"I remember going through my mother's old wooden sewing box and finding safety pins, needles, and other things to hurt myself with. By the time I was 11, I was cutting my arms with razor blades and burning my hand with a light bulb from a bedside lamp. . . . On the outside, I was viewed as a high achiever, very successful in academics and in my career. On the inside, I suffered in silence. Especially during the last few years when I had live burns on my arms at every moment. I lived in a constant state of fear of people finding out. Accordingly, I spent most of my time alone.

These chilling words come from V. J. Turner, a pseudonym for the UCLA- and Harvard-educated clinical psychologist who wrote Secret Scars: Uncovering and Understanding the Addiction of Self-Injury (a Hazelden book to be released in September 2002). Turner began to self-injure herself as a six-year-old, and continued hurting herself until her recovery eight years ago.

While alcoholics and drug addicts might turn to a bottle, a pill, a joint, or a syringe to try to numb or escape their emotional pain, self-injurers may cut, bite, hit, or bruise themselves in an attempt to turn their pain "inside out" or to gain a false sense of control. Gone untreated, this maladaptive coping mechanism can become an addictive behavior, much like bulimia or anorexia. According to Turner, many medical and mental health professionals believe that self-injury is the fastest-growing problem among teenagers.

Addictive self-injury is not about body piercing or tattoos. Those practices are more about trends and self-expression. Nor is self-injury about suicide. Self-injurers are generally trying to release or numb their emotions in order to stay alive and appear normal in a world that often overwhelms them.

One anonymous self-injurer wrote a poem that is posted on a Web site for self-injurers: "The scars, the incisions in my flesh/They look painful, but they calmed me when I was stressed/It helps me to harm, and I won't try to deny/That this is the only way I know how to survive."

Many who self-injure had an extremely difficult or traumatic childhood. Many also struggle with other addictions such as eating disorders, alcohol or other drug dependency. Although young women represent the majority of self-injurers, the disorder also affects men and women from all walks of life, from troubled teenage boys and girls to people as famous as Princess Diana.

Turner says research suggests that self-injury causes a release of chemicals in the brain similar to addictive opiates, making it more difficult for a person to stop the behavior after frequently engaging in it. In addition, she says that self-injury often involves compulsive acts and obsessive thought processes that can lead to a behavioral addiction.

Like millions of others who suffer with addictions, Turner credits her recovery to Twelve Step mutual-help programs and philosophy. When she couldn't find a group specifically for self-injurers, Turner benefited by attending Alcoholics Anonymous, Al-Anon, and Narcotics Anonymous groups that were open and accepting. "Even though my addiction was not alcohol or drugs, something felt very right about this approach," she writes. "Along the way, I met several other people who were also addressing their problems with self-injury in Twelve-Step meetings, either as their primary addiction, or along with alcohol, drug addiction, eating disorders, or codependency."

Turner does not discount the validity of other sound therapeutic approaches, and she says that professional medical treatment must be sought immediately for infected scars or burns or other physical problems resulting from self-injury. But she underscores how the spiritual focus of the Twelve Steps can help self-injurers learn to fill the "chronic emptiness" they have tried to endure and also help them satisfy the deep craving for something more that they have lived with for so long. In addition, Al-Anon and other family support groups might greatly help the families and loved ones of self-injurers.

"Of everything I've accomplished in my life, the one thing I am most proud of and value the most is my recovery from self-injury," says Turner.

For information on the book Secret Scars, check out www.hazelden.org/bookplace or call 1-800-328-9000.