A new report by the U.S. Centers for Disease Control and Prevention reveals that between 2009 and 2015, rates of self-injury among girls aged 10-14 years skyrocketed from 110 per 100,000 Emergency Room (E.R.) visits to 318 per 100,000 visits. The rate for older teen girls doubled to 633 per 100,000 E.R. visits. Rates for boys were relatively stable, the New York Times reported.

The report’s definition of self-injury included self-cutting, self-poisoning (drug overdoses), suicide attempts and other forms of self-harm. Self-cutting and self-poisoning accounted for the majority of incidents.

Dr Mark Olfson of Columbia University commented that, “One important reason to focus on reducing self-harm is that it is [a] key risk factor for suicide.” This runs contrary to studies by leading British self-harm researcher Jan Sutton. Although self-cutting can cause accidental suicide Sutton found that it was more often used as a means of staying alive by releasing toxic feelings of shame and low self-worth. For this reason teaching self-harmers to understand the risks and implications of cutting different areas of their bodies is paramount.


What the E.R. statistics from the Centers for Disease Control and Prevention leave unsaid is the number of unreported self-injury incidents. Sutton found that many self-harmers deliberately managed their self-injuring to avoid a trip to the emergency room. Some, however, admitted to using hospital trips as a means of getting attention they were otherwise not receiving.

As I have written elsewhere, self-injury (more commonly called self-harm in Britain) is part of a family of issues based on shame and low self-esteem that operate on a cyclical basis. This family includes eating disorders, binge drinking and porn addiction. Negative feelings build up to a point where an outlet for them becomes necessary. A brief respite follows—often including a short-lived high—until guilt sets in and the cycle repeats.

Anxiety, panic attacks and other forms of mental illness are also widespread among those afflicted by these shame-based issues. There’s a strong correlation between all these and high sensitivity.

Body shame

What is also noticeable about shame-based issues is that they all relate in some way to the body and to body shame. This body shame has different forms:

  • Shame of the physical body itself
  • Shame of eating and/or elimination
  • Shame of appearance not meeting media standards
  • Shame of the sexual parts of the body
  • Shame of having sexual feelings

Despite calls to de-stigmatise self-harm and other shame-based issues, it remains a challenging subject that is often met by stonewalling from school staff, nurses and even parents. This is because recognising another’s shame implicitly calls on us to recognise our own shame. This is too painful and frightening for many.

And so the toxic cycle continues. New reports emerge. As far as I know, no one has ever reported a drop in self-injury rates in the couple of decades since statistics on them began. There is talk about the desirability of being vulnerable, but the ability to be vulnerable is altogether far more elusive. In the U.S., 10-14 year-old girls are feeling the pain of that elusiveness.

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