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

Self-harm among adolescents, mostly girls, has increased in the last years. Self-harm is associated with mental illness and the risk of suicide. This qualitative study aims to explore the lived experience of self-harm as it is related to everyday life and challenges among adolescents. Nineteen girls (13-18 years of age) in a clinical population (strategic selection) participated in personal interviews analyzed by Interpretative Phenomenological Analysis to capture how they made meaning of self-harm and essential features of experiencing self-harm. Adult persons with the first-hand experience of self-harm were included in the research analysis. Data-analysis resulted in three superordinate themes which all speak about ways to handle inner pain and vulnerability: 1. I deserve pain, 2. I don't want to feel anything, and 3. I'm harmed, and no one cares. Each superordinate theme included four main themes characterizing essential features of difficult experiences during self-harm, the purpose of the action, self-descriptions, and the role of others during self-harm. The three superordinate themes are discussed as emerging self-representations - the punished self, the unknown self, and the harmed self - during the transitional age of adolescence. This article argues that subjective personal data on self-harm related to adolescents' everyday lives may indicate diversity in the capacity to integrate difficult needs, feelings, and traumatic experiences as part of the self. This knowledge may bring a nuanced understanding of self-harm in adolescence, enhance self-understanding and treatment motivation, and inform clinical adjustment.

Automated summary

Self-harm among adolescents has been on the rise, primarily associated with mental illness and suicide risk. This qualitative study examined the lived experiences of self-harm in adolescents, identifying three superordinate themes: self-punishment, lack of emotional awareness, and feeling hurt and neglected. The study suggests that these themes play a crucial role in shaping self-representations during adolescence.