What do you think when you see a teenage girl with scratches on her arm too perfect to be a random cat scratch or a fall?

How about someone who always wears long sleeve shirts, all the way to the wrist, all the time; even in the heat of summer?

Cutting is intentionally hurting yourself: making scratches or cuts in the skin with a razor or sharp object until it bleeds and is painful. Self-inflicted burns via cigarette or lit match are another common method.

In society at large, predominantly among girls, it’s estimated that one in 250 is a self-mutilator or cutter.

Such behavior makes observers very uncomfortable and thus all the more likely to ignore the signs. And that’s if you see the signs. Cutters commonly hide their cuts, make up lies about how they were injured, and are careful to cut on arms, legs, belly, etc. – areas that can be easily covered and concealed.

While cutting is rarely life threatening, and it’s not failed attempts at suicide (G-d forbid), the behavior is not to be ignored – it’s a sign of emotional struggle and mental illness.

But why would someone cut herself intentionally? Let’s compare it to getting a piercing. When a woman decides to pierce her ears, she feels the pain of the needle and dislikes it. Some are even terrified of the pain, but they put up with it in order to be able to wear earrings. A cutter, however, harms herself because she wants the pain and blood. She’s far less concerned with the change that is produced.

For some, a childhood filled with pain is what is familiar. Inflicting pain in the present moment is calming and relieving, because it’s familiar. Others feel their emotional and psychological pain temporarily alleviated by inflicting physical pain; like a distraction.

Sometimes teens use cutting as method of coping with intense, overwhelming emotions. Others employ it as a means of feeling in control when life seems so out of control.

Whatever the reason, cutting is a clear sign of emotional and psychological issues that need to be addressed by a professional. If you see such suspicious cuts and odd behavior by someone you know, ask them about it, show them you care, let them know you are there for them. Getting them to admit to it and talk about is often the first step towards getting help. And encourage them to get professional counseling to explore and address the deeper issues leading to the cutting.