Understanding the experiences of middle school girls who have received help for non-suicidal self-injury

Abstract

This study aimed to understand the experiences of middle school girls who have engaged in non-suicidal self-injury (NSSI) and have received professional help for these behaviors. Participants described engaging in NSSI in response to uncomfortable feelings and invasive negative thoughts. They reported that engaging in NSSI decreased their uncomfortable feelings. While each participant had at least one person in her life who knew about her NSSI, participants did not feel supported or validated by these people. Participants were not completely honest with their therapists because they were afraid of being misunderstood, dismissed, or getting others into trouble. Despite these things, participants wanted support and understanding about who they are as unique individuals, why they are struggling, and why they self-injure. They also wanted to be in a transparent therapeutic relationship where they felt respected and accepted. Unfortunately, they did not describe relationships with their therapists as possessing these qualities. Professionals would better meet the need of adolescents by clearly discussing confidentiality, boundaries, conveying respect and acceptance, and recognizing the uniqueness of their clients. Assessing for self-harm and treatment reluctance should be done in the context of resistance to therapy and a sensitivity to judgment.

Why is non-suicidal self-injury more prevalent among women? Mediation and moderation analyses of psychological distress, emotion dysregulation, and impulsivity

“…Indeed, NSSI is bi-directionally related to distress (Buelens et al, 2019) including in this cohort studied prior to the COVID-19 pandemic (Polek et al, 2020). NSSI can elicit feelings of shame, guilt, and self-criticism (Bachtelle & Pepper, 2015;Daly & Willoughby, 2019) and strain interpersonal relationships (Waals et al, 2018), with many people who engage in NSSI reporting feeling unsupported by family, friends, and mental health professionals (Tillman et al, 2018).…”

A Necessary Pain: A Literature Review of Young People’s Experiences of Self-Harm

“…Young people who self-harm may feel that they have low control over their life, but by harming themselves, they can maintain a certain amount of control over something. They can take control over the pain caused by their emotions by harming themselves and instead focussing on the physical pain and the actual injuries (Bheamadu et al, 2012;Hill & Dallos, 2012;Kokaliari & Berzoff, 2008;Lesniak, 2010;Moyer & Nelson, 2007;Rissanen et al, 2008;Tan et al, 2019;Tillman et al, 2018). Using self-harm in this way can also be a way to take control over internal factors such as thoughts, feelings and external factors related to the environment and the family (Bheamadu et al, 2012;Hill & Dallos, 2012;Tan et al, 2019).…”

“…The results show that young people sometimes harm themselves in order to feel better and they often experience immediate relief of their emotional pain. They feel secure in the knowledge that self-harm can make them feel better (Klineberg et al, 2013;Kokaliari & Berzoff, 2008;Lesniak, 2010;McAndrew & Warne, 2014;Moyer & Nelson, 2007;Tan et al, 2019;Tillman et al, 2018). After the self-harm episode, young people express that they can feel more alive (Bheamadu et al, 2012;Lesniak, 2010;Rissanen et al, 2008), relieved, and relaxed (Lesniak, 2010;Tan et al, 2019).…”

“…For some, self-harming behaviour becomes a way to temporarily escape from exhausting feelings (Moyer & Nelson, 2007;Tillman et al, 2018). Furthermore, that they have no choice but to harm themselves, and that it is necessary to do so in order to survive (Hill & Dallos, 2012;Lesniak, 2010;McAndrew & Warne, 2014;Moyer & Nelson, 2007;Rissanen et al, 2008).…”

“…Self-harming behaviour is described as a way of dealing with repressed emotions (Lesniak, 2010;Moyer & Nelson, 2007;Tan et al, 2019;Tillman et al, 2018) and a strategy to block out emotions that may feel overwhelming (Moyer & Nelson, 2007;Tan et al, 2019;Tillman et al, 2018) such as anger, frustration, and anxiety (Bheamadu et al, 2012;Lesniak, 2010;Moyer & Nelson, 2007;Tillman et al, 2018). Some young people describe self-harming when they are troubled by anxiety about problems, feelings of hopelessness (Lesniak, 2010), and negative thoughts (Hill & Dallos, 2012;Moyer & Nelson, 2007;Tan et al, 2019).…”