Girls on the Edge – of a Razor Blade


Why are so many girls cutting themselves?

This workshop begins with a consideration of girl/boy differences in non-suicidal self-injury. Boys who engage in self-injury such as cutting with razor blades usually meet DSM criteria for another diagnosis, such as generalized anxiety disorder or major depressive disorder. But the “golden girl” – the girl who has lots of friends, who is doing exceptionally well in school – is actually somewhat more likely than the average girl to be secretly cutting herself with razor blades on her upper inner thigh where she doesn’t think anyone else will see. It’s not a “cry for help”: she doesn’t want to be discovered. It’s not a “suicide gesture”: she doesn’t want to die.  She may have no other DSM diagnosis; that’s a major reason why many psychiatrists have called for a new diagnostic category, in order to accommodate the growing proportion of girls and young women who are engaging in this behavior (see chapter 3 of Girls on the Edge, especially pp. 93-96, for more discussion of the debate surrounding the new diagnosis of NSSI).

So why is she doing it? If her life is going well, why is she secretly and repeatedly cutting herself with a blade? How is this behavior in girls whose life is not going well? And why has this behavior become so common in just the past decade? Why are North American girls today (both in Canada and in the United States) at least three times more likely to engage in this behavior than boys are? (In addition to my book Girls on the Edge, please see my essay on this topic for Psychology Today, online at

The focus of this workshop for professionals is on evidence-based best practice for evaluation and intervention with young people who are engaging in NSSI, with an emphasis on female/male differences in presentation and with regard to interventional strategies.

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