Psychological Mechanisms of Nonsuicidal Self-Injury:Theoretical Developments and Therapeutic Implications From Traditional to Recent Models
10.18529/psychoanal.2025.36.2.19
- Author:
Jung-hyang MIN
1
Author Information
1. Department of Psychology, Seoul National University, Seoul, Korea
- Publication Type:Review Article
- From:
Psychoanalysis
2025;36(2):19-27
- CountryRepublic of Korea
- Language:English
-
Abstract:
Nonsuicidal self-injury (NSSI) has emerged as a significant clinical concern due to its high prevalence and serious psychological consequences. From a psychoanalytic perspective, NSSI is closely associated with the expression of thanatos and aggressive drives, while ego psychology interprets it as a manifestation of fragile ego functions. Object relations theory connects NSSI to borderline instability, which arises from an inability to achieve object constancy. These foundational concepts have given rise to various psychological models over the past two decades. This review examines the development of theoretical models that ex-plain the psychological mechanisms underlying NSSI and discusses their therapeutic implications. Traditional models, such as the Four-Function Model, Experiential Avoidance Model, and Integrated Model, primarily focus on the functions of NSSI and its role in emotion regulation, emphasizing the concept of negative reinforcement. In contrast, more recent models, including the Emo-tional Cascade Model, Cognitive-Emotional Model, and Benefits and Barriers Model, highlight the interplay between cognitive strategies and emotional responses. These newer models propose a more comprehensive and individualized approach by incorpo-rating cognitive restructuring and barrier enhancement, alongside cognitive and social factors. Currently, there is a lack of “wellestablished” evidence-based treatments for NSSI. Existing interventions primarily target the improvement of emotion regulation skills through Cognitive Behavioral Therapy and Dialectical Behavior Therapy. However, the integration of cognitive and social elements from recent models may facilitate the development of more tailored and effective treatment strategies. Future efforts should focus on the creation of personalized interventions that address individual differences in cognitive expectations and barri-ers related to NSSI and assess their effectiveness.
