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For some young people self-harm carries something besides relief: belonging, recognition, a name for who they are among friends who do the same.
That is uncomfortable to sit with and it changes what helps. If a behaviour is the reason someone feels understood, taking it away without touching that need leaves a hole that tends to get filled the same way or by something worse. So the assessment has to include the social side, gently and without shaming anyone: who knows, what it means among them, what would be lost. Then belonging can be built somewhere else before anything is asked for.
Qur’an and Sunnah
When the earth, for all its spaciousness, closed in around them (Quran 9:118). It is said of three men left outside the community, and mercy is what the verse moves towards rather than blame.
وَعَلَى ٱلثَّلَٰثَةِ ٱلَّذِينَ خُلِّفُواْ حَتَّىٰٓ إِذَا ضَاقَتۡ عَلَيۡهِمُ ٱلۡأَرۡضُ بِمَا رَحُبَتۡ وَضَاقَتۡ عَلَيۡهِمۡ أَنفُسُهُمۡ وَظَنُّوٓاْ أَن لَّا مَلۡجَأَ مِنَ ٱللَّهِ إِلَّآ إِلَيۡهِ ثُمَّ تَابَ عَلَيۡهِمۡ لِيَتُوبُوٓاْۚ إِنَّ ٱللَّهَ هُوَ ٱلتَّوَّابُ ٱلرَّحِيمُ
And to the three men who stayed behind: when the earth, for all its spaciousness, closed in around them, when their very souls closed in around them, when they realized that the only refuge from God was with Him, He turned to them in mercy in order for them to return [to Him]. God is the Ever Relenting, the Most Merciful
Qur’an 9:118read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
What actually reduces loneliness is not always more company. A meta analysis of four broad strategies found that those addressing how the lonely person thought about social situations worked better than simply providing more social contact. Arranging more contact around someone is rarely enough on its own.
Masi CM, Chen HY, Hawkley LC, Cacioppo JT. (2011). A meta-analysis of interventions to reduce loneliness.. Personality and social psychology review : an official journal of the Society for Personality and Social Psychology, Inc doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A behaviour that brings connection will keep returning until the connection has somewhere else to come from.
When not to
Curiosity about what self-harm provides never replaces a proper risk assessment, especially where the injuries are escalating.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Nearly all of them do the one thing: keep a monoamine hanging about in the synapse for longer. So when you hear that some other tablet is stronger, be a little sceptical.
Some newer antidepressants do two jobs in a single tablet: the familiar one of keeping serotonin available, plus a direct nudge at the receiving end.
Put something in before you take something out. Removing the only way a person has of coping leaves them with nothing, which is not safer.