Self-harm and social media: thematic analysis of images posted on three social media sites

Objectives To explore the nature of images tagged as self-harm on popular social media sites and what this might tell us about how these sites are used. Design A visual content and thematic analysis of a sample of 602 images captured from Twitter, Instagram and Tumblr. Results Over half the images tagged as self-harm had no explicit representation of self-harm. Where there was explicit representation, self-injury was the most common; none of these portrayed images of graphic or shocking self-injury. None of the images we captured specifically encouraged self-harm or suicide and there was no image that could be construed as sensationalising self-harm. Four themes were found across the images: communicating distress, addiction and recovery, gender and the female body, identity and belonging. Conclusions Findings suggest that clinicians should not be overly anxious about what is being posted on social media. Although we found a very few posts suggesting self-injury was attractive, there were no posts that could be viewed as actively encouraging others to self-harm. Rather, the sites were being used to express difficult emotions in a variety of creative ways, offering inspiration to others through the form of texts or shared messages about recovery.