Background
Understanding the processes underlying non-suicidal self-injury (NSSI) is important given the negative consequences of this behaviour. Qualitative research has the potential to provide an in-depth exploration of this. There has been limited research regarding the interpersonal processes associated with NSSI; therefore, a meta-synthesis was conducted to investigate this.
Methods
A search of PsycINFO, MEDLINE, Web of Science, and CINAHL electronic databases from date of inception to November 2020 was conducted. In total, 30 papers were included in the final review. A meta-ethnographic approach was utilized to synthesize the data.
Results
Two overarching themes were found. Within ‘Powerful relational dynamics’, NSSI was cited as a response to participants becoming stuck in aversive or disempowering relational positions with others. Within the ‘Taking matters into their own hands’ subtheme, NSSI was reported as a way for participants to get interpersonal and emotional needs met.
Limitations
Several included papers did not comment on the researcher–participant relationship, which may have affected qualitative results. A small number of potentially eligible papers were unavailable for synthesizing.
Conclusion
Findings provide a more nuanced investigation of the interpersonal processes underlying NSSI. Consistent with relevant theories, NSSI appears to be a way of mitigating difficult interpersonal experiences or getting interpersonal needs met. NSSI may be engaged in as a substitute to other, less damaging ways to cope. An argument is made for a more empathetic understanding of NSSI and the use of relational interventions.
Practitioner points
Self-injury may occur in response to interpersonal stressors
Self-injury can be a means to get interpersonal needs met
Self-injury may replace other means of coping that become blocked or thwarted
Emotional distress can be closely linked with interpersonal factors for this group
Relational therapies may be beneficial where interpersonal processes are linked to NSSI