How I work with this
In working with self-harm, I draw upon a combination of Transference-Focused Psychotherapy (TFP) and Schema Therapy. First and foremost, we establish clear therapeutic boundaries to ensure the space is safe. Through the lens of TFP, we explore how the adolescent perceives themselves and others. Quite often, this perception consists of extremes, where the world is either idealized or entirely hostile and devaluing (splitting mechanism). This way of perceiving is characteristic of emerging borderline personality organization (BPO), where the individual lacks a stable core self. We observe how these sudden shifts in attitude unfold right in the consulting room, in the relationship between therapist and client (analysis of transference). Gradually, this helps the adolescent integrate the "good" and "bad" parts of themselves and the world into a coherent, realistic picture (identity integration).
Concurrently, schema therapy helps identify deep emotional deficits—the early traumas or unmet needs that formed stable negative beliefs about one's self-worth (maladaptive schemas). We work to strengthen the adolescent's internal capacity to protect themselves, practice self-compassion, and tolerate complex, mixed emotions without needing to damage their body (tolerance of ambivalence). Over time, the need for physical pain subsides as an internal support structure develops.
Do you recognise yourself?
- ✓ the adolescent constantly wears long sleeves or pants even in hot weather to hide arms or legs
- ✓ you find razor blades or blood-stained tissues in their room
- ✓ the adolescent describes a state of unbearable emptiness or detachment from their own body (depersonalization)
- ✓ feels temporary relief after self-harming, which is quickly replaced by burning shame and guilt
- ✓ suddenly withdraws from communication after intense emotional outbursts
- ✓ has a deep conviction of being inadequate or "broken"
- ✓ cannot explain in words what triggered the acute anxiety or anger, choosing physical punishment instead
If you recognised 3+ points — it is a good reason to talk to a psychologist.
Approach & Methodology
When an adolescent deliberately harms their own body, it is almost never manipulation or an attempt to seek attention. More often, it is a desperate way to cope with overwhelming emotions that simply have no place in the psyche. Physical pain grounds them for a moment, silencing unbearable anxiety or shame, or conversely, helping them feel something instead of a terrifying, dead emptiness within. An adolescent's psyche is still actively developing and often faces experiences of such intensity that they cannot be contained, processed, or comprehended.
Since words cannot yet fully capture this internal pain, it is translated into physical action directed against one's own body (acting out occurs). The body becomes the only available stage for acting out internal conflicts. My goal is to help the adolescent gradually translate these conflicts from the language of wounds and scars into the language of words, giving their pain a safe space and a meaningful form.
Questions & Answers
Do I, as a mother/father, need to constantly check the child's body for new cuts?
Total control often increases a teenager's internal tension and provokes new episodes. In therapy, we make a safety contract with the teenager, and with the parents we discuss how to provide support without violating boundaries, creating an environment of emotional availability rather than that of a warden.
How quickly will self-harm stop after the start of therapy?
The symptom itself may decrease or disappear relatively quickly, as soon as the first skills of verbalizing emotions appear. But the deeper goal is to change the very structure of the psyche, so that the adolescent can rely on themselves in crisis situations. This is a long process that usually requires from one to several years of regular work.
Do you use antidepressants or other medication?
I work using talk psychotherapy methods and do not prescribe medication. However, if the level of impulsivity is too high or the episodes are accompanied by severe depression, I recommend a parallel consultation with a psychiatrist. Medication can reduce the acuteness of the condition and give the psyche a resource for our therapeutic work.
What should I do if my teenager comes back from a session angry at you and says that therapy isn't working?
This is a natural and very valuable stage. Anger, disappointment, or devaluation of the therapist is a manifestation of the same difficulties the adolescent has in their relationship with the world (negative transference). Instead of being frightened by it, the client and I explore this anger. It is precisely the experience that conflict and anger can be discussed without destroying the relationship or causing rejection that is healing.
Process
How the work unfolds
Initial contact
Write in the messenger or leave a request on the site. Do not look for the right words — I will help you carefully start our journey and we will choose a convenient meeting time.
First consultation
A safe space for acquaintance, where you will feel if my approach suits you. This meeting does not oblige you to anything and only helps determine the next steps.
Regular therapy
Meetings are held 1-2 times a week for 50 minutes, online or face-to-face. A stable schedule is necessary for deep transformation and the development of your internal supports.
Payment and booking
The session fee is 50 USD (in hryvnias). Please read the Public Offer. The time is finally reserved and confirmed after payment.
Contact
Book a consultation
I reply on weekdays. If you are in crisis — call me directly.
Or write directly