"It's not avoiding anything": Exploring avoidance in the context of non-suicidal self-injury

Non-suicidal self-injury is a concerning and prevalent behavior, particularly among adolescents and university students. Most theoretical models focus on the role avoidance plays in self-injury but, there is no consensus on what is being avoided. The aim of this study was to gain insight from individuals with lived experience of self-injury to better understand the role of avoidance in NSSI. Thirty-five interviews were conducted with individuals with lived experience of NSSI (18 - 44 years) and analyzed using reflexive thematic analysis. Three themes were developed to address our aim: active not passive; a short term distraction; externalizing inner turmoil. Our analysis suggests that avoidance is not a term that resonates with individuals with lived experience of NSSI. The theoretical and methodological implications of these findings are that we need to use language that resonates with individuals with lived experience and improve the way avoidance is conceptualized.