The Internet's impact on self-harm exploration and perpetuation.
Certain individuals intentionally hurt themselves, either by cutting or burning themselves. Professionals have observed a rise in these instances since the COVID-19 pandemic and suspect the internet might be a contributing factor.
Emma Thompson hasn't felt comfortable showing her arms in public for years, even during summer heat. However, this summer was different. She started wearing t-shirts and tops, and learned to deal with the stares and questions about her numerous scars. "At least they'd ask what happened to me."
Thompson is a 31-year-old woman from Nuremberg, and her arms bear the evidence of countless self-inflicted cuts from razor blades. She has a borderline personality disorder, a mental illness characterized by drastic mood swings. Many with this disorder resort to self-harm to alleviate internal tension. "I couldn't help it," Thompson now admits. But she always felt guilty and filled with self-loathing afterwards.
Rise since the COVID-19 pandemic
Experts refer to this kind of intentional self-harm as non-suicidal self-injury (NSSI). It can occur once or repeatedly, and isn't always related to borderline personality disorder. "Self-harm is primarily an outlet for intense emotional pain or pressure, and this can manifest in any mental illness," explains Michael Kaess, director of the University Clinic for Child and Adolescent Psychiatry and Psychotherapy in Bern. For instance, it can also be seen in depression or schizophrenia.
Adolescents are especially vulnerable, according to Kaess. Recent statistics come from a study published in August in "European Child & Adolescent Psychiatry" involving Kaess, where 17.7% of approx. 9,500 German students reported experience with self-harm.
Since the COVID-19 pandemic, Kaess reports an increase in self-harm incidents. "Social media may be a potential factor," he suggests. Individuals who frequently consume content related to sadness or crisis topics may be shown more of such content, leading them to stumble upon content about self-harm and suicide.
Self-harm as a competition
Thompson too has encountered a vicious circle of negative emotions on the internet. Some individuals would boast about their hospital visits or the severity of their injuries, seeking attention in return. "It creates a kind of contest – like a challenge," she says.
Psychotherapist Sascha Zuleger, from the Nuremberg Clinic, has heard similar stories from other patients. The concept of self-harm might not seem too far-fetched for some, he worries. "There are blogs, websites, and forums dedicated to self-harm, featuring posts, music, videos, and films about it."
However, Zuleger believes the internet can have a positive impact too. Sufferers can find support and realize they're not alone. "Many individuals think they're the only ones dealing with this issue, and when they come to our ward, they're surprised at how many have this problem," Zuleger says.
Thompson also felt this way before her therapy: "Having contact with fellow patients was crucial for me. I always felt like an outsider, but here, I finally found people who understood what I was going through." However, she says it took her a long time to come to terms with her problems and seek help.
The study also shows that many affected individuals are hesitant to seek help due to shame or other reasons. Only 25% of individuals with psychological problems pursued professional help, explains Kaess. Professionals like Kaess are concerned about this. "We know that adolescents who self-harm often have suicidal thoughts and incur an increased risk of attempting suicide later," he warns.
Researchers from universities and university clinics in Heidelberg, Karlsruhe, Landau/Koblenz, Mannheim, Neuruppin, and Ulm have developed an online program to provide quick and flexible help to young people and young adults. Over 700 affected individuals have participated in this.
Whether the program has been effective is now being assessed. The data could be available in early 2025, says Kaess, who coordinates the STAR project.
Thompson has not self-harmed using razor blades or caused burns on her hands for almost a year. She has learned to better manage her emotions and stress. She spends her free time playing with her cats, doing yoga, and reading to keep her mind occupied. "It'll never completely disappear," she admits. But she no longer hides her scars on her arms. "They're a part of me," she says. Accepting this is part of the healing process.
After recognizing the negative influence of online content, Thompson decided to avoid sites that promoted self-harm as a competition. This helped reduce her desire to engage in non-suicidal self-injury (NSSI).
The increase in self-harm incidents during the COVID-19 pandemic prompted experts to caution about the potential role of the internet in exacerbating mental health issues, particularly in adolescents.
