Understanding Self-Harm: Essential Insights for Concerned Parents of Teenagers
- Irena-Marie Makowska
- Jul 10
- 6 min read
This week, three different parents reached out to me — shocked, afraid, not sure what to do. Each said some version of the same thing: "I found out my daughter is cutting herself."
If you're reading this because you've just found out, or you've suspected it for a while, here's the first thing you need to know: you are not a bad parent. Your child is not broken. And this is more common than you think.
Let's talk about what's actually going on - in her mind, in her body - and what you can do about it, starting today.
(I write about transgender and non-binary in a separate follow-on blog)
First, let's clear something up
Self-harm is not attention-seeking. It's not manipulation. It's not "for likes" or copying a friend, even if it can spread socially among peer groups.
At its core, self-harm is a coping mechanism. It's what happens when a young person is carrying more emotional intensity than she has the tools to manage - and she's found something that, in the moment, works.
That's the uncomfortable truth. It works. Not in a healthy way, not in a sustainable way - but it interrupts something unbearable. And until she has a better tool that does the same job, it's unlikely to just stop because you ask her to.
Teenagers may hurt themselves for several reasons:
To express feelings they cannot put into words. Many teens struggle to communicate intense emotions like sadness, anger, or loneliness.
To regain a sense of control. When life feels chaotic or out of control, self-harm can provide a temporary feeling of control over their body.
To relieve emotional numbness. Some teens feel emotionally numb or disconnected and use physical pain to feel something real.
To punish themselves. Feelings of guilt or low self-worth can lead to self-punishment through injury.
To influence others. In some cases, self-harm is a way to signal distress and seek help when words fail.
Understanding these reasons helps parents approach the situation with empathy rather than judgment.
Recognising the Signs of Self-Harm
Self-harm is often hidden, so parents need to be aware of subtle signs. These include:
Unexplained cuts, burns, or bruises, often on the arms, legs, or stomach.
Wearing long sleeves or pants even in hot weather to cover injuries.
Frequent reports of accidents or clumsiness.
Withdrawal from family and friends.
Changes in mood, such as increased irritability, sadness, or anxiety.
Possession of sharp objects like razors or knives without clear reason.
If you notice these signs, it’s important to approach your daughter gently and without accusation - and especially without judgement.
What's actually happening in her body
This is the part parents almost never get told, and it changes everything about how you respond.
When a teenager is flooded with emotion - shame, panic, numbness, self-hatred, overwhelm - her nervous system tips into a state of dysregulation. Her amygdala (the brain's alarm system) is firing, her prefrontal cortex (the reasoning, rational part) goes quiet, and she is, quite literally, not thinking clearly. She's not choosing this… She's reacting.
Physical pain triggers a rapid, measurable physiological response - the body responds to injury by releasing natural chemicals that dull pain and create a sense of calm or relief. For a small window of time, it works like an escape valve, dropping her out of unbearable emotional intensity and into something more manageable.
For some girls, it's the opposite problem: not too much feeling, but too little. When someone feels emotionally numb, disconnected, or "unreal," seeking sensation is a way of reminding the body she's still here.
Either way - the pattern is the same. It is her nervous system trying to regulate itself, using the only tool it currently has.
This is why shouting, punishing, or confiscating things rarely helps. You can't reason someone out of a nervous-system response. But you can help her build a different one.
So why is it "girls," specifically?
Girls are more likely to internalise distress - to turn big feelings inward, onto themselves, rather than outward - while boys are more likely to externalise it through anger, risk-taking, or acting out. This isn't just "how girls are wired." A lot of it is learned: from a young age, girls are often encouraged to be accommodating, emotionally attuned, and mindful of others' feelings, while boys are more often given permission to express frustration outwardly. That socialisation shapes where the distress goes - inward, at self, rather than outward, at the world.
What to do right now, as a parent / guardian
1. Lead with curiosity, not fear. Your fear is valid - but if you show panic, she'll shut down or hide it better next time. Try: "I noticed this, and I love you, and I want to understand what's going on for you..."
2. Don't ask "why" — ask "what." "Why would you do this to yourself?" invites shame and shuts the conversation down. Try: "What's usually happening right before you feel the need to cut yourself”? What are you feeling in that moment?" This helps her (and you) start noticing patterns and triggers.
3. Resist the urge to fix it in one conversation. This isn't solved with one heart-to-heart. It's solved with an ongoing relationship where she knows she can come to you without an explosion of fear or anger.
4. Get her professional support - sooner rather than later. This is a skills gap, and skills can be taught. A therapist trained in emotional regulation (this is exactly the work I do) can help her build a genuinely different relationship with her emotions - not just stop the behaviour but understand and manage what's underneath it. From experience its pressure at school, grades, friends being mean, not liking how they look, problems at home…
5. Look after your own nervous system too. You cannot pour from an empty cup, and a dysregulated parent can't co-regulate a dysregulated teenager. Get your own support if you need it. You're allowed to.
Here's what I'd like you to know...
With the right support, your child absolutely can learn to regulate their emotions differently. Many don’t really understand their own emotions, so this is a starting point. It’s vital that they don’t feel judged.
I focus on them believing in themselves, that they are “good enough”, that it’s okay to have all these emotions – that it can be safe to be heard and seen.
Neurodivergent teenagers often don’t know how they feel, so its about helping them develop their own tools that work for them. Be creative.
If you're a parent reading this and your stomach has been in knots for some time, I want you to know: help exists, it works, and you don't have to figure this out alone.
If you're worried about your child I offer a free discovery call where we can chat confidentially and discuss the next step.
When to Seek Immediate Help
If your daughter talks about wanting to die, shows signs of suicidal thoughts, or if the self-harm is severe and life-threatening, seek emergency help immediately. Contact a mental health professional, your family doctor, or emergency services.
Resources for Parents and Teens
Many organizations offer support and information for families dealing with self-harm:
National Suicide Prevention Lifeline
Child and adolescent mental health services
Books and guides on teen mental health
Other points, what the research shows:
Transgender and nonbinary youth self-harm at markedly higher rates than their cisgender peers. In one large study, past-year self-injury was highest among transgender boys and men (72%), followed by nonbinary young people assigned female at birth (68%), transgender girls and women (52%), and nonbinary young people assigned male at birth (48%), compared with cisgender girls and women (47%) and cisgender boys and men (28%). The Trevor Project
Nonbinary youth specifically show poorer general mental health compared to both transgender and cisgender youth, with similar rates of self-harm and suicidal behaviour compared to transgender individuals. PubMed Central
Critically, the driver isn't gender identity itself — it's minority stress: discrimination, rejection, invalidation, and lack of safety. One study found that when controlling for experiences of victimization and perceived discrimination, the disparity in adverse mental health outcomes for transgender and nonbinary youth decreased. In other words, it's the world's response to who they are, not the identity itself, that's doing most of the damage. Jahonline
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