Self-Care Is … A Qualitative Characterization of Self-Care Among Individuals Engaged in Non-Suicidal Self-Injury

Self-care is increasingly recognized as a central aspect of mental health recovery, yet its meaning and enactment among individuals who engage in non-suicidal self-injury (NSSI) remain poorly understood. Existing conceptual models emphasize self-care as behavioral regulation, awareness, and autonomy but may overlook the emotional and relational complexities that shape this process in psychiatric contexts. This qualitative study explored how individuals receiving psychiatric care for NSSI conceptualize and understand self-care in their everyday lives. Twenty-six semi-structured interviews were conducted with twenty-five adults (ages 20-55) currently engaged in self-injurious behavior and receiving outpatient psychiatric treatment in Sweden. The material was analyzed using reflexive content analysis. Six interrelated categories were identified, reflecting self-care as a multidimensional and relational process: bodily and practical maintenance; emotion regulation; strategies driven by cognitive insight; self-directed emotional support and doing what feels good; engagement in work and daily activities; and relating to others. Participants described self-care as an ongoing effort to balance control and acceptance, effort and rest, and independence and connection. Although many articulated a clear understanding of what self-care involved, they often struggled to implement these practices consistently. Self-injury was at times described as a paradoxical form of care-an attempt to manage overwhelming emotions or regain control when other strategies felt unavailable. These findings extend existing frameworks by demonstrating how self-care, within the lived experience of NSSI, entails continual negotiation between vulnerability and agency, and self-criticism and self-compassion. Understanding self-care in this way can inform more compassionate, recovery-oriented, and person-centered approaches within mental health practice.