Do not shout at them, punish them or ignore the problem: how to respond when a teenager self-harms

“Do you know what she did? She took all the cutlery, glasses and scissors out of the house… She treats me like some kind of nutcase!” That is what a 15-year-old boy told me in my consulting room after his mother found bloody cuts on his arms and brought him to see me.

The first thing a parent usually feels when they see that their child has been harming themselves is fear. “What should I do? Why is my child doing this to himself? Does he want to die? What have I done wrong?” That fear often gives way to anger and helplessness, expressed through shouting, trying to control the child, removing everything that might be dangerous, forcing the child to talk and explain, and demanding a promise that it will not happen again.

This article explains why those reactions usually do not work and what you can do instead.

If you need help now

A wound that needs dressing is a medical matter, not a disciplinary issue. If there is a deep cut, bleeding that will not stop, or a wound to the neck, wrist or groin, go to a hospital emergency department or call 112. Leave the conversation about what happened until later.

• 112: when there is an immediate risk to the child's life or health.
• 116 111: a helpline for children and young people under 18, run by the Empowering Children Foundation. It is available 24 hours a day, free and anonymous. You can give this number to your child.
• 800 12 12 12: the Children's Helpline run by Poland's Ombudsman for Children, for children and teenagers. It is available 24 hours a day and free to call.
• 800 100 100: a helpline for parents and teachers concerned about a child's safety, run by the Empowering Children Foundation. It is free and anonymous. This one is for you.
• 800 70 2222: the Crisis Support Centre for adults experiencing a mental health crisis. It is available 24 hours a day and free to call.

If something sudden has happened in your family and you need prompt support, crisis intervention may be the appropriate form of help.

Why a parent's first reaction usually does not work

And every one of those reactions is natural.

But they often have the opposite effect on the child. Why? Driven by fear, we try at all costs to stop a teenager's self-destructive behaviour, and sometimes forget that we also need to understand what lies behind it. Not every instance of self-harm indicates suicidal thoughts or is an attempt to attract attention. Most often, the teenager does not know how else to regulate intense emotions or express them in words. They may be unable to say “I feel so awful that I don't know what to do with myself.” So they look for something that will reduce the tension, even for a moment.

When a parent discovers signs of self-harm, they will often start regularly checking their child's room and personal belongings, remove sharp objects and inspect their arms and legs. Whenever the child goes to the bathroom or their room, the parent asks whether they are “going to do it again”.

These actions come from fear and a wish to protect the child. From the teenager's perspective, however, the message may be:

“Mum doesn't trust me any more”

“I'm the problem”

“I can't tell my parents when I'm struggling, because they'll control me even more”

“I've let my parents down”

This creates a paradox: the parent tries to make the child safer, but the child hides their problems even more carefully and finds new ways to release difficult emotions. Of course, self-harm puts a child's health at risk and must not be dismissed. The issue is how we explain those safety measures to the teenager and whether, at the same time, we help them feel accepted and supported.

What a teenager hears when we try to comfort them

Fear can also show up as anger, and the child may hear things such as: “You have everything you need! Other people have much bigger problems! Breaking up with your boyfriend at fourteen isn't a tragedy. You won't even remember him in a year.”

Here, the parent is trying to “talk some sense into their child” by showing them that their life has value. From the parent's perspective, this is true. But the teenager may hear something else:

“I have no right to feel this way”

“Something is wrong with me”

“Nobody takes me seriously”

We need to remember that even if we find it hard to understand why a situation is so difficult for our child, we still need to take their distress seriously.

I have spent several years working with teenagers facing complex problems: self-harm and other self-destructive behaviours, truancy, depression and suicidal thoughts. Below are examples of the automatic interpretations that most often arise in young people's minds:

“Stop doing that”: “You can't cope”

“Why are you doing this to us?”: “Everything is my fault. I ruin everything”

“But you have a home, food, friends and us!”: “I have no right to feel unhappy”

“Promise me you won't do it again!”: “If they catch me again, the consequences will be even worse”

“You have to tell me everything”: “It is better not to tell them what is happening”

Shame, guilt and a sense of rejection follow. And with them, the distance between parent and teenager often grows.

Do not force them to talk. Stay close

Putting sharp objects away will not solve the problem, nor will constant monitoring and searching. The teenager may feel that they are being treated as someone unpredictable and dangerous, which can heighten their anxiety and difficult emotions.

Do not bombard your child with anxious questions: “Tell me what you're doing, why, what happened, when it started, how many times and where else.” At that moment, they may not be ready to talk or may be afraid of the conversation. Pressure can therefore have the opposite effect.

Instead of “Tell me what's going on”, you could try:

“I can see that you're going through something very difficult. You don't have to explain everything to me right now. I just want you to know that I'm here, and I'll listen whenever you want or need to talk.”

At first glance, that may not seem like much. In fact, it sends an important message: you do not have to deal with this alone.

What if they are doing it “for attention”?

This is one of the most harmful myths about self-harm.

Even if a teenager's behaviour is also a way of communicating, that does not mean that they are pretending to suffer. Someone who cannot say “I need help” may try to show it through their behaviour. Instead of asking “Why are you doing this?”, it is worth asking: “What is happening for you just before you feel the need to hurt yourself?”

That is a completely different kind of conversation: it starts with emotions, not blame. We are not focusing only on the behaviour, but trying to understand what purpose it serves.

Self-harm can be a way to briefly reduce tension, anxiety or feelings of emptiness, or to cope with anger or rejection. The teenager has not found another way to regulate those emotions. Simply demanding that they stop is therefore not enough.

How can I encourage my teenager to see a psychologist?

I hear this question very often on the phone. Here too, it is easy to fall into a struggle for control:

“You're going to see a psychologist. End of discussion”

“You need help and you have no choice”

“I'm your parent, so I decide”

Sometimes an adult does need to make a decision for a child, especially when their safety is at risk. But we can still give the teenager some say in what happens:

“I'm worried about you and I don't want you to have to deal with this alone. Let's try to find someone you would feel safe talking to, someone who can help you understand what is happening and find another way to cope with it.”

It also helps to know that you do not have to persuade them straight away. In a child and adolescent psychology consultation, the first appointment is held without the child. Only the parents attend. You can come and talk through the situation before your teenager decides whether to attend.

If they still refuse outright, parent counselling is still available. Changing the way you respond at home can make a real difference to your child's situation, even if your child is not yet attending appointments.

What helps? What the research says

Research into dialectical behaviour therapy for adolescents (DBT-A) suggests a small to moderate effect in reducing self-harm compared with control groups. The findings are promising, but they do not mean that one method is right for everyone. The appropriate form of help depends on the person's circumstances and an assessment by a professional.

The scale of the problem

Figures on self-harm can be misleading, and it is worth knowing why. Study results vary widely depending on how the question was asked: a one-off question in a school survey produces a different result from a detailed clinical assessment tool, and “at any point in your life” is not the same as “in the past year”. In a Polish study of 2,220 upper secondary school students, 4.8% reported non-suicidal self-injury: 6.3% of boys and 3.2% of girls (Kądziela-Olech et al., Psychiatria Polska, 2015). In international studies using broader definitions, reported rates are several times higher. If you see a few per cent in one source online and more than ten per cent in another, that does not mean that one set of figures was made up. It means that the studies measured different things.

To put the wider mental health crisis among young people in context: in 2025, the National Police Headquarters recorded 1,925 suicide attempts involving people under 18, 161 of which ended in death. In 2024, the corresponding figures were 2,054 and 127.

One thing is certain: if this concerns your child, the statistics do not matter. What matters is what you do over the coming weeks.

The most important thing you can do

A parent does not need to be their child's therapist, have the perfect words or know how to ease their pain. They do not need to know how to solve the problem. They should, however, try to do something important:

Make sure your child does not feel alone with their difficulties.

You can set boundaries and offer support at the same time. You can keep your child safe without subjecting them to humiliating, excessive monitoring. You can reject self-harm without rejecting the person who self-harms:

“I don't want you to hurt yourself. But I won't love you any less because of this. Let's try to understand together what makes you feel that urge.”

If you are unsure whether what you are seeing in your child warrants an appointment with a specialist, you may find When to Take Your Child to a Psychologist: 5 Signs to Watch helpful. And if you simply want to discuss the situation with someone outside the family, a child and adolescent psychology consultation begins with a conversation with the parents: without the child, without a diagnosis and without any commitment to further appointments.

This article provides psychoeducation, not a diagnosis. Reading it cannot establish why a particular teenager is self-harming or determine what treatment they need.

Sources

• Kothgassner, O.D., Goreis, A., Robinson, K., Huscsava, M.M., Schmahl, C. and Plener, P.L. (2021). Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis. Psychological Medicine, 51(7), 1057–1067. https://doi.org/10.1017/S0033291721001355
• Kądziela-Olech, H., Żak, G., Kalinowska, B., Wągrocka, A., Perestret, G. and Bielawski, M. (2015). The prevalence of Nonsuicidal Self-Injury (NSSI) among high school students in relation to age and sex. Psychiatria Polska, 49(4), 765–778. https://doi.org/10.12740/psychiatriapolska.pl/online-first/3
• National Police Headquarters (2026). Statistics on suicide attempts among children and young people in 2025.