COUNSELING AIDS TEENS IN NEED CUTTERS INFLICT OWN `MANAGEABLE' PAIN.

Byline: JUDY O'ROURKE Staff Writer

SANTA CLARITA -- Bianca is smart, reflective and model-pretty, but to relieve painful feelings that became unbearable the 16-year-old has purposely inflicted physical pain on herself.

Long-sleeved tops cover telltale scars where she burned her inner arm with a lighter and sliced it with razor blades.

Bianca discovered ``cutting'' in ninth grade, but took it up hard-core as a sophomore. It was a solitary pursuit and a big secret until she met a kindred soul.

``I was in P.E., changing (clothes), and (my friend) saw my arm and I saw hers,'' Bianca said. ``I said, `You cut? I don't mean to be mean, but I didn't notice before.' I felt I could breathe. I didn't tell anyone about it before.''

Cutters wield razor blades, knives, glass shards, erasers, poke their skin with pins or burn it with cigarettes. They most often injure their arms, legs or chest, but the relief it brings is fleeting.

Bianca is among a growing number of young people in the Santa Clarita Valley who cut themselves as a means of coping. The act of cutting releases endorphins, nature's pain relievers.

``(It) makes you feel euphoric ... It's a way of controlling pain,'' said Cary Quashen, executive director of the ACTION Family Counseling Program based in Saugus. ``The act of cutting will take away emotional pain and turn it into controlled physical pain. Cutters control the pain now.''

Quashen does not keep statistics, but said substantially more cutters have attended ACTION programs in the past couple of years.

Widespread phenomenon

A survey compiled by Cornell and Princeton university researchers published in the June issue of Pediatrics found roughly 17 percent of college students admit to having cut, burned, carved or otherwise harmed themselves. But less than 7 percent sought help for the injuries. The findings agree with large-scale surveys in the United Kingdom, and smaller studies in the United States and Canada, that describe self-injury as a ``widespread phenomenon'' in adolescents and young adults.

``Anybody who works with adolescents now says they are seeing a swelling of this behavior in the last five to seven years,'' said Janis Whitlock, the study's lead author and director of the Cornell Research Program on Self-Injurious Behavior. ``There is widespread consensus it's growing among all segments of the youth populations.''

Cutting may have a reputation as a white, upper middle-class, mostly female activity, but research paints a different picture. Whitlock said it may be more of a girl thing, but plenty of young men seem to be involved, too. While significantly more females may be venturing into lethal behaviors, males may be more reticent to seek help.

The pool of study subjects was limited to students attending the two prestigious schools, but Whitlock said Cornell is partly state-funded and draws a range of students from diverse socio-economic backgrounds.

Acting out got Bianca (not her real name) kicked out of six high schools: Hart, West Ranch, Golden Valley, Saugus, Opportunities for Learning and Bowman. She says no one but her closest friends knew about the cutting for two years. She is attending the ACTION residential treatment program in Bouquet Canyon, learning healthy ways to deal with her feelings.

Many who once guarded the secret now vent feelings, share concerns and offer knowing support to others on blogs and social-networking Web sites such as MySpace. Some agonize that bad-girl celebrities who may or may not be cutters could be lending cachet to the behavior.

Cornell researchers, who analyzed more than 3,200 Internet postings from those who cut, scratch or burn themselves, found 28 percent of the postings were supportive, roughly 20 percent yakked about triggers and motivators, about 9 percent talked about hiding the practice, and about 6 percent sought or shared techniques. Most identified themselves as females, 14 to 20. The study was published in the May special issue of Development Psychology.

``People tend to be more honest, they tend to create identities readily and it's easy to hide,'' Whitlock said. ``(Cutting) would have been much more private in the past. Now, it's very easy to find other people who feel the same way, you have communities coming together.''

While some experts say round-the-clock camaraderie can be helpful, they are concerned some communiques could be reinforcing or downright dangerous for some participants. Adolescents occupied with self-discovery may find online friends who know them in a way nobody else does.

``Leaving the behavior means leaving the community,'' Whitlock said. ``That can feel scary.''

Teens can become fixated on cutting, and researchers don't know how that might sidetrack them on the path to adulthood. Whitlock cautions parents about Internet use, with its endless possibilities for exposure and constant interaction.

``If they wouldn't let their teenagers get in the car and go to the mall or go on the street corner in the middle of the night (parents) should not let them be online,'' she said.

Victims need treatment

Cutters may feel empty, and the act of cutting makes them feel something, it makes them feel ``real,'' said Luanne Southern, a social worker with Mental Health America, formerly known as the National Mental Health Association. The self-destructive behavior can have serious consequences but is not the same as suicide attempts.

``As an isolated behavior, it doesn't necessarily mean the person is suicidal but it does mean the person is in need of treatment,'' Southern said. ``Whether (cutters) are suicidal or not, they definitely need intervention.''

Quashen added, ``When you flirt with danger, bad things happen, and I've buried people who died by accident. They've cut too deep, taken one too many aspirin, drank a little too much ... looking for attention in the wrong ways.''

Southern, who says adolescents feel more comfortable talking to each other than to parents, cautions parents to monitor Internet use to build a communication bridge.

``People often think children need us more when they're very young,'' she said. ``They need us just as much when they're in junior high school, high school or even college.''

Cutting can be repetitive, impulsive or planned, but, according to a Mayo Clinic Web site, it differs from culturally sanctioned practices such as scarring, piercing and tattooing, which have been deemed versions of self-mutilation.

``Self-injury is distinguished from such practices by the emotional intent behind it -- it's an unhealthy coping method for overwhelming feelings,'' the site said.

Cutting, like other self-injuring practices such as bone-breaking, hair-pulling or head-banging, may be connected with depression or substance abuse.

Bianca had smoked pot, popped pills, drunk vodka and beer and pilfered over-the-counter drugs from her family's medicine chest. After running away from home for a few hours when she was 14, her father's upset and angry reaction prompted the self-mutilation, she said.

``I had a lighter in my room and I started burning myself,'' she said. Later on, she shimmied the blades from disposable razors and often she would spend hours cutting her skin. ``Then I would take a shower, wash off the blood and go to bed.''

Bianca briefly stopped cutting when she was in a relationship in 10th grade, but resumed when it fizzled.

``I did it because I had pain I couldn't let out any other way, so I did that,'' she said. ``When I did it, I felt a sense of relief. But the feelings came back the next day.''

The few friends she confided in tried to get her to stop. One of her best friends, a young man who cut on his stomach, has also entered treatment.

Many cutters strive for unrealistic goals, such as perfect grades, perfect home life, perfect friends, and when their expectations are not met, they fall into a funk and cutting numbs the pain.

Many begin as adolescents and while the practice may be more common in girls than boys -- or perhaps girls more often seek treatment -- boys also abuse themselves in this way. Combo cutters-substance abusers attend group therapy sessions at the Child and Family Center in Santa Clarita.

``It's a way to sometimes also -- like using substances -- to take yourself away from the other pain you're feeling that you don't want to acknowledge or deal with,'' said Jaime Wilder, a marriage and family therapist at the center. ``If you're being abused and not able to stop it, cutting is a way to dissociate from the other painful event. You do have control 2over cutting.''

Bianca was flooded with frustration, anger and sadness when her dad became chronically ill, and cutting became ``addicting.''

``I had to do it,'' she said. ``After a while, it didn't hurt me.''

At ACTION, Bianca is trying to burnish her self-esteem and face anger-management issues.

Southern said parents should seek professional help for their kids if they notice significant changes in sleeping or eating patterns, changes in mood and attitude, changes in a young persons' social life and if they suddenly become isolated or engage in unusual types of social behavior.

Southern said a teen wearing a winter wardrobe year-round can hint at trouble.

``If your child's wearing long sleeves and it's 90 degrees outside, you're going to wonder if they're hiding something under there,'' she said.

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CAPTION(S):

2 photos

Photo:

(1 -- color) Bianca, who is at the Acton rehabilitation facility, has a history of cutting herself, a common form of self-mutilation.

(2) Bianca is among a growing number of young people in the Santa Clarita Valley who cut themselves as a means of coping with painful feelings, according to the ACTION Family Counseling Program.

David Crane/Staff Photographer