Attention Seeking.....Cutting

[Masta]

I am new to the whole world of cutting. i found out tonight my 18yr difficult child has been cutting for 1.5yrs.

her cuts aren’t deep so I have been told.

Brief summary of why I am here: my oldest difficult child has been a handful for a long time. I came to this board a few years back when I had no where else to turn.

I placed my difficult child in a short tern Residential Treatment Center (RTC) for 6mths. She came out worse. My insurance wouldn’t pay for her to stay any longer. We brought her home (she was 16yr) at the time. She kept running away. I asked DCFS to help me with her before she was released from the Residential Treatment Center (RTC).

I couldn’t control her outbursts, we had cops at out door, trouble at school, she would run away so I finally signed her over to DCFS. I placed her in foster care voluntarily nearly 2yrs ago.

Its been so much better on the rest of my family since difficult child has been in care, but she still seems to be getting into trouble. After being in foster care for 2mths she went on the run for 4 days.. ended up in DT.

She has done all sorts of thing for attention in the past, not eating (but sneaking food at night), running away, sluffing school the list goes on. My difficult child is forever making fires and we are forever putting them out.

Right now her current diagnosis is depression. Everything else has been ruled out (she has been diagnosed with all sorts in the past). We are currently waiting on her to have a MMPI test done.

Tonight we went to visit difficult child at her new job, husband seen cut marks on her arm.

So I wrote a letter to her dcfs worker: We (all the family) went to visit difficult child at her new job this evening took pics of her in her micky d’s uniform etc and had a chat with her.

husband noticed her arm had cut marks on it. When she was asked the first time by husband difficult child avoided to answer.

She came back over to talk to us a little while later and husband asked her again how long has she been cutting. She said 1.5yrs. She said she cuts on other parts of her body. She was cautious but open about it, she also tried to minimize the situation and avoid the questions.

I didn’t say a word I didn’t want to give her the attention she is seeking from it. I asked her all about her job etc.

I called foster mom when I got home to ask her if she knew. foster mom said she knew and she had told dcfs health lady and she is sure difficult child has told her therapist. difficult child teacher, mentor also know about it. She is sure everyone knows who needs to know. I don’t know why we weren’t told about it.

foster mom says when difficult child cuts she uses scissors. She cuts after she has issues with b/friends usually, and she shows foster mom the following day. She usually cuts late at night on her legs and arms.

foster mom hasn’t made a big deal of it because she thinks difficult child is doing it for attention, husband and I agree with her.

husband and I would like this addressed though in the next CFTM (child family team meeting). Just so everyone knows and is aware of the problem. I don’t want to make a big deal out of it so maybe just address it in an email instead of when difficult child is at the CFTM.

Ours concerns are: If the scissors are dirty, or wounds become infected, or if it gets out of hand one day when “her world is on fire” (a phrase difficult child has used before when she has called us up from foster mom’s, when everything has gone bad in her life).

difficult child hates shots; foster mom has said the cuts aren’t deep. I’m just shocked difficult child has resorted to this. She has always said she would never cut. foster mom said difficult child and ex boyfriend would take turns he would do it one night she would do it the next night.

I sure hope she isn’t doing it in front of the girl she shares her room with since its late at night.

MY difficult child has always been an attention seeker. I have detached allot since she has been in care.

Have any of you experienced this with a difficult child similar to mine? Do any of you have cutters? Any advice is welcome. I don’t know how to handle this situation.

Masta

 

[Allan-Matlem]

Hi,
Sorry about the difficult situation. in my humble opinion ' attention seeking' does not convey the serious and deep emotional problems, lack of coping skills, the ' relief' that cutting brings as a coping skill. Sending positives thoughts and prayers that some one in an empathetic way can reach out to her , validate her feelings, and remove her from the negative influences and work with her , giving her a vision for the future.
Allan

 

[BusynMember]

My daughter cut. She didn't do it for attention, in fact, she wouldn't do it in visible spots. Cutting is a problem and becomes addictive both according to my daughter and my grown friend who used to cut. It is way beyond the normal way of getting attention and needs attention. It is related often to mood disorders or drug use, which my daugher did. She said it was very hard to stop, even when she wanted to and my friend said the same thing. Unfortunately, I was a "therapeutic" foster parent. All that really meant is we'd take harder kids. We had no more knowledge of kids than anyone else. I'd push for getting help for this. She may be crying out for help, not attention, and could be suicidal. If this neuropsychologist found her normal, then I'd make sure she saw a Psychiatrist (with the MD). The way she is behaving is not normal nor, in my opinion, do I feel talk therapy is the answer. She probably could use medications, and, with ex's history, likely inherited a mental illness that he has, but may be undiagnosed. Substance abuse is often seen in mood disorders, such as bipolar. Depression is often the first diagnosis. before bipolar is found,and antidepressants make bipolar worse. Her behaviors are more consistent with bipolar and/or drug abuse then just depression. I have bipolar II.I am not saying she has bipolar, but I think it's way beyond just a teen looking for attention. Her behavior shows serious issues, and I hope that they don't get passed off as only attention seeking. They are way too extreme for just that. I hope you find a way to help her before she turns eighteen and is considered an "adult". Good luck!

 

[Masta]

MidwestMom: difficult child turned 18yr last Oct. difficult child is still in states custody, they will release her when they feel comfortable that she can cope on her own. They can keep her in their custody till difficult child is 21yr.

difficult child has been diagnosed with a mood disorder not otherwise specified before, but has lost that diagnosis. difficult child’s bio father hasn’t been diagnosed but I’m sure he is full blown bipolar, he raged allot. He was also very attention seeking. difficult child doesn’t rage.

difficult child has had a neuro pysch done sept 2006 its shows: the neuropsychological deficit scale is: 26: which is mildly impaired brain functioning. difficult child has impairment/damage on both sides of her brain. difficult child suffers from dysgraphia, and verbal dysgnosia , difficult child is learning disabled, has severe C.A.P.D. short term auditory memory problems

neuro pysch: difficult child impaired judgment - executive function judgment, difficult child is impaired in the ability to analyze situations, recognize relationships that are involved in complex situations, draw correct conclusions from her observations, and use accurate cause-and-affect reasoning. difficult child misperceives aspects/details of a situation, and/or attends to irrelevant details of that situation, and therefore responds in a erratic, erroneous and inappropriate manner.

I personally think difficult child has a mood disorder, as well as a personality disorder ... difficult child cycles slowly like every other month. The Child and family team watch her go in waves and hold mini interventions when we see that things are getting out of hand.

I also think she has some sort of personality disorder. difficult child believes the world should revolve around her. difficult child has made statements like: difficult child wishes everyone could read a manual written she has written about herself so we all could comply to what she wants. difficult child has always been a demanding child.

Every other month we are dealing with new issues when it comes to difficult child. When difficult child was living at home her issues happened daily. I’m sure its still that way now, foster mom doesn’t watch her like I use to. I have detached. I can’t handle the stress from all of difficult child’s dramas, I feel like I have pstd from it all. My other kids and husband have gone through allot… they are dealing with their own hurt when it comes to difficult child. We lived in a war zone when she was at home. I want to help difficult child but I have to remain detached in order to get through this.

Do people with personality disorders cut?

difficult child is currently on Zoloft.

I understand cutting is serious. I’m wondering if difficult child is a true cutter. difficult child barely breaks the skin then goes and shows her foster mom the next day. I am concerned, I wont be pushing this under the rug, I will make sure this gets addressed with dcfs.

 

[Sara PA]

I never bought the attention seeking explanation for cutting for most kids who cut. I thought most cutters did what they could to keep their cutting a secret. If she's been doing it for a year and a half and you are just finding out about, obviously it's isn't your attention she's seeking by doing it. Maybe it's peer attenion, but I don't think so even if she learned it through peer influence. Those who do it for attention allow their cutting to be "discovered" far more quickly than a year and a half after they start. As for showing the foster mother the next day -- that could be her way of asking for help in stopping a compulsive act, not attention seeking. difficult child is probably as distressed about it as you are, maybe more so if she is acting on a compulsion she can't control and fears she may really hurt herself.

Self harming behaviors can be an adverse reaction to antidepressants (Zoloft). Our experience which is not unlike many others, is that my son cut and self harmed only while taking an antidepressant. He cut (even picking up a piece of glass from the street in a moment of severe stress), burned, froze parts of his body (and attempted suicide) only while taking an antideperessant. The behaviors started after a few months on Celexa and ended within two weeks of discontinuing it.

If she's cycling, she probably shouldn't be on an antidepressant because they cause or worsen cycling (mania and depression phases) for many people. It isn't only bipolar people who cycle because of antidepressants, it can be anyone. There is a form of bipolar which is called "antidepressant induced bipolar". Treatment is discontinuation of the antidepressant.

 

[Stella Johnson]

How scary. I have never dealt with this but hopefully the others can give suggestions.

Steph

 

[Masta]

Sara PA: difficult child just began taking zoloft about 2 months sgo, so i dont think the medications have induced this problem.

i know difficult child isnt doing this to get my attention....since i was the last to find out.

what can be done to help cutters? difficult child has been in therapy since she was 12yrs old. so that isnt helping.

at what point do we say.. she is inflicing harm on herself and needs hospitalised for her mental health?

 

[BonnieJean]

Okay, from what little I've been told about cutting, most instance it's not about the attention that you might think. A family member who did this told me it was to release pain that was built up inside. Unfortunately she's resorted to tattoos, ALOT of them! She's now a new mom and by the way, she has BiPolar (BP) and is back on medications. But her cutting lasted for a few years, it was something she seemed to have started out of the blue and I don't even know when it stopped. I do know that she has terrible scars on her arms.

Now, easy child boy had his first girlfriend last year and he fell hard for her. But then one day she must have showed him her tummy area where she cut. She cut various places, again not only on the wrists. easy child boy had a difficult time of this. For a few days I could tell something was bothering him, he was "different", hard to explain. But anyways, when I asked him how thing with the girlfriend were going he broke down crying and told me. He said "Mom, I can barely handle my own stuff, how can I handle hers too?" I said "You can't!" And told him that he has to tell her. This was effecting every part of his living. Eventually after a couple of weeks he broke up with her. He began not wanting to go to school or wanting to be dropped off at a different door at school to avoid her, even different times where he was almost always late. He just didn't know how to cope. I know this young girl definitely had problems of her own. She came from a family where I learned that the father was in a car accident some time before easy child boy met the difficult child. The father got hit by a drunk driver, permanently injuring his leg, making it almost impossible to work for a very long time. He wouldn't even let her come to PCs place, even with our promise that we would take her back and forth. I can't imagine how paranoid he is about letting her travel on the school bus each day.

Attention is not the word I would use for cutters, but some might. I know someone else who was a victim of CHSA (Childhood Sexual Abuse) who still cuts to this day. She's had to get stitches for her cuts at least once out of the almost hundreds of times she's done it. The scars she will carry around forever, inside and out, unfortunately.

I dunno, therapy through talking if you can find the right therapist might work. ~SHRUGS~ I've thought about suicide myself more than once, but after talking to someone, more than a whole bunch of sessions, I was okay. Life is so tough for our kids and there's so many new things coming up that whether we're parents/educators/MH Workers, we struggle to educate ourselves in time to help those who need it the most. And in the end, sometimes I think, we end up needing more help than those we tried to help. Confusing I know!

BonnieJean

 

[DDD]

I believe there is info on cutting in the Archives that might be helpful for you. Good luck. DDD

 

[DammitJanet]

I am a cutter. Cutting is associated with borderline personality disorder quite frequently. There is a lot of information on the internet about ways to combat this but she has to want to stop. You can replace the cutting with things such as drawing on the body with ice, food coloring, colored glue that you allow to harden and peel off. I have had some luck with the above. Therapy has been most helpful.

 

[Sara PA]

Cutting alone, especially the superficial type you are decribing, isn't severe enough for hospitalization in most cases. Many of us whose children attempted suicide saw them released from the psychiatric facilities in less than a week, usually with nothing more than some sort of medication change or addition. My son spent almost as much time in the ICU as he did in the psychiatric ward. (And he was cutting at the time.) Any treatment they have for cutting can be done outpatient unless her cutting is severe enough to be a threat to her life.

 

[dreamer]

I have been a cutter, (have not cut in maybe 10 years) my oldest child is a cutter.
for me therapy was no help- it seemed tomake me cut more. Kinda like it kept it up front and in my face.

While others might think I cut for attention, nope, thats not the case for me. I cut becuz it ? equalized pain? emotional pain that was unbearable made into physical pain that could then heal?
Other times there was this...; sensation, a buzzy uncomfortable feeling...that could be let out by cutting.
Other times, I think, it might have been kind of- hurt myself before someone else hurts me, if I hurt myself, then the hurt someone else inflicts might not hurt quite as much? Or.sometimes- I donot deserve whatever good is going on, I am "bad" so Ineed to punish myself?

So- I am not sure just what to tell you----but I did want to share my feelings for why I cut.

 

[dreamer]

PS I cut far more and much deeper when I was on zoloft.
Infection is hopefullly not going to be any big issue- most people have a strong enough immune system that the superficial cutting does not usually result in infection.....Sending well wishes that that is the case here.....

 

[Masta]

Dang I posted a post but lost it…

Dammit Janet: thanks for bring up Borderline (BPD). I personally believe she shows allot of symptoms of Borderline (BPD). I will bring that up at our next child and family team meeting next Thursday.

All of difficult children therapists, social workers, Residential Treatment Center (RTC) placement says she shows no signs so they won’t diagnose her with Borderline (BPD). Show has many of the symptoms.

Sara PA: I had a funny feeling they wouldn’t hospitalize difficult child over cutting unless it was life threatening.

Dreamer: thank you for sharing and being so open about your experiences. That has opened my eyes.. this is all new to me… I’m glad you tried to explain how it felt and why you did it.

I don’t know what my daughter has suffered to trigger dealing with her pain like this.

DDD: How can I search the archives and by pass the posts that aren’t related to this topic, what would be the best words to use to search for this topic?

 

[BusynMember]

Masta, if you have a mental illness, you are attention seeking because you are crying for help. However, in talking to both my daughter and my best friend, both who cut and stopped, they said the identical things: "I did it to FEEL something or to divert the pain." This is associated with mood disorders and drug abuse (I don't know if your daughter abuses drugs or not) and becomes a habit that is hard to stop. There are other ways to get attention. in my opinion it's best to make one last attempt to get her help. Just because one professional took the bipolar diagnosis. away doesn't mean she doesn't have it. It's that one professional's opinion. Borderline is being treated with mood stabilizers these days and the connection to bipolar is being noticed by many psychiatrists, some who believe it's actually bipolar, with the mood swings and erratic behavior and neediness. If you are mentally ill, you are needy. I don't buy that cutters are spoiled and want attention--heck of a way to get attention. I think your daughter likely has a serious mental illness, and not just because of the cutting. Her symptoms indicate somebody way out of control. You can't discount the hereditary factor of her father. However, since she is eighteen, I'm not sure there is much you can do. I do hope she decides to comply with treatment. Good luck to both of you.

 

[Sara PA]

"I personally think difficult child has a mood disorder, as well as a personality disorder ... difficult child cycles slowly like every other month. The Child and family team watch her go in waves and hold mini interventions when we see that things are getting out of hand."

She's cycling six times a year and they haven't diagnosed bipolar? Rapid cycling, according to the DSM-IV, is at least four cycles into mania or depression a year. She's a rapid cycler and they put her on an antidepressant?

Has she taken antidepressants before?

 

[Masta]

difficult child has been on different anti depressants over the years. she has also been on mood stabilizers. nothing has helped.

2 yrs ago when she was released from the Residential Treatment Center (RTC) i seen a change in her, she was on abilify for a month. the doctor didnt up her dose after she reached 7.5mg,she got use to the strength after a month. during that time when she was on abilify age 16yr she was relaxed and sedated so to speak and it was like i finally got my child back.

doctors think she doesnt cycle, they say she just needs attention more then others. they think she doesnt have a mental health problem other then depression.

its getting harder to get her to take medications.. she hears from others in her self contained classroom that certain medications make you tired etc so she refuses to take them. now since she is still in states care difficult child's dcfs worker can make the courts order her to take her medications. but once she hits 21yr who knows how i will get through to her once all the extra support we have now is gone.

everything difficult child has done up until now with her behaviours etc tells me she has more than just depression.

 

[OTE]

Masta... how wonderful to hear from you... I often wonder how you're all doing. Seems like months ago and it's 2 years? I'm so impressed that you've managed to keep her in placements all this time. Is the citizenship issue resolved? So can she now apply for SSI which will give her better options for services when she is out of state custody (obviously because of charges which must have been very serious)?

I remember your story so vividly and it was so complex then. I'm sure her situation is even much more complex now, 2 years later. So I wouldn't even think about a diagnosis or medication recommendation from the little you've said.

But I agree with the above in terms of studies of cutters. NOT an attention seeking behavior. Sad that the foster mother doesn't know better. Most common to Borderline (BPD) and to girls vs boys. Done to focus the emotional pain on something tangible, something physical. Also, releases endorphins so they feel better after they cut. While depression can be co-morbid with Borderline (BPD), the idea of suicide is related to the depression, not to the cutting. What I mean is that cutting like you describe is not a pre-curser to auicide. But that doesn't mean that it won't be a result of the depression. Obviously teen suicides are sadly at high rates now.

So the cutting is a sign that the therapy and the therapeutic aspect of the group home are not working. If it were she would find another outlet for her emotional pain rather than cutting. I agree to bring it up in the next mtg, but I'd bring it up as the therapy needs to be improved in some way. Maybe she needs some sort of 24/7 person to call when she feels like cutting. So the pain is disolved in talking. I hear you that suggests that it's attention seeking and Borderline (BPD) kids are always looking for attention. But if the cutting is to be reduced...isn't there some kind of teen hotline she could call? There certainly are 800 suicide hotlines. But no teen therapy line? Maybe put her in group therapy so she meets other kids with similar issues who she could call? I also understand the Borderline (BPD) female need for male attention, she's looking for a guy to pay attention to her 24/7 no matter what he's doing. And very, very few are interested in that type of co-dependent relationship. So she's constantly disappointed with and by boys. Only thing I've seen work for that is to find her a platonic male friend with similar needs.

Other thing that is known to work for Borderline (BPD) in terms of therapy is DBT. Clearly she should be in DBT skills group therapy at least once a week for 2 hours at her age. If she's not I'd definitely demand that. DBT really is the only therapy documented to help Borderline (BPD) to my knowledge.

 

[Masta]

OTE: difficult child has to apply for citizenship on her own now that she is 18yr. I cannot force her to do that.
As for SSI, I have asked the CFTM (child and family team meeting which consists of her dcfs worker, therapist & the person who administered the neuro pysch evaluation), based on all of her neuro reports would she qualify because she has impaired brain functioning & judgment plus severe Central Auditory Processing Disorder (CAPD). they said based on her testing scores being higher then what SSI accepts difficult child would not qualify.

I had her in Residential Treatment Center (RTC) in 2004 for 6mths.. brought her home for 9mths then eventually said I couldn’t do it anymore, I voluntarily signed her over to DCFS both for her own good and for the rest of my families sanity. I still have parental rights…. DCFS is her guardian. When she gets out of hand she now answers to the courts. difficult child hasn’t had any charges against her other then running away from states care back in 2005, she went to DT for 2 weeks for that.

difficult child doesn’t use drugs as far as I know.

I don’t know how to discuss this problem with difficult child. When husband asked her about it last night when he seen the cuts she grinned at him (she always grins when she is busted). How do you talk to a difficult child who has impaired brain functioning & judgment plus severe Central Auditory Processing Disorder (CAPD)?

What gets me is that apparently dcfs, difficult child therapist and others knew about difficult child cutting but is it not documented anywhere. This week I will find out why.

 

[Marguerite]

My two middle kids have been cutters. None of it was attention-seeking, none of it was due to drugs. I think for them it also connects to Sensory Integration Disorder (SID) issues related to the Asperger's, plus associated depression. easy child 2/difficult child 2 was the worst. She would cut, so she tells us now, because she had to know she could feel SOMETHING. She seemed to need to transfer intense emotional pain into physical pain, to reduce the effect. Since getting a boyfriend, she has not cut. She has now stopped wearing long sleeves in summer, no longer tries to hide the scars. She would use a knife and sometimes cut deep, but it was all in secret. I think she was doing it for a number of years but we could never get her to admit to it or talk about it, until first boyfriend came along.

difficult child 1 - he would cut when extremely depressed or upset, such as when he broke up with first girlfriend at 15. He didn't cut as deep, but he would carve initials or images into his hands and arms. He had dome similar things before girlfriend, but to a much lesser extent.

I think one of easy child 2/difficult child 2's cuts got infected - she has one particularly bad scar - but in general, cutting leaves an open wound. It's when a wound seals back over that you can really have big problems. An open wound needs to be dressed and I've found cutters will tend to their wounds, if only so the blood doesn't give them away. They'll make up excuses - "I scratched myself," "I was using my letter opener and it slipped," "I was chopping wood in the back yard and dropped the axe." My kids know how to dress wounds and how to prevent infection. If a cut gets infected, it increases the chances of being found out, so they are generally careful.

I was really concerned at some of easy child 2/difficult child 2's deep cuts on her forearms - along the forearm, too, very dangerous, but she was insistent that it wasn't a suicide attempt. But she said she did need to see blood, because then she knew that there would have to be pain, so she knew that her body should be feeling something. The sight of blood seemed to ease the emotional pain.

I think they also stopped as they got older and better able to deal with their emotions. easy child 2/difficult child 2 really hated school (not helped by a lousy school, but she was too scared of change to let me move her). She cut through most of her high school years. boyfriend # 1 coincided with the end of high school, also, so she cut until end of high school. I don't think that's coincidence. School was THAT bad, even though she was a well-behaved, high-achieving student.

Janet, I really appreciate your insight, as well as the alternative activities that can substitute. I'll share those with easy child 2/difficult child 2 & difficult child 1.

Marg