Self-Harm on Social Media

Why do most (if not all) major social media platforms address self-harm in their community guidelines? Why are algorithms needed to respond to social media searches for self-harm with the message, "Can we help”? Why do so many “maneuvering” hashtags (Fulcher et al., 2020; e.g., #selharn, #selfharmmm) exist to circumvent the algorithms? Why are there 119,000 members of the subreddit, r/selfharm? The answer is because of the well-known, persistent prevalence of self-harm-related content on social media.

The draw to post, share, and discuss self-harm online is evident and has been the subject of much research and debate. Some people note concerns of online self-harm content serving to perpetuate social contagion (the imitation of a behavior by others in a social network; Seong et al., 2021; Walsh & Rosen, 1985), triggering negative reactions and urges to self-injure, and normalizing or encouraging the behavior (Dyson et al., 2016). Others highlight the potential benefits of self-harm posts for users, such as garnering support, finding non-evaluative acceptance and understanding, and avoiding stigmatization (Lavis & Winter, 2020). Yet what do we know about the motives and potential effects of posting self-harm content online?

Why post about self-harm?

Scholars who have investigated social media users’ motives for posting about self-harm noted that a primary function of the behavior is to experience a sense of belonging and find community (Brown et al., 2020; Dyson et al., 2016). Researchers also identified the theme of posting about self-harm in order to communicate the extent of one’s distress (Shanahan et al., 2019). In addition, those who post about self-harm may be motivated by the desire to raise awareness about the issue (Brown et al., 2020).

Moreover, scholars have found that subreddit members discuss the addictive nature of self-harm and report important milestones like the number of days clean (Himelein-Wachowiak et al., 2022). Finally, it has been proposed that the anonymity provided by social media platforms can shield those who engage in self-harm from the stigma and shame associated with the behavior (Moss et al., 2023).

So, what's the issue if posting about self-harm online is often motivated by finding community and a sense of belonging?

Potential Risks of Online Self-Harm Content

There is some evidence that those who post about self-harm online have more clinical symptoms, more suicidal ideation, lower resilience, and more craving for self-injury than those who self-harm but do not post online (Lee et al., 2022). Indeed, a recent exploration of hashtags associated with self-harm posts identified those related to “depression” and “suicide” (e.g., #wanttodie, #depressedgirl) as the most common (Giordano et al., 2022). Thus, although those who engage in self-harm may receive supportive comments and messages from other social media users, they may not be particularly effective or useful in addressing self-harm and co-occurring mental health concerns.

Scholars studying those who post about self-harm online noted, “help offered by peers on Instagram was rarely helpful and did not lead to a reduction of their NSSI [nonsuicidal self-injury]” (Brown et al., 2020, p. 6). It could be that the severity of the behavior and extent of psychological distress among those who post about self-harm online is beyond what a helpful or supportive social media comment can abate.

In addition to being unable to solve the psychological distress spurring the self-harm, posting about self-harm may create an artificial sense of belonging that hinders the development of supportive offline social connections (which, by nature, are more fulfilling and meaningful than virtual connections). For example, scholars found that high schoolers who engage in self-injury used social media significantly more than those who did not (De Riggi et al., 2018), indicating more time spent in virtual networks.

Escaping into online social media to discuss self-harm may further isolate individuals from developing helpful offline relationships and community (Dyson et al., 2016). Lewis et al. (2011) noted that in light of our brain chemistry and neuronal synchronization during in-person attunement (called limbic resonance), online connections could not replace face-to-face connections. Furthermore, if an individual is discussing self-harm with others online, they may not feel a need to seek professional help from a trained clinician.

Another potential risk of online self-harm content is the effect of exposure on children and adolescents unfamiliar with self-harm. Young internet users may come across these images, videos, and posts and become curious about the behavior or negatively respond to the potentially disturbing images. It may be helpful for caregivers to discuss the topic of self-harm with children before online exposure. For example, a parent/caregiver may explain, “Sometimes people have to deal with really difficult emotions and situations. If they don’t know what else to do, they may hurt themselves. We call this “self-harm.” If you see a picture of self-harm or read a post about it online, tell me so we can talk about it.”

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Being Informed and Taking Action

As technology continues to evolve and permeate society, we must be vigilant about monitoring its effects, especially on children and adolescents. One potentially unanticipated impact of the ubiquitous nature of social media is the prevalence of self-harm-related content. As social media platforms work to create effective algorithms and enforce their policies and community guidelines related to self-harm, clinicians need to be aware of online behaviors related to self-harm (e.g., uploading, sharing, liking, and viewing posts) and broach the subject with clients who engage in self-injurious behaviors.

Developing technology plans and/or periods of abstinence from social media may be helpful for clients who engage in self-harm. Moreover, parents/caregivers should also be aware of self-harm content online and consider this when determining when, if at all, a teenager/young adult should use social media. It is important to prepare all children and adolescents for what they may see online (e.g., self-harm images, videos, stories, graphics) and to have frequent, open conversations about their online activities.

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