“I can’t describe it and they can’t see the rain.” an interpretative phenomenological analysis of the experience of self-harm in young adults who report difficulties identifying and describing their feelings

Self-harm is a serious and increasing public health concern. Self-harm is significantly associated with alexithymia, a trait characterised by a difficulty identifying and describing feelings. Alexithymia has been found to be a barrier to psychological treatment. This article explores the experiences of self-harm among eight young adults who reported difficulties identifying and describing their feelings. Semi-structured interviews were conducted, with the optional use of photographs as visual stimuli for discussion. Transcripts were analysed using Interpretative Phenomenological Analysis. Two themes are presented here: The Obscure Self describes participants’ struggle to grasp a coherent sense of self, and how self-harm provided a means of physically reconnecting with their bodies. Words Fail Me describes participants’ difficulties communicating their subjective experience, which increased feelings of isolation and recourse to self-harm. There were also tentative indications that participants were able to recognise their emotional experience when expressed by others. The lack of interpersonal connection, arising from difficulties understanding feelings and communicating them to others, may create or exacerbate the context for self-harm. The findings have relevance for the treatment of self-harm, given the high, but often unacknowledged, prevalence of alexithymia in clinical populations.