Self-harm in adolescence: A review of psychoanalytical clinical studies

Abstract

Self-harm refers to the act of intentionally causing injuries to oneself. Currently, there is a significant increase in cases of self-harm among adolescents treated in clinical, school, and public health settings. The objective of this study was to gather clinical studies involving adolescents who self-harm in order to gain an understanding of the phenomenon from a psychoanalytic perspective. A narrative literature review was conducted, based on a search of studies from the last 15 years in the Scielo and Google Scholar databases. These studies were written in Portuguese, containing discussions of clinical cases, analysis of reports or interviews, and analyzed from a psychoanalytic perspective. Based on these criteria, 18 publications were selected: nine discussions of clinical cases and nine analyses of reports or interviews conducted in schools, juvenile detention centers, or psychosocial care centers. From a psychoanalytic perspective, self-harm was approached in these studies as a symptom, operating as a drive discharge in the body faced with the impossibility of symbolization. Studies have suggested that self-harm can act as a response to traumatic experiences, as well as to conflicts in family relationships. Cultural, historical, and social factors related to adolescents’ modes of social integration in contemporary times were also highlighted. Regarding psychoanalytic work with self-harming patients, clinical listening and transference management were highlighted as fundamental resources. It was concluded that the psychoanalytic approach contributed to the understanding of self-harm in adolescence as a manifestation characterized by unconscious conflicts, psychological suffering, and cultural issues.