The silent scream: Sari Grossman, now 16, is creative, funny and very smart. So smart, in fact, that it's hard to understand why she decided to cut her arms and legs on a daily basis. An inside look at the heartbreaking world of girls whose emotional pain has lead to torture themselves.

GROWING UP, I'm sure I seemed like any normal kid. In fact, I probably tried harder to fit in because I was an only child. But on the inside, I always felt like I was totally different--and not as worthy--than everyone else.

My parents divorced when I was 4, and that was really traumatic for me. I just didn't know how to deal with all of the fear and sadness I was feeling. Without thinking, I started scratching my arms and legs with my fingernails until I bled and, for some reason, that was always very comforting to me.

I already had skin problems, so my parents just thought I needed to see my dermatologist. But when the dermatologist told them I was scratching myself, they took me to my pediatrician for some answers. He suggested that I use a rubber band to snap on my wrist whenever I had the impulse to scratch myself, but it didn't work. My parents sent me to a therapist and, although that didn't stop me from scratching myself when I got scared, it was nice having a place to talk every week. Eventually, I was diagnosed with Attention Deficit Disorder, so I was put on Ritilin, Concerta and sleep medications.

My life became even more stressful when I started sixth grade. I was living with my morn and was moved from a private to a public school. Since I was "the new kid," I was teased every day, so I always came home crying. It was so horrible. Sometimes, my morn would even have to come and get me or my teacher would send me to the nurse's office--which only made matters worse with the other kids in my class. My grades plummeted that year and, for the first time in my life, I got three D's.

FIRST CUT IS THE DEEPEST

When my mom saw my report card, she called my dad, and they both yelled at me. I felt totally ganged up on and just couldn't handle it at all. I ran to the bathroom, locked the door and picked frantically at my skin. Then, I noticed a hair clip on the counter. I was so angry and frustrated that I thought, "If I use this to cut myself, I'll feel better--and they'll understand how depressed I am." So I used the clip to cut myself on my arms, and blood poured out.

As odd as it sounds, I suddenly felt completely calm. My mom finally broke into the bathroom with a screwdriver and, when she saw that I was bleeding, she held me and cried. Right away, my parents realized they had been too hard on me and, although they did want me to get better grades, they came to the realization that my problem wasn't about slacking off at school.

After that, I always hid my scar. When anyone noticed it, I'd just say my cat scratched me. I think I was embarrassed because I was afraid people would think I was suicidal, which I wasn't. I just wanted to feel relaxed--and that's how I felt when I bled. I continued scratching, but I never cut myself with anything for the rest of that year.

THE RAZOR'S EDGE

I thought seventh grade would be better than sixth, but it was really tough on me for different reasons. I felt bombarded with every emotion--about friends, school, parents, boys--and it was too much to take. I had a boyfriend who became totally controlling, telling me what to do, what music to listen to and what to wear. Although I eventually dumped him, I was so upset that I began cutting myself again. This time, though, I used a razor blade. I know some kids cut themselves for attention, but I didn't.

I cut myself to feel better about my life. That summer, my friend convinced me to go with her to camp, so I went but hated it! I got really sick and begged the counselors to let me call my parents. At first, they wouldn't let me but then the camp director said if I did this three-hour hike with everyone, he'd let me call home. I did the hike but, afterward, he changed his mind and said I couldn't call. I freaked! I was furious that he had lied to me, and I felt like screaming every foul word at him but couldn't. I grabbed a plastic knife, went off on my own and cut my arms.

A couple of days later, parents were allowed to visit the camp and, when I saw my morn, I told her what had happened. She felt terrible and said, "We're taking you home."

I stayed "clean" until school started, but I was put on higher doses of my medications, plus an anti-depressant. The meds helped but, when the doctor kept increasing the dosages, my life spun out of control. I felt like I was crazy, so I used candles to burn my hands, and knives to cut my arms and legs. I felt I had to do something for relief from all the feelings I had building up. Usually, I cut myself after school or before bedtime since it helped me sleep. My morn couldn't help noticing my new scars, and she felt completely frustrated and helpless. I hated myself for hurting her, but I couldn't stop myself. The therapy and medications clearly weren't working.

DESPERATE TIMES, DESPERATE MEASURES

Everything came to a head in the fall. I was shaking violently in school and thought the world was going to end. It was the worst feeling. I had no idea what was happening to me. Someone dragged me to the nurse's office, and my mom came to get me. We went to my doctor, who immediately cut my dosages.

My mom found me a new therapist but, soon after that, my parents got in this huge fight over my cutting and that threw me over the edge. I pleaded for them to stop, and my dad stormed out. I locked myself in the bathroom and cut myself. My arms and wrists bleeding, and fully clothed, I got in the shower and lay there with the water running over me. My mom broke into the bathroom, crying, and said, "Sari, you need rehab." I totally agreed. Not only was I completely out of control, but I was so angry at myself for hurting my parents when all I wanted to do was hurt myself.

In December, I checked into Self Abuse Finally Ends (SAFE) in Chicago. I was scared, but it started off pretty good because I discovered there were lots of other girls who had the same problems. I realized I wasn't crazy, but then I relapsed by cutting myself with my fingernails. I also got in trouble for jokingly hitting my roommate. I was kicked out of the program after only 15 days, and I felt so ashamed for failing.

My mom was angry at the staff for giving up on me, and she was beyond desperate. My therapist suggested a teen therapy group in Los Angeles with a psychotherapist named Dr. Elaine Leader. I went to weekly meetings at her house and, although I didn't stop cutting right away, it helped me immediately. Everyone there felt like family to me.

HEALING THE WOUNDS

Starting high school was like a whole new beginning. I made new friends and had cool classes, like art, which gave me a way to express myself. I was also the lead singer in my own band. I felt freer than I ever had. But by November, my new boyfriend had completely broken my heart. I saw a big knife at home and hacked up my arms, hoping I would feel better. But this time when I bled, it was different. I didn't feel calm. Instead, I thought, "Why am I doing this?!" I was dizzy and felt like vomiting. Suddenly, the cutting thing seemed so stupid. I was disgusted. That was about a year and a half ago, and it was the last time I hurt myself. Looking back, I think I hurt myself to replace emotional pain with physical pain. Somehow, physical pain was easier to deal with.

I've always hidden my scars under long sleeves and pants, but now I accept them as part of me. They are a reminder of what I went through and that I never want to go through it again. They make me proud of how far I've come. Now, I know how to deal with things as they come up and have a great support system--my best friend, my new boyfriend, Elaine's group and my mom.

If you have the desire to hurt yourself, talk to someone you trust. Although no one can keep you from doing it, you can get ongoing help from a good program or therapy group. I've learned a lot of coping tools and met a lot of people who've helped me to finally achieve a happy and fairly "painless" life.

WHERE TO GET HELP

There is help and hope for girls who hurt themselves. Here are some great websites and phone numbers:

siari.co.uk Amazing info on self-injury with many other suggested resources.

selfinjury.com (or call 1-800-DONT-CUT) This is the site for SAFE, a treatment center in Chicago. It offers treatment, referrals and info.

selfinjury.org The site for the American Self-Harm Information Clearinghouse has tons of information to offer.

teenlineonline.org (or call 1-310-855-HOPE or in California 1-800-TLC-TEEN) It has great info on self-harm, or you can speak confidentially to a trained teen for advice.

THE TRUTH ABOUT SELF-HARM

For some, the thought that anyone would enjoy cutting herself with a sharp object is unfathomable. Here are some facts to help explain where these girls are coming from....

A whopping 14 percent to 39 percent (exact umbers are hard to come by since many kids are too shameful to admit to it) of U.S. teens have injured themselves by cutting, burning, scratching, pinching, hitting or interfering with a wound.

AROUND 70 PERCENT OF SELF-INJURERS ARE FEMALES. Girls who have been physically or sexually abused or had some other childhood trauma, like the death of a family member, are more likely to self-harm.

BUT IT CAN HAPPEN TO ANYONE. Self-abusers also come from stable families with no history of trauma. Self-abusers are generally not suicidal or attention-seeking. They are just kids trying to cope.

FAMILY REPRESSION. What self-abusers do have in common is that 90 percent come from families who discouraged them from expressing their feelings.

SELF-ABUSERS USE CUTTING AS A WAY TO RELEASE PAINFUL FEELINGS. Strange as it seems, self-injurers feel little or no pain when they hurt themselves. Some experts believe cutting releases a brain chemical that dulls pain and brings on calm. On the other hand, self-harm can be used as a way for teens to punish themselves for "failure."

OTHER SELF-ABUSERS CUT AS A WAY TO GAIN CONTROL. Many feel that, by turning their mental pain into physical pain, their problems become easier to deal with. Then there are teens who do it for the opposite reason--they are numb as the result of trauma and use cutting to actually feel something--even if it's just the sting of a razor blade.

THERE IS HOPE AND TREATMENT FOR SELF-ABUSE. If you have thought of hurting yourself or have hurt yourself in the past, go to your parents, a teacher, counselor or other trusted adult about your feelings. Not being able to express yourself in a healthy way is the root of self-harm. Talking to someone and asking for help is the first step on the road to recovery.