Self‑harm in teenagers — why it's not "emotional blackmail" but a cry for help
"She did it for attention," "she wants to blackmail us," "she's making it up" — I unfortunately still hear such remarks too often when a teenager with cut forearms comes to my clinic. Yet when you talk to that young person you usually hear something completely different: "I didn't know what else to do with this pain inside," "I wanted to feel something," "it's the only thing I can control."
Self‑harm among teenagers is not "a trend" or "emotional blackmail." It's a very concrete way of coping with suffering that for a young person can be a cry for help because they lack other tools. Your reaction as a parent can either hear that cry — or drown it out.
What self‑harm in teenagers is — in plain terms
In serious publications we talk about non‑suicidal self‑injury — intentional infliction of physical pain (e.g., cutting, burning, hitting oneself) without the intent to die, used to regulate emotions.
In plain terms: a teenager injures themselves to:
alleviate psychological pain that feels unbearable;
"feel something" instead of emotional numbness;
punish themselves for guilt or shame;
regain a sense of control over anything.
This behavior strongly correlates with depression, anxiety disorders, trauma, experiences of violence, relational problems, low self‑esteem and difficulties regulating emotions. For the young person it is often the "best available way" they know to survive what is happening inside. It is not a good method — but it is real.
How cutting looks in youth — early signs for parents
Self‑harm is rarely immediately obvious. Teenagers usually do everything to hide it. If you notice something, it usually means the problem has existed for some time.
What to watch for:
Scars and fresh wounds in "typical" places
Especially: forearms, wrists, thighs, abdomen. Often linear cuts in various stages of healing. They may be explained as "the cat scratched me," "I fell off my bike."Persistent covering of the body
Long sleeves, hoodies, pants even in heat; reluctance to change clothes in front of others, to go to the pool or PE.Things that "mysteriously disappear"
Razors, blades from sharpeners, glass, sharp objects — suddenly these items are lost more often or moved into the bedroom.Blood on towels, bedding or clothes
Small stains "for no clear reason" that repeat.
If you see together: scars/cuts, covering up, missing sharp objects and emotional withdrawal — it's not an accident. It's a very serious signal that the young person is trying to cope alone in a way that endangers them.
Why self‑harm is not "emotional blackmail"
Sure: there are situations where a teenager shows wounds to parents in a heated moment ("look what I did"), sometimes in the context of conflict. From the outside this can look like "blackmail." But if you pause, you'll see this is still a message: "I'm so miserable I hurt my body", not "I'm doing this to you."
Why serious publications stress that self‑harm should not be reduced to blackmail:
most teenagers hide self‑harm, and disclosure happens only when it cannot be concealed — not typical for manipulation;
self‑injury is strongly associated with real psychological suffering — depression, anxiety, trauma, hopelessness — trivializing it as "blackmail" invalidates that suffering;
reactions like "how could you do this to me" shift the burden to the child, increasing shame and guilt, which can paradoxically intensify self‑harm.
This doesn't mean you can't set boundaries or express your own fear. But start from recognizing: "this is a signal that my child is really suffering, even if they can't say it in words."
My child is cutting — what to do (and what not to do)
What to avoid in the first reaction
Don't shout, shame, or threaten
"How could you do this to me?", "Are you crazy?", "Do you want to end up in a psychiatric ward?" — such phrases close the door. The young person learns it's better to hide their suffering more intensely.Don't minimize
"It's just a few scratches," "others have it worse," "pull yourself together" — these push the child deeper into isolation.Don't promise secrecy
"I won't tell anyone, just stop" — this is an enormous burden on the teen and risks leaving them without professional help.
What you can do instead
First ensure physical safety
If wounds are fresh and deep — stop bleeding, dress them, and if needed go to the emergency department or GP. Health and life are always the priority.Name it calmly, without judgment
"I see cuts on your arm. I guess you must have been in great distress to do this to your body. I want to understand what's happening to you."Offer to seek help together
"I don't want you to face this alone. We can look for a psychologist/psychiatrist together. This is not punishment but help with what hurts so much."Talk about emotions, not just wounds
Instead of "why did you do it?" try "what happens just before you feel you need to do this?", "which emotions are strongest then?", "what's been hardest lately?"
Self‑harm always signals an overwhelmed coping system. Conversation and professional support are ways to rebuild that system, not only to "patch" the wounds.
Self‑harm — where to seek help (and why)
This text does not replace individual consultation. It is not a promise of cure nor an advertisement for a specific service. It aims to help you not remain alone.
Possible help pathways:
Child and adolescent psychiatrist — assessment whether, besides self‑harm, there is depression, anxiety disorders, eating disorders, suicidal ideation. If needed — pharmacotherapy, decision about possible hospitalization.
Psychotherapist working with adolescents — teaching emotion regulation, self‑understanding, trauma work, relational work and building self‑esteem. Often using evidence‑based approaches (e.g., dialectical behavior therapy, cognitive‑behavioral therapy, schema therapy).
Crisis intervention centers, mental health clinics, psychological‑pedagogical counseling centers — places to obtain free support, also for parents.
Important: your child cutting themselves does not automatically mean they want to die, but it significantly increases suicide risk in the future. Therefore treat it as a serious signal, not a "phase."
I see the person as a whole — and with self‑harm that whole includes the child, parent, school, life history and emotion regulation system. The cuts on the skin are most visible. The suffering beneath them most needs someone finally to see it.
Sources:
The Global Prevalence of Nonsuicidal Self-Injury Among Adolescents — JAMA Network Open, 2024
Non‑Suicidal Self‑Injury in Adolescents: A Systematic Review on Prevalence, Risk Factors and Clinical Correlates — 2025
Risk factors for non‑suicidal self‑injury (NSSI) in adolescents: A meta‑analysis
Self‑harm: assessment, management and preventing recurrence (NICE Guideline NG225) — 2022Responding to self‑harm among children and adolescents – Suggestions for practice
Algorithm for managing self‑harm in children and adolescents — CBT Center / community psychiatric care materials
