"I wanted to be proud of myself, not ashamed”: a qualitative investigation of suicide and self-injury inflection points

Inflection points are pivotal moments immediately preceding self-directed violence (SDV; i.e., self-injury and suicide). This study qualitatively examined factors that contributed to halting SDV during inflection points. Participants (N = 166) completing an online survey were community-dwelling adults in the United Kingdom with some form of SDV lived experience. Thematic analysis yielded the following results. The most common themes across SDV inflection points were (in descending order): concern for the negative impact on others (e.g., fear of hurting loved ones), use of adaptive coping methods (e.g., general use of coping skills), physical deterrents (e.g., scarring, pain), social contact (sense of connection in the moment), and concern for negative consequences on oneself (e.g., fear of punishment). Healthy coping skill use contributed to halting both self-injury and suicide. Self-injury inflection points were largely characterized by intrapersonal factors, whereas suicide inflection points were highly interpersonal in nature. Implications for clinical practice, theory, and research are discussed.