The Quest for Meaning Around Self-Injurious and Suicidal Acts: A Qualitative Study Among Adolescent Girls

Abstract

Introduction: Suicide and non-suicidal self-injury (NSSI) are major problems in adolescent psychiatry and share numerous clinical characteristics. The principal objective of this study is to describe the subjective experience of adolescent girls and young women who present NSSI and/or suicidal behaviors and to determine the common aspects and the specificities of each experience. Method: This exploratory study is based on a procedure that is qualitative, phenomenological, and inductive. The data were collected from two semi-structured interviews each of 18 girls and young women aged 12–21 years, who were receiving care from a psychiatrist specializing in adolescents and who at least once had harmed themselves by NSSI or attempted suicide, or both. The thematic data analysis was performed by applying the methods of interpretative phenomenological analysis. Results: The results are described around four superordinate themes: relationships with the self, with others/otherness, with the body, and with death; they are then subdivided into 13 themes. Several themes appeared common to both types of behavior, especially the relational dimension of self-harming acts. The process of separation-individuation seems complex for these youth. Conclusion: The results underline the relational aspects of the self-harming behavior (NSSI or suicidal) among adolescent girls. These aspects also appear to be expressed in the family sphere, the social sphere, in contact with peers, and also at a societal level when the community no longer addresses adolescents' difficulties. When the process of subjectification does not appear to reach completion, self-aggressive behavior is seen as an ultimate attempt to regain a feeling of autonomy.

An Analysis of Young Clients' Communications About Their Suicidality on a Text Message Helpline: “I'm Scared of What I Might Do to Myself”

“…The young clients in our study also conveyed that suicide was a way for them to communicate pain and distress ( 32 , 54 ). This is in line with research, which suggests that suicidality among young people might serve an interpersonal function ( 31 ). Some researchers have argued that revenge was an aspect of this communication ( 29 ).…”

The Punished Self, the Unknown Self, and the Harmed Self – Toward a More Nuanced Understanding of Self-Harm Among Adolescent Girls

“…Although all participants shared self-harming, the three superordinate themes illustrate how self-harm may be motivated by qualitative different overwhelming experiences. The results are covering some of the specificities of the subjective experience of self-harm and suicide attempts, especially concerning relationships with the self and with others, which are reported by Grandclerk et al ( 2019 ). Still, the results nuance and exemplify patterns of qualitative essential features in experiences during self-harm which may vary among self-harming young people – conflictual differentiated feelings and thoughts which evoked guilt (#1), an uncontrollable state of diffuse feelings and stressful thoughts which evoked helplessness (#2), or a chaotic feeling and state of being abandoned (#3).…”

“…Several of the included qualitative studies in the mentioned meta-synthesis included non-clinical samples. In a study by Grandclerk et al ( 2019 ), including informants from a clinical sample, relational dimensions appeared as common aspects of the subjective experience of both self-harm and suicide attempts among young women. These young women described self-harm and suicide attempts in close relationships with the self, with others, with their bodies, and with death.…”

“…These young women described self-harm and suicide attempts in close relationships with the self, with others, with their bodies, and with death. Following these findings, Grandclerk et al ( 2019 ) discuss self-harm as related to complexities in the psychological developmental issues of separation-individuation during adolescence, and that self-harm may be an attempt to achieve autonomy for these youths. Hetrick et al ( 2020 ) highlight the importance of the idiosyncratic nature of triggers and self-help strategies and “the need for young people to maintain some autonomy and control while being supported to connect with others for support” (p. 1).…”

Étude qualitative de l’expérience des parents après la tentative de suicide de leur adolescent

“…Certains gestes suicidaires sont clairement identifiés par l'adolescent comme une tentative de dire la souffrance à son entourage (34), dans le but d'améliorer les relations avec lui (33). Pourtant, les réactions émotionnelles des parents telles que la tristesse ou la colère conduisent à des difficultés à être empathique avec l'adolescent et au doute sur sa capacité à l'aider.…”