Reviving Ophelia

Chapter 9 focuses on the topic of depression and self-harm among adolescent girls. Pipher begins with an anecdote about 15-year-old Monica, who came to therapy when her parents were worried that her complete lack of social life and depression were getting worse. Pipher took time to understand Monica and used a method that would work for her: Monica was a Suzuki viola player, and Pipher used the Suzuki method to help Monica develop friendships and a love for herself. The Suzuki method employs the idea that anyone can master any skill if they take small steps and work toward it consistently. Monica showed progress and, before long, was making some friends and learning to see her talents and skills.

Pipher explains that the pain of adolescence and losing oneself to cultural demands affects teenage girls in different ways. Specifically, it can manifest as either depression if they blame themselves or anger if they blame loved ones or the world. Because of the high impulsivity and reactivity of adolescent girls, depression or anger can lead to drastic decisions, like suicide and other forms of self-harm. Pipher notes that she did not observe self-harm among her clients until the 1990s, when it became “infrequent, but not surprising” (199). She began wondering what about 1990s culture was causing this reaction. She believes that the rise in self-harm was due mainly to the “girl-poisoning culture” (201) that pervaded society at the time and continues to do so today. Pipher categorizes the self-harm reaction to Western culture’s demands on adolescent girls into four possibilities: to protest the culture, to submit to the culture, to ask for help, or to attempt to regain control. She insists that many girls simply do not have the coping skills needed to deal with stress in other ways and that through therapy this can change.

Pipher relays a series of anecdotes about girls she worked with in the 1990s who were experiencing self-harm. Tammy used cutting to feel better after fights with her boyfriend. Daniella burned herself to express her anger at the world’s political landscape. Pipher describes the steady increase in depression rates over the past decade, noting that “by age seventeen, 36 percent of girls have been or are depressed” (207). She points to the disconnection people are experiencing due to overuse of technology, increasing political polarity, and lack of community. Economic uncertainty and climate change also play a role in hopelessness. Pipher refers to the anecdotes of Christina and Ariel, who each received intervention early for their self-harm, stating the importance of providing girls the support they need to overcome these issues. She concludes by listing some alternative strategies to self-harm, such as experiencing nature, listening to music, or calling a friend.