I’ll be honest, I have worked with youth for 15 years and one of the most disturbing behaviors I see (and I see a LOT of disturbing behaviors) is cutting.  As behavior analysts we look for the function.  Cutting can serve escape, attention or sensory functions based on the individual.

WebMD, a place many parents turn to for medical information introduces cutting “It’s a practice that is foreign, frightening, to parents. It is not a suicide attempt, though it may look and seem that way. Cutting is a form of self-injury — the person is literally making small cuts on his or her body, usually the arms and legs. It’s difficult for many people to understand. But for kids, cutting helps them control their emotional pain, psychologists say.”

I’ve heard young girls explain cutting as “A way to feel alive.” As we know reinforcement increases the future frequency of a behavior, so it only makes sense if youth who cut themselves feel freedom from their problems, receive the attention they desire or receive automatic reinforcement from the pleasure/pain associated with cutting the cutting will increase in the future.  The Journal Of Emergency Nursing, in an extremely interesting and informative article, The Self Cutting Behavior of Adolescents suggests “Many adolescents claim that they discovered this coping skill by accident, but once they found that it worked for them, they continued using it.8 Self-cutting is extremely addictive, so the majority of self-cutters continue the behavior throughout adolescence and even into adulthood, depending on how much time passes until psychiatric intervention.

Behavior analysts have the task (and ethical responsibility) of developing replacement behaviors for our clients. Let’s begin a discussion of interventions to try to help break this vicious cycle.  I’ve heard of some success with using taking baths and yoga as replacement behaviors for sensory and escape.  What interventions have you implemented?

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