Self-Mutilation Syndrome Also Scars Victims’ Self-Image

MOUNT PLEASANT, Mich. —  Long sleeves couldn’t hide the secret--not from her parents and a college roommate, who began to notice inconsistencies in the stories she made up about her scars.

Now Elizabeth Franas is going public with her problem and even gearing her studies at Central Michigan University to prepare for research that could eventually help her and others.

Franas is a “cutter,” a commonly used term for the estimated hundreds of thousands of people who injure themselves regularly--and deeply enough to draw blood--in times of stress, anxiety and depression. Some have called the practice the anorexia of a new generation, particularly for girls who seem to have a hard time expressing anger and frustration.

“We don’t know how to verbalize our pain, so we write it on our bodies,” says Franas, who is almost 20 and finishing her sophomore year. “I bleed it out instead of talking it out.”

Uses Whatever Objects Are Available

She’s used everything from broken glass and staples to her own fingernails to draw blood on her arm, belly and hip--inexplicably, all on her left side.

Even now, Franas occasionally gives in to the urge to cut herself with razor blades, thought to be the most common way cutters and other self-injurers hurt themselves. For some, the alarming trend also includes biting, burning and even self-strangulation (generally without the intention of suicide).

It is a quiet and often shame-filled obsession.

“You think you’re the only one. You feel like you’re absolutely crazy,” says Franas, who has also been diagnosed with an eating disorder and obsessive-compulsive disorder, both common diagnoses among self-injurers.

A trip to the hospital for stitches--one of three since she’s been at college--revealed her secret to her roommate and a dorm advisor. Their support prompted her to slowly start sharing it with others. And she found she was far from alone.

“Literally every person I talked to knew someone like me,” she says.

More Common Than Many Think

Steven Levenkron, a New York psychotherapist who treats cutters, says that’s not surprising. He used to believe that one of every 250 people was a self-injurer.

“But in interviewing school guidance counselors, they literally laugh at me,” says Levenkron, author of several books on cutting, anorexia and obsessive-compulsive disorder. “They’re saying one out of 50, [or] one out of 100.”

Levenkron says therapy and prescription drugs, including antidepressants, have helped his patients subdue urges to hurt themselves. About 80% of his patients are girls and young women. Although the source of their anger has many sources, he says, as many as 70% have been molested.

Despite successes, he and others note that help for self-injurers can be difficult to find, or at the very least expensive, in a profession that is grappling with its own misconceptions of the disorder.

Levenkron says some therapists are afraid cutters will kill themselves. “But this is not a suicide attempt. They all assume they will live to cut again,” he says, noting that the cuts are generally less than an inch long.

Support groups for cutters have formed at some schools, including Central Michigan and Bryn Mawr College. But they are still the exception, partly because shame keeps some students from coming forward.

“It’s still so underground,” says Franas, who began speaking at public forums on the issue last year.

A psychology major, she’s also taking upper-level courses in neuroscience and is among the youngest students helping with Parkinson’s and Huntington’s disease research at the university’s Brain Research Laboratory. It’s all part of her plan to eventually do research on self-injuring.

She’s also writing a memoir for her senior honors project, which she’ll complete in two years. “I’ve learned that I can get my emotions out with a pen,” says Franas, who has reduced her cutting from one to three times a day to once “every couple months.”

Her parents, who live about two hours south in suburban Detroit, are both pleased with her progress and astounded by her decision to go public.

“I said, ‘It’s going to be like coming out of the closet for a gay person back in the old days,’ ” her father, Ben Franas, says. “But she said, ‘I’m ready to do this, Dad.’ ”

This from the daughter they dragged from therapist to therapist after her mom first saw deep scratches on her shoulder in late 1999, as Franas was getting out of the shower.

“The first time they found out, my dad cried,” says Franas, who was a high school senior at the time.

Then came the question that was tough to answer.

“Why do you do this?” asked her parents, who had never heard of cutting.

She was, after all, a good student and an accomplished gymnast with a dream of competing at the college level.

But her parents had been consumed by the emotional troubles of their older daughter, Tara, and didn’t realize that their younger had developed an eating disorder. Tara eventually worked things out, after an ordeal of her own: She told her parents she’d been raped but was too scared to reveal it to them for more than a year.

Strong Feelings of Isolation Grew

The family turmoil took its toll on the younger Franas, leaving her feeling ignored.

“My sister was running the family,” says Franas, whose eating disorder began to sap her strength and ability to train for six hours a day. “It wasn’t her fault, but there wasn’t much left for me.”

Then Franas’ much-loved gymnastics coach decided to return to Russia.

“That was the beginning of the downfall for Elizabeth,” her dad says.

Unable to hold herself together to train, the self-described “adrenaline junkie” quit the sport--and, with that, lost her stress outlet and her dream.

“I was like an animal in a caged box that’s trying to get out,” she says. “That’s pretty much what it felt like.”

The feeling led her to repeatedly dig her fingernails into her arm. Six months later, she started cutting and ended up spending the rest of her senior year studying at home.

“A lot of friends gave up on me really quickly,” she says, recalling one boyfriend who told her to quit to prove her love.

“As if it was about him,” she says, rolling her eyes.

Looking for a Fresh Start

As rough as it got, Franas stuck with plans to go to college--a move her parents nervously supported.

“At home, my identity was gymnastics,” says Franas, whose bedroom in her parents’ house is still filled with medals and trophies. “Here, I could start again.”

She has since found a therapist she likes and, last year, made the decision to take medication. Through it all, she says, family and a few close friends have stuck with her.

“I’ve tested their support, pushed them away,” she says. “But they say, ‘I’m going to be there for you, like it or not.’ ”

She’s also slowly letting go of the gymnast image.

“I’m a writer. I’m a good student. I’m a good friend,” she says. “I’m slowly learning to take that in.”

And maybe she’ll be a researcher who’s able to help those like her.

“I may not cut every day, but that urge will always be there,” she says. “I know I’m going to be dealing with this for the rest of my life.”

‘We don’t know how to verbalize our pain, so we write it on our bodies. I bleed it out instead of talking it out.”