can help this teen. Encourage the parent to find professional help for their teen whether its through a local therapist or a counselor at school.
6. Lead them into a relationship with Jesus.
This is what you are trained to do. If they don’t already know Jesus, help them understand that Christ knows their pain and can provide the strength they need to cope. Explain that by putting our trust in Jesus, he gives us his Holy Spirit to live within us. When we fill our thoughts with his thoughts and listen to the Holy Spirit’s guidance, he can change the way we think and feel about ourselves and help us find better ways to cope with the pain we experience in life.
7. Remind them over and over of their identity in Christ.
If they do know Jesus, help them understand their identity in Christ. I find myself repeating phrases such as, “You are not what others say you are. You are not defined by what they think of you. Your worth and value in life is not dependent on what your mom or dad say about you, what kids at school say about you, what you hear yourself saying about yourself or what you see in the mirror.” I also speak things like “When you hear yourself saying that you’re not wanted, you’re not loved, you’re too fat, you’re not pretty, [etc.] … that’s Satan lying to you, deceiving you, trying to get you down. He’s trying to trap you in these lies so that you’ll cut again. Because of what Christ has done in you, you are not controlled by Satan. You are not controlled nor defined by the lies he feeds you.” Furthermore, I remind him or her of the statements we make over and over at church, “Only God can define who you are. You are a Chosen, and Changed, Child of God. Loved, wanted, and needed.” “God has given me a new identity. I will search for it no where else.” As their pastor, you must constantly remind them of who they are in Christ, how much he loves them, and how he is helping them (by leading them to talk with you, by giving them the church or their small group and youth leaders, by guiding their thoughts, etc.).
8. Treat cutting like an addiction
Because it is compulsive, addictive behavior, they need to see a counselor to overcome it. Your role is to check in with them, hold them accountable, or connect them with another adult or small group leader who can. Ask them if they have access to razors, knives, etc. at home. Encourage them to get rid of anything that they can use to hurt themselves. Encourage the parents to go through their home and do the same.
9. Help them find better ways of coping.
One thing the therapist will be doing is helping the teen find other more productive ways of coping with their feelings such as the following.
- Carving in wood allows them to cut as hard and deeply as they want, exerting the same pressure, without causing any damage to themselves.
- For some, wearing a rubber band to snap themselves when they feel the urge to cut can be helpful. It’s still a kind of self-injury but it can be helpful as a transitional replacement.
- Writing in a journal is a healthy way to express feelings. Even people in the bible did that. Look at Lamentations and many of the Psalms!
- Calling a friend, trusted adult, youth leader, or pastor in the moment of urge can also be helpful.
- Taking a cold shower, or putting ice on your arm can be helpful
As a pastor, I like to add the skill of Listening Prayer and the three R’s
- Relax – when you begin to feel anxious, overwhelmed, or the urge to cut, breath deep, inhale, exhale and relax your shoulders.
- Release – hold each worry, feeling, concern, anxiety, problem, whatever, in your fists with the finger sides down facing the floor. Squeeze each one tight then open your hands to let them fall to the floor as if you’re dropping them at the foot of the Cross. Repeat this for each one and as often as necessary.
- Receive – after you’ve released each one to Jesus, open your hands and turn them palms up facing the sky. Cry out to God for help. Ask him to speak truth to you. Let your heart be filled with his love. Listen to what he might say to you through whatever positive thoughts, truths, and scriptures, come into your mind. Let him replace your feelings of anxiety with feelings of peace, rest, confidence, and his loving presence.
10. Don’t forget about it and move on. Stick with them.
For many teens, the urge to cut doesn’t just go away over night. For some it takes months of intentional effort to overcome it. For others it can take two to three years of intense counseling and discipleship to get to the bottom of it all. Keep up with their progress, check in with them often. Surround them with healthy people who love Jesus and will love them. It’s a long road to walk but it’s the journey to which you have been called.
This information is not a substitute for professional diagnosis and treatment.