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Letter
I cut therefore I am? Avoiding labels in the context of self-injury
  1. Stephen P Lewis
  1. Correspondence to Dr Stephen P Lewis, Department of Psychology, University of Guelph, Guelph, Ontario, Canada N1G 2W1; stephen.lewis{at}uoguelph.ca

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Non-suicidal self-injury (NSSI) represents a critical global health concern. While our understanding of NSSI has evolved dramatically over past two decades,1 the language used to refer to those who self-injure has not. Terms such as self-injurer and self-harmer continue to be used throughout the empirical literature2 and likely in clinical settings. From a humanistic standpoint, these referents may perpetuate unhelpful discourses and exacerbate the stigma that many individuals already experience by labelling and ostensibly equating them with the behaviour enacted. Indeed, guidelines have been offered to improve and offer a more socially judicious nomenclature when referring to those who experience mental health difficulties (eg, avoiding terms such as schizophrenic). However, the use of self-injurer or self-harmer fail cohere with such efforts. Clinically, these terms may be inadequate and impractical in the sense that they seemingly connote similarity across individuals who self-injure by grouping them together. This is in contrast to research highlighting immense heterogeneity across those who enact NSSI as well as mounting evidence pointing to the possible inclusion of NSSI within the diagnostic nomenclature, which inherently implies that not all who self-injure are the same.1 Relatedly, from an empirical perspective, researchers have investigated the role of identity in the context of NSSI.4 Beyond elucidating identity processes involved in NSSI engagement, this line of research indicates that a small subset of individuals who self-injure may actually refer to themselves (and others who self-injure) as self-injurers, which may constitute a form of social identity.4 To this end, terms such as self-injurer incorrectly blanket together people who self-injure and do not allow for consideration of the myriad ways that these individuals may identify. Following the above, it seems incumbent upon researchers and clinicians to refrain from using self-injurer or self-harmer in published works and clinical conversations. This is essential towards the diminishment of stigma and to offering a more empirically and clinically useful way to understand and refer to people who self-injure.

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Footnotes

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.