Individuals’ accounts and explanations of continued engagement in non-suicidal self-injury: a qualitative study

ABSTRACT

Non-suicidal self-injury (NSSI) is the deliberate damage of bodily tissue which occurs without suicidal intent. NSSI is a common behavior among young people and a frequent focus in clinical practice. Many models of the aetiology and maintenance of NSSI are focused on emotion regulation. The role that cognition plays in the behavior is less well understood. We used thematic analysis to explore how individuals explain or attribute their engagement in NSSI. The study identified several ways of thinking that may be play a role in why people engage in NSSI. Specifically, five themes were generated: Limited Controllability, Benefits, Limited Resources, Stability, and Changing Meaning and Significance. Implications for research and practice are discussed.

KEYWORDS:

• Attribution
• cognition
• Non-suicidal self-injury
• thematic analysis
• qualitative

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Heather Pearce

Heather Pearce is a graduate from the University of Guelph's B.A. Psychology program and is currently pursuing her MEd in Counselling Psychology at the University of Toronto. Her honours thesis focused on people's attributions of their engagement in non-suicidal self-injury. She is currently working with youth with complex mental health needs and lived experience with self-injury in Toronto, Canada.

Olga Smoliak

Olga Smoliak, PhD, is an Associate Professor in Family Relations and Applied Nutrition at the University of Guelph, Canada. She is also a clinical/counselling psychologist and marriage and family therapist. Her primary research areas are postmodern (discursive) therapies and research (discursive psychology, conversation analysis, critical discourse analysis). She co-edited Therapy as Discourse: Research and Practice (with T. Strong) and The Handbook of Counselling and Psychotherapy in Canada. Dr. Smoliak has published extensively on the topics of postmodern (discursive, collaborative, dialogic) therapies, interaction in couple therapy, therapist authority and collaboration, and gendered power in therapy.

Stephen P. Lewis

Stephen P. Lewis, PhD is a Professor in the Department of Psychology at the University of Guelph. His research focuses on self-injury and related difficulties, with emphasis on promoting recovery and advocating for individuals with lived experience. He has published extensively in these areas and undertaken an array of related advocacy activities. Along these lines, he has shared his own lived experience in a TEDx Talk, published narrative, and numerous speaking events. Dr. Lewis is Past President of the International Society for the Study of Self-Injury and Co-Founder and Co-Director of Self-injury Outreach and Support (SiOS: www.sioutreach.org), which has been accessed in over 180 countries globally. SiOS is the first international non-profit initiative providing current information and resources about self-injury to individuals with lived experience of self-injury and those who support them.