A Silent Scream

By Urbani, Laura | Tribune-Review/Pittsburgh Tribune-Review, November 13, 2006 | Go to article overview

A Silent Scream


Urbani, Laura, Tribune-Review/Pittsburgh Tribune-Review


There are days when Judy Welty does not enjoy her job. As the child and adolescent inpatient unit nurse manager at Excela Health Latrobe Hospital, she finds that achieving rewards in her work often means navigating painful and sometime horrifying experiences with her patients.

One problem, in particular, stands out. Welty has noticed a disturbing increase in the practice of self-mutilation, especially among teens.

And she's not the only one to notice. So many teachers and medical professionals have expressed concern over self-mutilation -- sometimes called "cutting" -- that Excela Health recently held a seminar to explain the behavior.

"We are responding to a community request for (information about) self-injurious behavior," Welty said. "Schools are very concerned. We're happy that the community has asked us to explain it."

"There was a spike (in this behavior) a few years ago, but it has remained at the increased level," confirmed Donna Kean, executive director of the St. Vincent College Prevention Project, which provides school-based programs. "This area definitely requires a student assistance liaison. We're the link between the schools and the professional services."

Trying to explain why teens would deliberately hurt themselves is difficult. Self-mutilation -- which professionals also call self- injury or self-abuse -- is hard to discuss.

People hurt themselves precisely because they can not talk about their intense feelings or emotions, experts say. This inability to communicate keeps the behavior shrouded in secrecy, and makes it difficult for cutters to ask for help.

"Self-injury is a deliberate mutilation of the body or a body party," Welty explained. "It's not to commit suicide, but it is a way of dealing with painful emotions. It is a substitute for words."

Seventeen percent of college students -- about one in six -- have injured themselves, Welty said. Of those, 75 percent have done it on multiple occasions, and 25 percent need a doctor's care to treat the injury.

More than 40 percent begin to harm themselves between the ages of 17 and 22.

Self-injury is a bigger problem than most people realize. The Mayo Clinic estimates that between 3 percent and 5 percent of Americans have deliberately harmed themselves at some time. Although women seek help more often than men, people of every economic status, race and religion may practice self-injury. Even celebrities are susceptible.

"You never want to see this behavior," said Kean. "It's a hidden activity. It can go on for awhile before it's recognized."

When she talks about the problem, Welty often uses Diana, Princess of Wales, as an example. Diana revealed that she was a "cutter" during a BBC television interview in 1995. She said she had cut her arms and legs, using a variety of instruments from razors to shards of glass.

"You have so much pain inside that you try and hurt yourself on the outside because you want help," Diana said in the interview.

Like Diana, most self-injurers cut themselves repeatedly. Others scratch or burn their skin or pull out their hair. In severe cases, some even break their own bones or blind themselves.

Any behavior that damages one's own tissue is considered self- injury. And although troubled teens may bury their own emotions, they can see the scars even on high-profile celebrities.

Actress Christine Ricci still sports scars from burning her hands with lighters or scratching her forearms with soda tops. Actress Angelina Jolie continues to answer questions about her scars caused by cutting, a practice she began at age 13.

"Initially they will probably use scissors or razors," Welty said of young cutters. "Keep a close eye on those things."

Most self-injurers claim they discover the behavior inadvertently. They find the physical pain dulls an emotional one. …

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