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).