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.