Author and psychologist Madeline Levine once met with a 15-year-old girl who was “bright, personable, highly pressured by her adoring, but frequently preoccupied . . . parents.” Levine recognized the girl’s “cutter disguise”—a long-sleeve T-shirt pulled halfway over her hand with an opening torn in the cuff for her thumb. When the young girl pulled back her sleeve, Levine was startled to find what the girl had carved into her forearm: “EMPTY” . . . sadness and confusion personified.