'Cutters,' as they are often called, are overwhelmingly women, often with histories of incest and sexual abuse.

Touch Srey Mao's eyes are veiled with sorrow. The raised white marks which ladder

her arms represent years of self-mutilation. In a guttural whisper she translates

the braille of scars into an increasingly common tale of drug abuse, prostitution

and self-harm.

The habitual cutting of the wrists and arms is becoming more and more pervasive among

prostituted women in Cambodia says Aarti Kapoor, International Director of local

women's NGO AFESIP.

According to Kapoor, the worrying trend is linked to a recent growth in drug use

identified among young Cambodians. Kapoor said AFESIP has recently seen "whole

batches" of girls with serious substance abuse problems come into their shelters.

The majority of girls were introduced to drugs by those who facilitated or coerced

their entry into prostitution, and an increasing number of them bear the telltale

marks of self-abuse.

Touch Srey Mao, 28, works as a prostitute near Wat Phnom. She said she never wanted

to take drugs, but at seventeen capitulated to her peers and began smoking heroin.

It was at this juncture that she began to cut her forearms. As the effects of the

heroin wore off, Srey Mao would slash her arms with a razor blade in an attempt to

curb her cravings and vent the storm of emotions brewing inside her.

"When I don't have drugs I get very bad withdrawal symptoms like mood swings

and anger," Srey Mao said. "When I am cutting myself I don't know what

I am doing, but it helps me to calm down. It is only when I am calm again that I

realize how painful the cuts are."

The British Royal Society of Psychiatrists (RSP) says that self- harm should be viewed

as a coping mechanism. "Extreme feelings of fear, anger, guilt, shame, helplessness,

self-hatred, depression or despair can build up over time," reads the RSP research,

distributed through the website selfharm.org. "Self harm can be a way of dealing

with them. [It is] something [self harmers] can control when other parts of their

life may seem out of control."

According to the RSP, the conjunction of drug use and feelings of powerlessness can

cause vulnerable individuals to turn to self-mutilation.

"I don't feel like I have any control over my life as I cannot even control

my own mind," said Srey Mao, who has been cutting herself for eleven years.

"The people around me are always smoking yama and whenever I see people smoking

it makes me crave the drug myself. I don't think I will ever be able to stop. When

I smoke I fall into moods and experience emotions which I do not understand. I have

no outlet except to cut myself."

For the RSP, self-harm can be interpreted as a way of writing "help" across

one's body when all other channels of self expression have been closed. Touch Srey

Mao has never spoken to anyone about her emotional state, her drug abuse, or her

self mutilation.

"People don't want to talk to women like me - they just try to ignore us,"

she said.

She has always used cutting herself as a means of dealing with her fear, tension

and anger: Emotional pain is turned into physical pain and so rendered more manageable.

Yet the scars etched on her arm fill her with regret and shame-she tries to keep

them a secret.

The prevalence of self-harm in a society is frequently under reported. According

the RSP research low self-esteem and feelings of guilt and shame cause "cutters"

to shroud themselves and their scars in secrecy. Also, while low self-esteem is a

common cause of self harm, it swiftly becomes an effect: Srey Mao cuts herself because

she feels worthless; she feels worthless because she cuts herself.

Yuk Srey Pao, 18, also works as a prostitute near Wat Phnom and has cut herself in

the past. "I think I am a really dull person," said Srey Pao. "When

I was young I didn't imagine I would be in the situation I am in at the moment, but

now I am trapped. I really want to change my life; however, I don't think I am able

to."

Yuk Srey Pao and Touch Srey Mao both know many young women who cut themselves-Touch

Srey Mao's sister cuts herself particularly deeply. Despite Touch Srey Mao's entreaties,

her sister has refused all medical treatment and has consequently lost much of the

use of her hands.

The depth of emotional turmoil which drives people to self harm means that the damage

done is often incomprehensible not only to the outsider, but to the perpetrator themselves.

"When I was angry I couldn't feel anything but anger-I couldn't feel pain,"

Yuk Srey Pao said. "When I was calm I saw the damage I had done to myself and

I was afraid-afraid of myself."