document: Specialists say stats on self-injury are alarming She could n't cope . More than that , she could n't feel . The teenage girl was a victim of incest , and all that she endured , all the emotional damage that she carried , she buried . '' `` She just had bottled up her emotions , all this pain . She just could n't feel anymore , '' '' said Jeff Johnston , a psychotherapist with Cape Girardeau-based Associated Counseling Services . By the time the teen came to Johnston , she had been in and out of home placement , removed from her family . By the time she came to Johnston , she had discovered a dangerous relief . The girl was a cutter , tearing her flesh with a paper clip or a razor blade to achieve a kind of curious release , a bloody catharsis . '' `` She resorted to hurting herself so she could feel something , '' '' he said . Johnston has worked in counseling services for nearly a quarter-century , and this cutter was the worst case of self-injurious behavior he said he 's seen . He said he has seen more clients battling self-injury in recent years , most of them young , more female than male . He sees them as young as middle school , and the incidents of cutting tend to get worse as they get older . While there are conflicting statistics on prevalence , there are signs that self-injury , or self-mutilation as it also is called , is on the rise , according to research analysis from Cornell University and the University of Rochester . Guidance counselors and mental health specialists in Southeast Missouri say the numbers are n't epidemic but that the incidents are alarming . In her first few years as a counselor at Perry County Middle School , Barb Macke learned of a group of boys who were cutting themselves . She had never heard of such behavior , and it was terrifying . Macke did some research and found behavioral science theories suggesting cutting might be an indicator of suicidal thoughts . The boys were recommended for counseling , and the four friends did n't appear to have any subsequent problems . It seemed more of a machismo thing , young teens trying to show how tough they were . For several years , Macke said cutting seemed to disappear from the list of adolescent problems . It has resurfaced , she said . This year , she has worked with the parents of a sixth-grader who was cutting himself with the wire from his loose-leaf notebook . She has seen others who have cut deeper , most for similar reasons . When confronted , some have claimed their marks and scars are cat scratches . '' `` These are very uniform , almost parallel marks , obviously not a cat scratch , '' '' the counselor said . After seeing a half a dozen cutters last school year , Macke said she knows of only a couple of confirmed cases at the middle school this year . The numbers are difficult to track ; there are few comprehensive studies on self-injury , and the research often is contradictory . Broad estimates indicate about 1 percent of the total U.S. population , perhaps as many as 3 million Americans , show signs of self-injurious behavior . Another study in the Journal of Clinical Psychology reported rates of 4 percent . A 2004 British study , '' `` Young People and Self-Harm , '' '' estimates 10 percent of people ages 11 to 25 self-injure . Research suggests females are only somewhat more likely to self-injure than males , according to the New York universities fact sheet . While it may seem paradoxical , cutters see self-injury as a coping mechanism - an unhealthy coping mechanism , Johnston said , but a way to relieve stress , anxiety , frustration , fear , nonetheless . '' `` It appears these kids have a lot of internalized emotions they have n't coped with , and they are looking to express the pain , '' '' he said . It 's often about control , mental health care professionals say . Cutters often feel like hurting themselves is one of the few actions over which they have control . Some seek to purify themselves or to re-enact a trauma . Cutters come from all backgrounds . Ruth Ward , social worker for the Jackson School District , said she has seen the stereotypical '' `` good student '' '' struggling with cutting issues . What most have in common , she said , is they are looking for something . '' `` I think it can be a cry for help , '' '' Ward said . '' `` I think a lot of times , if a person is a true cutter , they are doing it to get a sense of relief from the anxiety or the built-up emotions . '' '' Johnston said some kind of dysfunction - abuse , divorce , a bitter custody battle - is a common thread among self-abusers . Cutting , research suggests , can become addictive . As painful as it may seem to carve or mutilate the skin , cutters come to depend on the release of endorphins , clinical experts say . The progression to sharper instruments and deeper cuts becomes part of the demanding high . '' `` The process can be likened to that of a growing drug addiction , where at first , small amounts provide a sense of calm and well-being , '' '' says the Self-Injury Fact Sheet from the New York universities . '' `` As tolerance builds , the user needs increasing amounts to achieve the same effect . '' '' '' `` I had a student who had scarred her body , '' '' Ward said . The teen received psychiatric help , she said , and appears to be doing better . While there is debate in the psychiatric community , Johnston said self-injury appears to decrease suicidal thoughts and action . For most it serves as a temporary release , he said . Though he said he hates to use the word in the context of cutting , Johnston sees some self-injury among teens almost as a fad . '' `` Some kids even identify around it , like it 's cool to be a cutter , '' '' he said . '' `` That 's always a scary thing when you see a child falling into that category , where they feel affirmed because they are a cutter . '' '' Ward said Jackson Middle School dealt with a copycat situation a couple of years ago , when a true cutter experiencing emotional problems was imitated by friends . On another occasion , a number of students tried cutting after reading a book detailing a young person 's struggle with self-mutilation . They used the book as a manual to injure themselves . '' `` It was very scary , '' '' Ward said . '' `` We had to address that with the whole group of students involved . '' '' Johnston believes cutters , like alcoholics , are always in a state of recovery . The tendency is always there . Johnston employs cognitive behavior therapy , helping clients recognize emotional triggers and correcting distorted forms of thinking . For many teens , particularly girls , he said journaling is an effective and positive form of coping . And he encourages self-abusers to openly express their emotions with safe people in their lives . It is important to substitute a more positive coping strategy and not just eliminate the self-injury , according to the Self-Injury Fact Sheet . Cutters will sometimes replace self-injury with other self-destructive behaviors , such as drug abuse . Anti-depressants also have been found to reduce some of the urge to self-injure , the fact sheet says . Ultimately , there must be recognition , Johnston said . '' `` They have to realize this is an unhealthy behavior , '' '' he said . ___ Information from : Southeast Missourian , http://www.semissourian.com Advertisement
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