“I thought that crying was weakness”: a thematic analysis of emotional experience in an online self-harm forum

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Objective This study aimed to investigate the emotional experiences and beliefs of individuals who engage in self-harm by analyzing data from an online self-harm forum. Emphasis was placed on understanding how these individuals describe and evaluate their emotions (emotion beliefs) and the role these beliefs play in their emotion regulation and self-harming behaviors. Method A total of 119 posts from a self-harm discussion board on the forum were analyzed. Thematic analysis, following a critical realist perspective, was employed to identify and interpret recurring patterns in how posters articulated their emotion beliefs. Results Four themes were created during analysis: "My emotions are too much," "Self-harm as control or controlled by self-harm," "Suppression is better than expression," and "Self-harm helps me escape my emotional pain." Posters described experiencing overwhelming, uncontrollable, and unacceptable emotions, resulting in a desire to suppress or escape them through self-harm. Conclusions Individuals struggling with self-harm hold negative beliefs about their emotions, which intensify emotional experiences and contribute to feelings of shame and guilt. The findings highlight the necessity of interventions targeting these negative emotion-related beliefs to foster alternative emotional regulation strategies and reduce reliance on self-harm, as well as the importance of increased education on these emotional beliefs for those who support them, in order to reduce stigma. Furthermore, the study emphasizes the potential of online forums in gaining valuable insights into sensitive behaviors.