>>> GOOD EVENING.
I'M HUGH DOWNS.
>> AND I'M BARBARA WALTERS.

AND THIS IS "20/20 MONDAY."

CAPTIONS MADE POSSIBLE BY
THE U.S. DEPARTMENT OF EDUCATION
AND ABC, INC.

.....................................

>>> AND --
A SHOCKING GLIMPSE AT A DARK
DISORDER YOU'RE PROBABLY DON'T KNOW
ABOUT
MEN, WOMEN, TEENAGERS, HURTING
THEMSELVES ON PURPOSE, BURNING
THEMSELVES, CUTTING THEMSELVES.

>> I'D USE KNIVES OR RAZORS
OR TACKS OR SAFETY PINS.
IT JUST MADE ME FEEL SO MUCH
BETTER WHEN I WAS DONE.

 IT'S CALLED SELF-MUTILATION
BIZARRE INJURIES INFLICTED
IN SECRET.
THEY SAY IT MAKES THEM FEEL
BETTER.

>> IT HELPED DISTRACT ME
FROM THE EMOTIONAL PAIN.

>> Announcer: MORE PEOPLE ARE
DOING IT THAN YOU EVER THOUGHT
POSSIBLE.
HOW CAN THEY BE STOPPED?
TOM JARRIEL WITH A DANGEROUS NEW
FORM OF SELF-LOATHING.
"THE HURT INSIDE."


..................................


>>> NEXT !- PRINCESS DIANA DID
IT TO HERSELF.
SO DO MILLIONS OF OTHER PEOPLE.
THEY DELIBERATELY CUT OR BURN
THEMSELVES, USUALLY IN SECRET.
SO NO ONE WILL KNOW.
WHY DO THEY DO IT?
HOW CAN THEY BE HELPED?
TOM JARRIEL WITH A BIZARRE
AND DANGEROUS PRACTICE.

..................................


20/20 MONDAY CONTINUES.

>> WE'RE ABOUT TO TELL
YOU ABOUT SOMETHING SHOCKING.
IT'S CALLED SELF-MUTILATION.
YOU MAY THINK YOU'VE NEVER HEARD
OF IT, BUT YOU'LL BE STUNNED
TO LEARN HOW MANY PEOPLE ARE
DOING IT IN SECRET.
WE KNOW PRINCESS DIANA WAS ONE
OF THEM.
IN HER NOW FAMOUS TV INTERVIEW,
SHE ADMITTED THAT AT ONE POINT
IN HER MISERY, SHE DELIBERATELY
CUT HERSELF ON THE LEGS.
UNBELIEVABLY, AS MANY
AS 2 MILLION PEOPLE IN THIS
COUNTRY REGULARLY HURT
THEMSELVES ON PURPOSE, CUTTING,
BURNING, JABBING THEIR OWN
BODIES, ANYTHING TO CAUSE PAIN.
WHY WOULD ANYONE DO IT?
TOM JARRIEL FOUND, LIKE ANOREXIA
SELF-MUTILATION IS ROOTED
IN A DEEP AND OVERWHELMING SENSE
OF WORTHLESSNESS.

 Reporter: SHE APPEARS TO BE
THE GIRL NEXT DOOR.
HEINTZ, A 16-YEAR-OLD HIGH
SCHOOL SOPHOMORE FROM KANSAS, IS
PRETTY, SENSITIVE
AND WELL-LIKED.
SHE HAS LOVING PARENTS, VICKI
AND WAYNE HEINTZ, AN OLDER
SISTER, DARA AND YOUNGER
BROTHER, RYAN.
ASIDE FROM THE TYPICAL FAMILY
STRUGGLES, LIFE HAS ALWAYS BEEN
GOOD.

>> Mother: WE'RE JUST AN AVERAGE TYPICAL
FAMILY.
WE'RE ABOUT AS AVERAGE
AS YOU CAN GET.

>> Reporter: IT'S HARD
TO BELIEVE THEN THAT EARLIER
THIS YEAR, TALLI HEINTZ CAME
PERILOUSLY CLOSE TO TAKING
HER OWN LIFE.

>> Talli: I DIDN'T HAVE A HIGH
SELF-ESTEEM AT ALL AND I WAS
REALLY DEPRESSED.
I DIDN'T LIKE THE WAY I LOOKED.
I DIDN'T LIKE ANYTHING.

>> Reporter: HER CRISIS BEGAN
WHEN TALLI ASKED IF SHE COULD
GET
HER BELLY BUTTON PIERCED,
A POPULAR FASHION TREND
WITH GIRLS HER AGE.
HER MOTHER FORBADE IT
SO IN DEFIANCE, TALLI PIERCED IT
HERSELF.

>> Talli: IT JUST MADE ME FEEL SO MUCH
BETTER WHEN I WAS DONE.
PIERCING IT, IT HURTS, BUT IT --
EVERYTHING WAS OKAY THEN.
I HAD CONTROL.

>> Reporter: UNKNOWINGLY, TALLI
HAD DISCOVERED A WAY TO RELEASE
THE OVERWHELMING FEELINGS OF
DEPRESSION AND SELF-HATRED.
SO SHE BEGAN TO PURPOSELY CUT
HERSELF.
AT FIRST ON HER ANKLES AND
STOMACH, SO NO ONE  WOULD
DISCOVER THE WOUNDS.
BUT EVENTUALLY SHE CUT HER
FOREARMS.

>> Talli: I'D USE KNIVES OR RAZORS OR
TACKS OR SAFETY PINS.
AND I'D DO IT IN MY BEDROOM.
I'D GO INTO THE BATHROOM AND DO
IT.
WHEREVER THERE'S A CLOSED DOOR.

>> Reporter: IT SOUNDS
INCREDIBLE THAT THIS DISTURBING
BEHAVIOR COULD MAKE TALLI FEEL
SO MUCH BETTER, AT LEAST UNTIL
THE NEXT TIME WHEN  SHE DID IT
AGAIN AND AGAIN AND AGAIN
SURPRISINGLY SHE'S NOT ALONE
WITH THAT FEELING.
LIKE AN ALCOHOLIC REACHING FOR A
DRINK, THE VIOLENT ACT OF
CUTTING OR BURNING ONESELF-FOR
MANY PEOPLE IS A MEANS TO COPE
WITH OR ESCAPE FROM PROBLEMS
THAT DISRUPT THEIR LIVES.
IT IS ONE OF THE MOST 
SERIOUS AND LEAST UNDERSTOOD OF
ALL HUMAN BEHAVIORS.

>> Woman: THIS WAS A WAY OF EXPRESSING
MY FEELINGS AND MAYBE CALLING
ATTENTION TO MYSELF.

>> Reporter: THIS WOMAN, WHO
PREFERS HER NAME NOT BE USED,
BEGAN HURTING HERSELF AT AGE 13.

>> Woman: IT HELPED TO MAKE
THE FEELINGS THAT I COULDN'T
DEAL WITH INSIDE OF ME BECOME
NUMB.
IT HELPED TO DISTRACT ME FROM
THE EMOTIONAL PAIN.
IT WAS THE ONLY OUTLET THAT I
HAD.

>> Reporter: FOR PEOPLE WHO
SELF-INJURE, THE PHYSICAL PAIN
BECOMES THE RELEASE FOR THEIR
UNDERLYING OFTEN UNKNOWN
EMOTIONAL.

>> Dr.: THE DECISION TO SELF-MUTILATE
IS OFTEN AT THE SPUR OF THE
MOMENT.

>> Reporter: THIS DOCTOR
ROUTINELY LECTURES ABOUT THE
TREATMENT OF SELF-MUTILATION.
WHY DO YOU FEEL IT IS VERY
IMPORTANT TO SHARE
YOUR INFORMATION WITH YOUR PEERS
AND WITH THOSE WHO ATTEND
YOUR LECTURES?

Dr.: WELL, BECAUSE SO MANY
INDIVIDUALS ARE HARMING
THEMSELVES AND ARE NOT KNOWING
WHAT TO DO ABOUT IT.
THEY'RE AFRAID TO TELL PEOPLE.
THEY'RE AFRAID TO COME
FOR TREATMENT
AND ALSO THERE ARE MANY
THERAPISTS WHO IF THEY ENCOUNTER
THESE INDIVIDUALS, MIGHT NOT
REALLY KNOW WHAT TO DO.

>> Shelley: THIS WAS A SURVIVAL TOOL.
THIS WAS SOMETHING THAT ENABLED
ME TO LIVE.

>> Reporter: SHELLEY GOLDBERG,
FROM NEW YORK CITY, HAS SPENT
MOST OF HIS LIFE STRUGGLING
WITH THIS BEHAVIOR.

>> Shelley: I WAS ABOUT 12 OR 13,
AND I STARTED TO PICK
AT MY FACE.
AS THE YEARS PROGRESSED,
I STARTED USING ALL KINDS
OF TWEEZERS AND THINGS TO GET
AT MY FACE.

>> Reporter: IS THE SCAR TISSUE
ON YOUR FACE TODAY TOTALLY
FROM SELF-INJURY?

>> Shelley: YES, YES, IT IS.

>> Reporter: HAVE YOU DISCOVERED
THE EMOTIONAL TRIGGER THAT SET
OFF THIS PROBLEM FOR YOU?

>> Shelley: I DON'T KNOW.
I GUESS IT'S JUST HATRED
OF ONESELF.

>> Reporter: HOW FREQUENTLY
WOULD YOU DO THIS?

>> Talli: IN THE BEGINNING, I ONLY DID
IT LIKE MAYBE ONCE EVERY WEEK,
BUT NEAR THE END OR THE
MIDDLE OF IT, I'D DO IT EVERY
DAY AND USUALLY MORE THAN ONCE A
DAY.
JUST WHENEVER I'D HAVE
AN EMOTION.

>> Reporter: EACH EPISODE BECAME
WORSE THAN THE LAST,
AND OVER TIME, SHE HAD TO MAKE
DEEPER CUTS TO GET THE SAME
RELIEF OF HER EMOTIONAL PAIN.
BY NOW, TALLI BEGAN TO FEAR FOR HER
LIFE.
SHE KNEW SHE HAD TO STOP CUTTING
BUT COULDN'T.
WHAT WAS THE MOMENT THAT
YOU REALIZED THAT YOU REALLY
NEEDED HELP?

>> Talli: I WAS REALLY FRUSTRATED
BECAUSE I WAS IN SPANISH
AND I GOT MY TEST BACK AND I HAD
FAILED IT.
SO I JUST ASKED TO GO USE
THE RESTROOM.
AND WHEN I WENT THERE AND I CUT
MYSELF, I MEAN, IT JUST WOULD NOT
STOP BLEEDING.
I MEAN, IT WAS JUST LIKE
REALITY HIT.
THIS WAS A BIG PROBLEM.

>> Reporter: IN DESPERATION, TALLI
CONFIDED IN A TEACHER WHO
INSISTED THAT TALLI CONFRONT HER
PARENTS AND ASK FOR HELP.

>> Father: I WAS DUMBFOUNDED.
I WAS TOTALLY CONFUSED AND JUST 
COULDN'T UNDERSTAND WHY SOMEONE
WAS GOING TO CUT THEMSELVES.

>> Mother: WHEN I SAW THAT TALLI WAS
CUTTING HERSELF, I WOULD GROUND
HER.
I DIDN'T REALIZE THE REALM
OF DANGER SHE WAS IN.

>> Reporter: TALLI BECAME
AN OUTPATIENT AT A NEARBY
HOSPITAL AND BEGAN INTENSIVE
THERAPY.

>> Talli: IT GOT BETTER FOR A WHILE,
LIKE RIGHT AFTER I GOT OUT
OF THE HOSPITAL, BUT THEN IT
JUST GOT SO MUCH WORSE.
I MEAN, THE HOSPITAL I WENT
TO FIRST, IT DIDN'T HELP ME AT ALL, I THINK.

>> Reporter: VICKI HEINTZ
SEARCHED FOR SOLUTIONS
AND BY CHANCE LEARNED
ABOUT THE ROCK CREEK CENTER,
A PSYCHIATRIC HOSPITAL NEAR
CHICAGO, WHICH HAD A TREATMENT
PROGRAM SPECIFICALLY DESIGNED
TO HELP PEOPLE LIKE HER, WHO
SELF-INJURE.
TITLED S.A.F.E., SELF-ABUSE
FINALLY ENDS, IT'S THE ONLY
IN-PATIENT PROGRAM OF ITS KIND
IN THE ENTIRE COUNTRY.
DR. WENDY FRIEDMAN-LADER IS
A PSYCHOLOGIST AND CLINICAL
DIRECTOR OF THE PROGRAM.
SHE BELIEVES THE BEHAVIOR CAN BE
ADDICTIVE.

>> Friedman-Lader: IF YOU'RE LOOKING
AT ADDICTIONS AS AN ABILITY
TO RUN AWAY FROM FEELING
AND TO NUMB, I THINK IT IS VERY
MUCH LIKE THAT.

>> Reporter: I SPOKE WITH SOME
PATIENTS ABOUT THEIR
SELF-INJURY.
EMILY, WHAT HAPPENS?
WHAT DO YOU DO TO HURT YOURSELF?

>> Emily: I DO A LOT OF DIFFERENT
THINGS.

>> Reporter: TELL ME
SPECIFICALLY HOW YOU GOT THAT
SCAR ON YOUR ARM THERE.

>> Emily: THIS IS FROM AN IRON.

>> Reporter: HOT IRON? WOUNDS ON YOUR ARMS.
TELL ME WHAT YOU DO TO INFLICT
INJURY.

>> Person: THESE SCARS ARE FROM LIKE
HOUSEHOLD CLEANING CHEMICALS
LIKE OVEN CLEANER OR SOMETHING
THAT'S USED TO UNCLOG A DRAIN.

>> Reporter: WHAT'S GOING
THROUGH YOUR MIND AS YOU PREPARE
TO GO THROUGH SELF-INJURY?

>> Person: I FEEL A PRESSURE BUILD UP INSIDE
OF ME AND I SELF-INJURE AND IT'S
KIND OF LIKE A RELEASE
OF THE PRESSURE.

>> Reporter: THESE INJURIES CAN
BE SERIOUS AND LIFE THREATENING,
BUT SUICIDE IS NOT USUALLY
THE INTENTION.
CYNTHIA, HAVE
YOU EVER DONE THIS
WITH THE INTENTION OF KILLING
YOURSELF?

>> Cynthia: THE MAJORITY OF SELF-INJURY
EPISODES THAT I'VE HAD HAVE JUST
BEEN TO BLOCK OUT THE PAIN
IN MY HEAD.

>> Reporter: KAREN CONTERIO IS
THE PROGRAM'S FOUNDER.
TO SIT ACROSS FROM THE PEOPLE, TO HEAR
ABOUT ACID BURNS, TO HEAR
ABOUT CIGARETTE BURNS, TO HEAR
ABOUT ICE PICK STABS, TO HEAR
ABOUT RAZOR SLICES, ARE THESE
PEOPLE KOOKS?
ARE THEY MENTALLY UNSTABLE

>> Conterio: I THINK THEY'RE DESPERATE.
I THINK THEY'RE TERRIBLY
DESPERATE TO FIND A WAY TO COPE
AND MAYBE TO HAVE PEOPLE LISTEN.

>> Reporter: IN THE S.A.F.E.
PROGRAM, PATIENTS ARE TAUGHT
THROUGH INTENSIVE THERAPY
TO EXPRESS THEIR EMOTIONS
IN WAYS OTHER THAN SELF-INJURY

>> Voice from answering machine:
I'M LOOKING FOR SOME
INFORMATION ABOUT CUTTING
BECAUSE I'VE BEEN A CUTTER
FOR MANY, MANY, MANY YEARS 
AND I CAN'T SEEM TO BE ABLE
TO STOP THIS KIND OF BEHAVIOR

>> Reporter: THE S.A.F.E.
PROGRAM ALSO LISTS A TOLL-FREE
INFORMATION NUMBER WHICH ENABLES
THEM TO HELP OTHERS WHO ARE
IN THAT DESPERATE STATE.
THEY RECEIVE CALLS FROM ALL
OVER THE COUNTRY.

TO DATE IT IS NOT UNDERSTOOD
EXACTLY WHY SOME PEOPLE, AND NOT
OTHERS, SUCCUMB TO HURTING.

PSYCHIATRIC INSTITUTE
IN NEW YORK CITY, PSYCHOLOGIST
DR. BARBARA STANLEY
AND PSYCHIATRIST D KEVIN
MALONE, ARE LOOKING FOR ANSWERS.
FOR THE FIRST TIME, THEY'RE
TRYING TO DETERMINE
IF SELF-MUTILATION MAY ACTUALLY
BE A BIOLOGICAL DISORDER
INVOLVING ABNORMAL LEVELS
OF THE BRAIN CHEMICAL SEROTONIN.

>> Dr. Stanley: WHAT WE HAVE FOUND
BIOCHEMICALLY UP TO THIS POINT
IS THAT THERE ARE LOWER LEVELS
OF SEROTONIN IN PEOPLE WHO
SELF-MUTILATE COMPARED TO PEOPLE
WHO DO NOT SELF-MUTILATE.

>> Reporter: AS A RESULT,
THE DOCTORS ARE NOW CONDUCTING
NUMEROUS STUDIES USING
ANTI-DEPRESSANT MEDICATIONS
AND PSYCHOTHERY. COMPLETE RESULTS ARE NOT
EXPECTED FOR AT LEAST A YEAR.

AS FOR HER [Talli], SHE'S BEEN ON
ANTI-DEPRESSANT MEDICATION SINCE
LEAVING THE HOSPITAL AND IS NO
LONGER HURTING HERSELF.
ONE OF THE THINGS SHE LEARNED
AT THE HOSPITAL WAS TO DEAL
WITH HER EMOTIONS BY WRITING
ABOUT THEM IN A JOURNAL.

>> Talli: I DON'T THINK I'LL EVER BE
COMPLETELY RECOVERED.
I THINK I'LL ALWAYS HAVE
THOUGHTS ABOUT SELF-INJURY,
BUT I DON'T HAVE TO ACT ON THEM.
AND I KNOW THAT I CAN CONTROL
THEM.

>> Barbara: STRANGE.
>> Barbara: POOR CHILD.

>> Hugh: YOU MENTIONED PRINCESS DIANA
DID THIS TO HERSELF.
WHY, IN YOUR OPINION?

>> Barbara: IT IS INTERESTING WATCHING
THIS CHILD KEEP IT IN A JOURNAL.
PRINCESS DIANA EXPRESSED HERSELF
IN THE TELEVISION INTERVIEW SHE
DID WITH THE BBC.
SHE SAID THAT EARLIER IN HER
MARRIAGE, SHE HAD SUCH
SELF-LOATHING.
SHE WAS ALSO BULIMIC. PART WAS TO HURT HERSELF.
PART OF IT WAS A CALL FOR
ATTENTION.
WITH MATURITY, WITH SOME THERAPY
SHE GREW AND GOT OVER IT.

>> Hugh: SHE CAME OUT OF IT.
THAT WAS FORTUNATE.