Thrills That Kill (page 2 of 3)

A Private Pain

Elsewhere in California, in the southern coastal town of Palos Verdes, 14-year-old Caitlin Scafati retreated after dinner most evenings and spent two hours glued to her computer. Nothing unusual about that, her parents thought. That's what kids do these days; they instant message their friends and "chat" for hours at a time. Only Caitlin had other reasons for going online.

A high school freshman, she had trouble adjusting to her school's social cliques and their emphasis on being thin and fashionable. Overweight much of her life and struggling with depression, she felt like an outcast when she became the target of cruel teasing by some of her classmates. "Are you really going to eat that?" a boy once asked Caitlin when he saw her nibbling on a doughnut. In swim class, a girl took a picture of Caitlin in her swimsuit and posted it in the locker room. "I ripped it up, threw it away and cried most of the night," she says.

In the privacy of her room, Caitlin would log onto the Internet and type in the search words "anorexia" and "cutting." Instantly, dozens of websites appeared that discussed and even promoted the behaviors. Caitlin had turned to both as a way of dealing with her painful emotions and feeling of worthlessness. When she cut her arms and legs, "It made me feel better," Caitlin explains. "I hurt so much inside that this was a way of shifting my pain to the outside."

What Caitlin found online was what she thought she never could in real life -- acceptance and understanding from others, many of whom were participating in the same self-destructive behaviors that she was. Instantly available to her were anonymous website contributors who posted comments like: "The thinner I got, the happier I felt," or "I cannot change certain circumstances in my life, but at least I have the power to control what I do and do not eat." On a cutting website were tips such as, "Cut on a full stomach," and, referring to the direction of the incision, "Always down the road, not across the street."

Unfortunately, experts say, the stories of Joel and Caitlin are not uncommon and represent a growing, destructive trend among kids across the United States and around the world. "These practices are spreading like wildfire because of the Internet," says Dr. Thomas Andrew, a pediatrician who, in his position as New Hampshire's chief medical examiner, has seen several accidental suffocation deaths among teens in the last few years. According to a 2005 Pew Internet research project, 21 million -- or 87 percent of American youth (ranging in age from 12 to 17) -- use the Internet as a source of information; 22 percent of them go online to learn more about hard-to-discuss topics like drug use, sexual health or depression.

Psychologists, pediatricians and youth counselors contend that under the radar, hundreds of websites and chat rooms are fueling an explosion of self-destructive practices considered in vogue by a surprising number of kids. They swap techniques about how to injure themselves -- and, like Joel and Caitlin, keep it all hidden from their parents.

"Clearly, the Internet is a major tool for good," says Ken Mueller, co-director of CPYU.org, an informational website about youth culture. "But as we're seeing now, it can also lead to great harm. Kids become addicted to these sites, and suddenly behaviors that used to be considered taboo are no longer hidden, which makes them seem more acceptable -- even cool."

On the Internet, Caitlin found "pro-ana" (short for pro-anorexia) websites that view anorexia nervosa in a positive light -- a lifestyle choice rather than a psychological disorder. Suffering from the illness, and losing so much weight that she fainted, the last thing Caitlin needed were tips on how to avoid consuming food -- "drink lots and lots of water" or "adopt a dog and feed him your food." Some pro-ana sites provided motivational messages: "Say it now and say it loud: I'm anorexic and I'm proud." Still others bombarded her with color photos of Kate Moss, Calista Flockhart and other thin, beautiful actresses and models to "inspire" her to avoid food.

In May, the first study that examined the impact of eating-disorder websites confirmed their destructive influence. Researchers at Lucile Packard Children's Hospital at Stanford University in Palo Alto, California, found that 40 percent of adolescents who had been hospitalized for eating disorders had spent time on pro-ana websites.

When Caitlin clicked on cutting websites, she found short bios of famous self-injurers, including Princess Diana and singer Fiona Apple, which, she says, "made it seem cool and okay." She even discovered sites that gave her tips on how to hide her wounds. On one discussion board, a cutter suggested, "Depending on wear [sic] the cuts are ... sweatbands will work very well."

"I was amazed to find so many other people with my same problems," Caitlin says. "I felt so isolated, but online I found solidarity from strangers who I felt some connection to."

Though not as common as anorexia -- approximately 7 million females and 1 million males suffer from eating disorders -- cutting is a growing epidemic among teenage girls. Experts who study self-injury estimate that as many as one out of every 200 teen girls hurt themselves, resulting in 2 million reported cases per year. "Because of the awareness created by these websites," says CPYU.org's Mueller, "cutting has gone from being a way to cope to the hip thing to do."

In fact, studies suggest that there are 3 million self-injurers in the United States. Two million of them cut or burn themselves, while the other million hit, brand, scar, or excessively pierce themselves. "People who cut themselves believe they are horribly flawed in some way," says Wendy Lader, PhD, clinical director of S.A.F.E. Alternatives, a referral and treatment program for self-injurers. "It makes them feel strong. They think, I'm not like the rest of you. I'm tough. I can tolerate pain or starvation better than you. But no matter how much they cut or starve themselves, they're not dealing with the real issue -- their out-of-control emotions."

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