Finding pleasure in the pain

"Nobody can make you feel inferior without your permission."

The words, written in black and red marker and punctuated with a heart-shaped exclamation point, hang above Laura Turpin's bed.

There are other hand-written signs taped to the wall, Bible verses and inspirational sayings, a cut-out of a colorful butterfly and a page ripped from a Hello Kitty coloring book.

There's a Cabbage Patch doll on the dresser and three stuffed Care Bears propped up in a chair.

There's no doubt it's a girl's room. Any happy young girl's room.

The room's decor, like so much about the 17-year-old girl who lives there, is a contradiction.

For the past two years, Laura has used the privacy of her room to hurt herself.

There are various labels for her behavior: cutting, self-injury, parasuicide, self-mutilation.

Whatever the term used, health professionals say such behavior among teenagers, especially girls, is on the rise.

Laura began cutting her arms with a yellow box cutter nearly three years ago after a breakup with a boyfriend and pressures at school sent her into emotional overload.

"People think it's for attention or that you're trying to kill yourself," said Laura. "It's to get the pain out, it's the only way I know how. It's like letting my skin cry for me."

Dr. Brad Robison has heard that description often in his 10 years of working with adolescents.

"I think of it as an emotional intensity disorder," said Robison, a Cape Girardeau psychiatrist. "They usually describe a feeling of complete emptiness or lonliness. They'd rather have the physical pain than feel nothing."

There's also research that suggests self-injury is a technique for triggering the body's biochemical responses to pain, thus releasing endorphins -- the body's natural painkiller.

While cutting skin with razors or knives is the most common form, the definition of self-mutilation includes biting, hitting or bruising oneself; picking or pulling at skin or hair; burning oneself with lighted cigarettes, or amputating parts of the body.

Though there's no hard statistics on how many teenagers in the United States face the problem, some sources estimate about 0.75 percent of the general population deal with it. A recent report on youths in Britain found that 3.1 percent of the 1,338 girls and 1.9 percent of the 1,344 boys ages 13 to 15 surveyed had tried to harm or kill themselves.

Robison said self-mutilation is not a new problem. What is new is the formation of a subculture around the behavior. Attraction to that sort of culture is what prompts many teens to initially cut themselves, he said.

Laura says her friends pushed her to try it. Once she started, she found it hard to stop. When family members noticed the cuts on her arms, she began cutting her inner thighs and other parts of her body that weren't as visible. She wears pants year-round now because of the scars.

She says she's tried to quit. In fact, she's gone up to 198 days without cutting herself. And then there's a relapse. She's now gone more than 20 days without an episode.

She sees a counselor once a week and makes bracelets from colored rubber bands whenever she feels like cutting herself.

But she still keeps a box of knives, a bag of safety pins, a packet of needles and other cutting paraphernalia beneath her bed.

"It's my safety net," she explained.

Laura also writes poetry and paints to help express herself. Talking about her problem also helps.

"There are so many girls out there who struggle with it, and guys too," she said. "If I can quit, they can too."

cmiller@semissourian.com

335-6611, extension 128