He sat at the desk in his darkened, upstairs bedroom fooling around with a pocket knife the first time he cut himself on purpose. He made a small slit on his forearm. Then another and another. Before long, he had doodled an hourglass shape into his flesh. Drops of blood trickled across his skin like the tears he could not shed.

A feeling of relief washed over the troubled eighth-grade loner. It made him momentarily forget that cruel classmates called him fat and spread false rumors that he was gay.

The cuts filled the hollowness inside. It was a rush but not a high. He was no longer numb. He felt alive.

His mother's voice shook him from his trip to normalcy. She needed him to take out the garbage. He didn't bother to hide his fresh wounds. She saw them and scolded him. She told him it was satanic and to never do it again.

Bruce Howell, now 19, can't explain why he drew a blade across his arm that first time. But it gave him a feeling he came to desire.

"It's like someone going out and having a cigarette," he said.

Self-injury, particularly cutting, is a secret plague among young people across the country as a way to cope with inner turmoil. Some burn themselves. Some hit. Most cut. They say it eases their emotional pain, clears their minds or calms them down.

Some use cutting as self-punishment. Others do it to assert control when everything seems to be spiraling out of control.

Utah teenagers like Howell are no different. Chances are high school students can point out a peer who cuts as easily as he or she could score a bag of marijuana.

"It does happen. It is a growing concern," said Pam Jacobson, a Clearfield High School counselor and president of the Utah School Counselor Association. "I can't tell you the prevalence."

Many cutters sort of stumble into the behavior, said John Waterbury, a Bountiful licensed professional counselor. They might start with scratching and pinching away what they feel inside. It then escalates to cutting on the wrists or arms and then to the thighs or stomach.

Cutters go to great lengths to conceal their wounds, which usually are superficial and not life-threatening. They'll often say a cat scratched them. They also will wear long sleeves and pants, even in warm weather. They will avoid swimming pools and beaches.

"A lot of them feel really ashamed," said Karen Platis, a child psychologist with Valley Mental Health. "They know something about it isn't right."

Whether cutting is happening more or whether people are becoming more aware is hard to say. Mental health professionals say a little of both.

Research suggests an estimated 2 percent of people, or about 3 million nationwide, purposefully hurt themselves, said Cheryl Cozzens, a licensed clinical social worker at Utah Valley Regional Medical Center. The behavior often starts in the teenage years but may persist much longer.