Dr. Linda Helps - Jan sat quietly on my couch with little to say. She looked at me with distrust. "Don't think you can help me because you can't. I'm not talking to a shrink so leave me alone."

"OK, but there is one condition," I replied. "You have to stop cutting on your body. Once that stops, I'll leave you alone."

"You wouldn't understand," Jan fired back. "Try me," I replied. "You aren't the first young woman I've seen with arms and legs that look like you've been through barbed wire. I know those cuts have something to do with feeling out of control and releasing feelings of anxiety and depression. Am I right so far?" "Maybe." For the first time, Jan made eye contact.

"My parents are really putting a lot of pressure on me. We never spend time together. I guess they are too stressed out with their lives. And I'm having trouble keeping up with all that's required of me. At home, my parents fight about money, bosses and our family. My mom looks depressed and my dad is angry most of the time. One night when things were really bad, I took a small kitchen knife and began to cut on my upper thigh. It was kind of awesome. I could focus my pain on the blood running down my leg and not think about what was happening in my house. I stopped cutting when it hurt too much and I couldn't control the pain. But for a moment, I stopped feeling bad."

Jan is one of many teen girls who self-harms as a way of coping with the emotional distress in her life. As bizarre as it might sound, Jan cuts herself to relieve the stress and emotional pain she feels. Stress from school, peers and her family combined with a media driven culture have thrown Jan into such turmoil that harming her body is one way she finds momentary relief from it all. While cutting occurs more often with females across all socio-economic groups, Jan is not suicidal. She is looking for a way to manage her pain. Self-punishment seems like a workable strategy.

The momentary "high" Jan feels when she cuts her thigh is actually related to a release of endorphins that are secreted into her bloodstream. This release provides a quick numbing or pleasurable sensation and temporarily distracts her from the stress she feels.

Girls like Jan who self-harm often do so because they feel emotionally distant or invalidated by their parents. Some are rewarded for this behavior by a peer group that also engages in self-harm as a coping mechanism for stress and feelings of disconnection. Others describe feeling "dead" inside or invisible to parents, and feel alive or confirmed in their existence when they cut. For many, cutting is a way to manage overly demanding parents.

Self-mutilation is often hidden under clothing. Cutting usually takes place on the arms, thighs and legs and/or the abdomen. A sibling might notice the marks or a parent may find a razor or sharp object in the adolescent's room. And if a teen has a habit of becoming highly distressed and locking herself in her bedroom, she may be inflicting self-harm as a form of self-punishment. This is often the case with the eating disorder girls I have treated. They would rather harm themselves than openly deal with a conflict or challenge a parent.

Obviously, self-harm requires intervention by a mental health professional. The best treatment is family therapy with a skilled and trained family therapist. Therapy usually focuses on improving family communication, lessening expectations and demands, teaching conflict resolution, problem-solving and developing closer and more meaningful relationships with parents and siblings.

In addition to family therapy, girls who self-harm have to learn to identify the triggers that lead to cutting, learn to control their thoughts and solve problems. They need to be taught that harming themselves is not an appropriate way to feel alive or cope with emotional pain.

Spiritually, feeling connected to God, their Father and developing an intimacy with God is the best way to feel validated and alive. Understanding that God unconditionally accepts them regardless of their accomplishments, accepts their failures, promises peace in the middle of their emotional storms and is always present and willing to help can be life changing. The momentary "high" that comes from cutting can be replaced with God's peace and transforming power. Learning to bring all burdens to the cross is key. The truth is that the blood of Jesus has already been spilled and no other blood sacrifice is required.

Dr. Mintle – author, professor, Approved Supervisor and Clinical member of the American Association for Marriage and Family Therapy – is a speaker and media personality, as well as a licensed clinical social worker with over twenty years in psychotherapy practice.

For more articles and information, visit Dr. Linda Mintle's Web site.