This paper discusses the steep increase, in recent years, of self-harm presentations in adolescent clinics in the UK. It explores this increase, particularly evident in adolescent girls, in the context of a number of parallel developments: the gradual desexualisation of psychoanalysis; the dwindling mental health resources after the 2008 financial crisis with the pressures that adds to young people’s stress levels, sense of identity and mental health; the impact of social contagion in adolescents, with both offline and online pressures. The classic psychoanalytic notion of hysteria, as it overlaps with these developments, is suggested as a theoretical and clinical framework to consider for the child psychotherapist working with self-harming adolescents.