Non-suicidal self-injury, henceforth referred to as NSSI, refers to the act of intentionally destroying one’s own body tissues with no suicidal intent and for purposes that are socially sanctioned (International Society for the Study of Self-Injury, 2020). Some common examples of NSSI might include cutting, burning, scratching, banging, and hitting.
In India, the rate of NSSI in 2013 was found to be 31.2% among college students, with the mean age of onset being 15.9 years. (Kharsati & Bhola, 2014). These behaviors are often performed in secret, and the most prominent reason behind the performance is to induce a feeling of calmness and relaxation. (Bhola, Manjula, Rajappa, & Phillip, 2017).
Understanding the causes behind NSSI requires consideration of the complex interaction of the cognitive and social forces. Individuals who engage in NSSI feel negative emotions, and performance of the act provides results in reduced negative emotions and a feeling of calm and relief (Klonsky, Victor, & Saffer, 2014). Self-injury is also a result of self-directed anger or self-punishment, caused by extreme amounts of self-criticism (Hooley & St Germain, 2013). In a study conducted over 2640 high school students, it was found that adolescents who experience a greater level of psychological distress, receive poor social support from family, and have poor self-esteem are more likely to start indulging in self-injury. (Andrews, Martin, Hasking, & Page, 2013).
Individuals indulging in NSSI might have a different way of perceiving and making sense of the world around them. Hankin and Abela (2011) found that a negative cognitive style predicts NSSI in adolescents. Unfortunately, not much research has been conducted to understand the underlying cognitive factors that contribute to NSSI behaviors.
A number of social factors can contribute to engagement in NSSI. These include low family support, high dysfunctions within the family (Prinstein et al, 2000), negative parenting practices (Ying, You, Liu, & Wu, 2021) and low family cohesion. Peer support also plays a role in NSSI (Prinstein et al., 2000).
Social support, especially support from family and parents, is important as a preventive factor against NSSI as well. Individuals who perceive their parents as dependable and have better communication with them have a greater foundation for developing adaptive coping skills than the ones who rely on peers for developing such skills (Wolfe et al., 2013). Social support plays an important role in dealing with NSSI. Individuals engaging in NSSI have comparatively less social support and fewer people they seek support from compared to those who don’t engage in NSSI. People who engage in NSSI might find it difficult to form relationships (Levesque, Lafontaine, Lonergan, & Bureau, 2021) and develop adaptive interpersonal skills (Muehlenkamp, Brausch, Quigley, & Whitlock, 2012).
One cannot talk about social factors that contribute to NSSI without talking about the cultural factors that underlie every society. Xu et al. (2019) recruited 4799 students from two medical colleges in the Anhui province of China and found that physical, emotional, sexual, and overall childhood abuse is positively associated with NSSI frequency and. There is also a negative correlation between social support and frequency of NSSI, which means participants who had more social support were less prone to engage in NSSI. Brown and Witt (2019) found that in non-Western cultures, family factors are not associated significantly with NSSI, probably because of the stigma and misconception surrounding mental illness. However, in the Western context, negative parental and peer variables are closely related to the onset of NSSI. Relation with siblings is also an important predictive factor.
Very closely related to the social factors is the immediate reaction that individuals who engage in NSSI receive upon disclosing their act. In a meta-analysis of 10 studies, Park, Mahdi, and Brooke (2020) found that people who disclose their NSSI behaviors are often met with negative responses, which often cause them to withdraw from seeking further help. While peers may not have as significant an impact as family on acts of multiple NSSI (Adrian et al., 2011), whenever peers respond positively to the disclosure of NSSI, it leads to a feeling of comfort in the disclosing individual, and might also offer them an opportunity of receiving instrumental help. It might also strengthen the friendship, as was found by Gayfer, Mahdi, and Lewis (2018) in their study. Surprisingly, individuals who disclose their NSSI to health professionals rate the conversation as being ineffective compared to when they disclose it to peers or friends (Baetens et al., 2011). Based on the previous trend, the first impression of the therapeutic setting might influence therapeutic attendance and compliance.
While a lot of studies have been conducted to understand more about this behavior, most of them have been focused on the Western world, where the social factors might be completely different from those in the non-Western world. Hence there needs to be more research in the context of Indian society which would take into account the various cultural typicalities which might often be omitted in research conducted in the Western world.
Thus, this study aims to bridge the gap that exists between the Western and Indian society regarding the psychosocial experiences that contribute to NSSI and the support-seeking behaviors of individuals who engage in NSSI so as to develop a rich and concise account that might be helpful for addressing the problems that force people into NSSI and develop a proper support system to help them deal with the difficult times. As such, this article focuses particularly on two research questions: (1) what are the cognitive and social experiences of individuals that lead to engagement in NSSI? and (2) what are the support-seeking experiences of individuals who indulge in NSSI and how do they perceive the immediate reaction of others upon disclosure?