One common denominator in kids who cut themselves is an inability to express their feelings. They either never learned how to do it or were invalidated when they tried. They have gotten the idea, possibly from an abusive home life though not always, that certain feelings are wrong and not to be articulated. They may have not had a role model for coping with troubling situations in a healthy way.

Cutting also gives the child a great sense of control. Some kids do it as a form of self-punishment, but this isn't always the case. Many cutters use it to express feelings that there are no words for.

Some kids are predisposed toward this kind of behavior and it may take very little to set it off. Serotonin may be involved in making some kids more aggressive and impulsive than others, therefore more likely to self-mutilate. Once a kid tries the behavior and realizes the immense stress relief it provides, it may seem like a good idea for the next time the child is under stress.

Cutting is not done, as frequently believed, to "fit in" or to garner attention. Many teens will go to great lengths to hide the effects of the behavior in an attempt to avoid adding shame to their already fragile mental state.