How Do Young People Understand Their Own Self-Harm? A Meta-synthesis of Adolescents’ Subjective Experience of Self-Harm
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What makes young people—most often young women—inflict damage on their own bodies? Epidemiological studies drawing on surveys have estimated incidence and identified risk factors, but studies that explore the individuals’ experience and understanding of self-harm, which typically comprise a small series of persons, are omitted in many reviews. We conducted a systematic database search of studies on adolescents’ (12–18 years of age) first-person experience of self-harm in clinical and non-clinical populations, and included 20 studies in a meta-synthesis. Four meta-themes were associated with the participants’ subjective experiences of self-harm: (1) to obtain release, (2) to control difficult feelings, (3) to represent unaccepted feelings, and (4) to connect with others. The meta-themes support self-harm as a function of affect-regulation, but also highlight how the action of self-harm may contain important emotional and relational content and an intention or wish to connect and communicate with others. Our findings underline the importance of relating self-harm to developmental psychological needs and challenges in adolescence, such as separation, autonomy and identity formation. Self-harm in adolescence may be a result of a conflict between a need to express affective experiences and a relational need for care.
KeywordsAdolescence Meta-synthesis Self-harm Subjective experience Qualitative research
The authors wish to thank Glenn Karlsen Bjerkenes and Hege Ringnes at the University of Oslo, Norway for their assistance with the literature search, and Caryl Gay, PhD at the University of California, San Francisco for proof reading the manuscript.
LIS conceived of the study, participated in its design and coordination and drafted the manuscript; HH participated in the design and interpretation of the data; SEG participated in the design and interpretation of the data. All authors read, helped to draft, and approved the final manuscript.
The Norwegian Extra Foundation for Health and Rehabilitation and The Norwegian Council for Mental Health provided funding for this study, FO4115. They had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the article for publication.
Compliance with Ethical Standards
Conflict of Interest
The authors report no conflict of interests.
Research Involving Human and Animal Participants
This article does not contain any studies with human participants or animals performed by any of the authors.
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