Why Teens Self-Harm: What They’re Trying to Feel (or Not Feel)
Self-harm is one of the most frightening issues a parent can encounter. It can be hard for parents to understand and emotionally difficult to sit with, particularly as it is something many feel unprepared for when it comes to light and raises immediate concerns over safety and wellbeing.
In this Let’s All Talk Mental Health session, GP, author, TEDx speaker and young people’s mental health specialist Dr Dom Thompson spoke about why teens self-harm, what it offers them in the moment, and how parents and schools can respond in ways that reduce risk, rather than unintentionally increasing it. Throughout the session, Dr Thompson repeatedly returned to three principles for adults: calm, compassion and kindness.
What self-harm is really about
Self-harm is usually a coping strategy for overwhelming emotional pain. When emotions feel too intense, confusing or unbearable, physical sensation can act as an alternative distraction. The brain shifts focus away from emotional distress and onto something concrete and immediate.
In this sense, self-harm can feel effective in the short term because it creates relief and release. Understanding this does not mean approving of the harming behaviour, but it does help parents move away from “Why would they do this?” towards “What are they trying to manage?”
Why it can make sense in adolescence
Humans have always responded physically to emotional distress. Slamming doors, punching walls, or banging a desk are recognised expressions of overwhelm. Self-harm sits on the same spectrum, but is turned inward and often hidden. Adolescence is a particularly vulnerable period. Emotional regulation is still developing, stressors are high, and many teens feel pressure to cope silently. When feelings build with nowhere to go, self-harm can begin to feel like an available release.
Talking to teens about big emotions
One of the strongest protective factors against self-harm is helping young people understand that big emotions are normal, tolerable and temporary. Dr Thompson encouraged parents to communicate that emotions can be uncomfortable without being dangerous, and that support is available without pressure:
Normalise emotional ups and downs in everyday life
Talk about feelings without making the conversation directly about the teen. Avoid asking “how are you feeling”?
Use “side-by-side” moments, such as car journeys or walks, rather than face-to-face questioning
Use TV programmes, films or news stories as conversation starters
Being a safe harbour
It’s good for teens to know there is a place they can return to without fear of panic, anger or judgement. Dr Thompson described parents as a “safe harbour”: a steady, calm presence that remains available even as teens grow more independent. It doesn’t mean constant checking or intense questioning. It means showing:
“I’m here.”
“I will listen.”
“You won’t get in trouble for telling me.”
“I may not fully understand, but I care.”
Trust will build slowly through repeated calm and compassionate responses.
When parents discover self-harm
Discovering that your child has self-harmed can be incredibly upsetting, but the most helpful first response is calm, compassionate and kind. Try to:
Avoid panicking or catastrophising
Deal calmly with any immediate medical needs
Focus on understanding what led up to the behaviour
The instinct to demand that it stops, or to remove all means immediately, is understandable. However, if a teen has no alternative coping strategies in place, this can increase distress rather than reduce it.
What can make things worse
Well-intentioned responses can sometimes shut conversations down. Dr Thompson talked about some of the common pitfalls:
Using guilt (“Think how upset this makes us”)
Negative framing (“You’re not going to do that again, are you?”)
Repeatedly checking wounds without consent
Treating self-harm as purely behavioural rather than emotional
These responses, though well intentioned, can increase shame, which often leads to secrecy. Calm, compassionate responses are far more likely to keep communication open.
Alternatives to self-harm
Moving away from self-harm is often a gradual process. The aim is not to remove coping instantly, but to replace it. Dr Thompson described other alternatives to match the young person’s needs. Some need calming and comfort; others might need physical release for adrenaline or anger. Options discussed included:
Movement or exercise
Creative activities such as art or writing
Sensory comfort and safe spaces
Talking or messaging a trusted person
Best practices for self-harm support continue to evolve. Some older strategies such as snapping elastic bands or using ice are no longer recommended, as they continue to reinforce pain-based coping rather than support regulation.
Harm and safety
In some cases, immediate removal of all means can increase risk if no alternative coping strategies are in place. Harm minimisation, while counter-intuitive, may be part of early support while therapeutic help and safer strategies are introduced. Any safety decisions should be calm, planned and discussed collaboratively wherever possible.
Effective therapy
Evidence-based therapies such as DBT, CBT-informed approaches and mentalisation-based therapy are the most effective for self-harm and offer good chances of recovery. Even with therapeutic interventions, progress is rarely linear, but with the right support, outcomes can be transformative.
Self-harm within peer groups
When self-harm appears within friendship groups, the priority is not panic or suppression. Calm adult responses, open conversations and clear support pathways reduce risk much better than silence or fear-based reactions.
Takeaway
Self-harm is not about attention or failure. It is a signal of distress and an attempt to cope. Dr Thompson’s message was simple and powerful: respond with calm, compassion and kindness. These principles reduce shame, build trust and make it more likely that young people will seek help again when they are struggling. You do not need perfect words or all the answers. Being present, patient and willing to listen already matters more than you may realise.
Watch Now
You can watch the full Let’s All Talk Mental Health session with Dr Dom Thompson on the hub.
Dr Dom Thompson also recommend some other helpful resources:
TEDx Understanding why: What young people wish we knew
Growing a Grown Up Blog: What Parents Need to Know about Self-Harm
Book by Dominique Thompson: How to Grow a Grown Up
Self Care Support App: Distract
The Centre of Excellence for Self-Harm and Suicide Protection
Self Injury Support Charity
Staying Safe Website: Staying Safe (from Suicidal Thoughts)
Youngminds: Self-Harm Advice