"My entire life has moulded the person that I am": Narrations of non-suicidal self-injury and complex trauma in individuals with complex posttraumatic stress experiences.

Abstract

Background: Previous research suggests that complex trauma and Complex Posttraumatic Stress Disorder (C-PTSD) experiences can contribute to the risk of developing and possibly maintaining Non-Suicidal Self-Injury (NSSI). Individuals' accounts of how complex trauma and subsequent development of C-PTSD experiences can contribute to the difficulties of NSSI remain underexplored. This qualitative study aimed to explore in-depth: (1) how individuals with C-PTSD experiences narrate life conditions and events that influenced their difficulties with NSSI over time and (2) what factors the individuals perceived to have helped the process of controlling their experience of NSSI.

Methodology: This novel qualitative narrative study used an adapted version of the Free Association Narrative Interviewing Method (FANIM) to facilitate the exploration of the lived experiences of eight individuals aged 20-56 years. The initial data analysis involved an interpretation of individuals' stories followed by a thematic narrative analysis of 14 interviews to explore the shared and unique experiences narrated by participants.

Results: Four primary themes were established: (1) Voiceless, invisible, and out of control within the dysfunctional system during childhood, (2) "shaky foundation" leading to future traumas, (3) the link between complex trauma, mental health difficulties, and NSSI, and (4) Regaining autonomy and a sense of control in managing NSSI. The findings highlight the importance of adopting a flexible and person-centred treatment that addresses the specific needs of these individuals. The treatment plan should empower individuals to improve their control and autonomy and support them to live a meaningful life.