The Disclosure of Non-Suicidal Self-Injury: A Qualitative Dyadic Study

The Disclosure of Non-Suicidal Self-Injury: A Qualitative Dyadic Study | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 16 August 2025 V1 Latest version Share on The Disclosure of Non-Suicidal Self-Injury: A Qualitative Dyadic Study Authors : Kassandra Hon , Stephen Lewis [email protected] , Mark Boyes 0000-0001-5420-8606 , and Penelope Hasking 0000-0002-0172-9288 Authors Info & Affiliations https://doi.org/10.22541/au.175533675.50865109/v1 361 views 134 downloads Contents Abstract Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Objectives : The disclosure of non-suicidal self-injury (NSSI) can be critical in facilitating recovery and preventing future NSSI, thus understanding the disclosure process is important. However, the disclosure of NSSI has traditionally been studied through an individual perspective, which falls short of capturing its true interpersonal nature. To address this gap, the current study aimed to qualitatively explore the experience of NSSI disclosure from both the discloser and their recipient’s perspectives. Methods : We conducted semi-structured interviews with 12 dyads ( N = 24, age = 18–45, 78% female) and analysed data using the framework method. Results : Seven themes were present across three stages of the disclosure process: the antecedent factors (relational factors, function of disclosures, anticipated reactions), the disclosure event (social reaction, emotional experience), and the perceived outcome of the disclosure (relational impact, intrapersonal growth). Conclusion : The findings position NSSI disclosures as a relational process wherein disclosers and recipients continuously draw on interpersonal factors to interpret and find meaning in their experiences with the disclosure. The insights from the current study offer important clinical implications for improving support in informal contexts, extend theoretical models of disclosure by accounting for dyadic processes, and demonstrate the methodological value of capturing the disclosure experience from a dyadic perspective. The Disclosure of Non-Suicidal Self-Injury: A Qualitative Dyadic Study Objectives : The disclosure of non-suicidal self-injury (NSSI) can be critical in facilitating recovery and preventing future NSSI, thus understanding the disclosure process is important. However, the disclosure of NSSI has traditionally been studied through an individual perspective, which falls short of capturing its true interpersonal nature. To address this gap, the current study aimed to qualitatively explore the experience of NSSI disclosure from both the discloser and their recipient’s perspectives. Methods : We conducted semi-structured interviews with 12 dyads ( N = 24, age = 18–45, 78% female) and analysed data using the framework method. Results : Seven themes were present across three stages of the disclosure process: the antecedent factors (relational factors, function of disclosures, anticipated reactions), the disclosure event (social reaction, emotional experience), and the perceived outcome of the disclosure (relational impact, intrapersonal growth). Conclusion : The findings position NSSI disclosures as a relational process wherein disclosers and recipients continuously draw on interpersonal factors to interpret and find meaning in their experiences with the disclosure. The insights from the current study offer important clinical implications for improving support in informal contexts, extend theoretical models of disclosure by accounting for dyadic processes, and demonstrate the methodological value of capturing the disclosure experience from a dyadic perspective. Non-suicidal self-injury (NSSI), the deliberate damage to one’s body without suicidal intent, is a serious public health concern (International Society for the Study of Self-injury, 2024). NSSI is a relatively common behaviour, with an estimated lifetime prevalence of 15.7% among the general population and even higher at 20.2% among university students (Deng et al., 2023; Swannell et al., 2014). Alongside the inherent risks of the behaviour itself, NSSI is associated with adverse outcomes, including psychological morbidity, academic underperformance, and later suicidal behaviours (Franklin et al., 2017; Kiekens et al., 2023). Despite the widespread prevalence and clinical significance of NSSI, up to 57% of university students who self-injure have never disclosed their NSSI (Armiento et al., 2014). Given that disclosing NSSI can promote recovery and early support, a growing body of research has focused on understanding the disclosure process (Mirichilis et al., 2024). However, research on NSSI disclosure has yet to explore the dynamics of the disclosure process from both the discloser and their recipient’s perspectives. Understanding the dyadic experiences of NSSI disclosures may be key in conceptualising the disclosure process, ultimately to inform support efforts for people who wish to disclose their NSSI and equip potential recipients with the skills to respond effectively. NSSI Disclosure Self-disclosure, the sharing of one’s experiences of NSSI with others, is a critical step in facilitating recovery (Simone & Hamza, 2020). Positive experiences of NSSI disclosures can catalyse one’s recovery by promoting further disclosures and facilitating access to timely professional support (Hasking et al., 2015). University students who disclose their NSSI have a greater desire to stop the behaviour and view disclosures as key in managing real-time and future urges to self-injure (Simone et al., 2023). Beyond NSSI prevention, online disclosures can increase one’s sense of social support and reduce stigma, ultimately contributing to greater self-acceptance (Lewis & Seko, 2016). Conversely, concealing NSSI often poses a major stressor, leading to negative self-belief, psychological distress, and strained social relationships (Simone & Hamza, 2020). Stigma is the primary barrier to disclosing NSSI, with stereotypes of the behaviour being attention-seeking and manipulative, leaving many to conceal their NSSI for fear of shame and negative social reactions (Simone et al., 2023). Although evidence often supports the benefits of disclosing over concealing the behaviour, NSSI disclosures may entail negative social reactions such as discrimination and rejection (i.e., public stigma; Simone & Hamza, 2020). Such reactions can adversely impact psychological well-being (e.g., induce shame), discourage support-seeking, and worsen the sense of isolation often already present among people who self-injure (Fisher et al., 2017; Simone & Hamza, 2020). Beyond public stigma, people who self-injure may internalise negative attitudes toward NSSI in the form of self-stigma and anticipated stigma, which presents another major barrier to disclosing and support-seeking (Simone et al, 2023). The Disclosure Experience According to lived experience perspectives, recipients’ responses to NSSI disclosures are central to determining the outcome of the disclosure (Park et al., 2021). Positive responses involve a calm, empathetic approach that expresses a genuine willingness to talk about the discloser’s feelings (Rosenrot & Lewis, 2018). However, not all experiences are positive or lead to beneficial outcomes. Strong emotional reactions, silence surrounding discussions of NSSI, and judgment towards the discloser may reinforce the stigma associated with NSSI and discourage future attempts to disclose and seek support (Park et al., 2021). Despite increased knowledge of what constitutes a helpful versus unhelpful response, many recipients of disclosures feel ill-equipped to respond effectively, leading to poor disclosure experiences and exacerbating the risk of continued NSSI and subsequent suicidal behaviours (Gayfer et al., 2020). A commonly overlooked aspect of NSSI disclosure is the impact that disclosures may have on the recipient. Based on the available evidence, receiving disclosures can broaden one’s understanding of NSSI and strengthen the relationship with the person who disclosed (Simone et al., 2023). However, recipients often report increased anxiety, worry, and fear following their efforts to support the person who has self-injured (Fisher et al., 2017). For many, these feelings were compounded by the lack of NSSI-specific resources (e.g., pamphlets, websites) to help them respond to the disclosure. Despite research consistently demonstrating that discussing NSSI does not increase the likelihood of engagement and may even offer altruistic benefits (e.g., increase awareness on NSSI), there is a common belief that talking about NSSI may increase one’s risk of NSSI engagement (Mueller & Abrutyn, 2015). Accordingly, there have been calls for research to understand if and how NSSI disclosures may impart risk and how these risks may be best managed (Muehlenkamp et al., 2015). Importantly, NSSI disclosure is a transactional process that can impact both disclosers and recipients. Despite this, research on NSSI disclosure has either 1) focused on the sole perspective of the discloser without attending to the recipients’ view (Mirichlis et al., 2024) or 2) focused on the recipients’ perspective without attending to the disclosers’ view (Park et al., 2020). This neglects a critical opportunity to explore the reciprocal nature of disclosures and the specific ways that social interactions and interpersonal correlates may configure the disclosure experience. In practice, disclosing NSSI is inherently a dyadic process. Yet, research on NSSI disclosure has largely overlooked the joint experiences of the discloser and the recipient and how these factors may impact the disclosure outcome. The Current Study To capture the NSSI disclosure process more comprehensively, the current study aimed to understand the experiences of NSSI disclosure from both the discloser and their recipient’s perspectives. Further, we aimed to explore how factors of a disclosure may be perceived differently within and across dyads, and how these perceptions may shape the disclosure outcome. Given the exploratory nature of the study, no priori hypotheses were formed. However, understanding the dyadic experiences of NSSI disclosures may be critical in identifying responses perceived as helpful by both parties. Such knowledge may guide the development of best practice responses to enhance the relevance and impact of future support efforts for people who wish to disclose their NSSI and equip potential recipients with the skills to respond effectively. Method The current study adopted a phenomenological approach guided by Collaco et al.’s (2021) methodological framework for dyadic analysis. This methodology was underpinned by a social constructivist epistemology, which views reality as individually shaped through one’s subjective experiences and social interactions (Burns et al., 2022). Through this perspective, people’s experiences and views of NSSI disclosures are individually constructed and influenced by their social context. Our phenomenological approach aimed to capture these individual perspectives, gathering insight into how people give meaning to their experiences with NSSI disclosures. In line with Collaco et al.’s (2021) framework, we conducted separate interviews with each member of the dyad to capture the dynamics of disclosures whilst preserving the in-depth accounts of each respondent. Central to our methodological framework is its ability to synthesise data from separate perspectives to highlight the interrelations among components of the dyad’s experience with a given phenomenon. This method of analysis shifts from an individual-level analysis to one that accounts for both members of a dyad’s perspectives, which together construct a more complete understanding of NSSI disclosures. The inherent nature of dyadic interviews allows for direct comparisons of the disclosure experience from two perspectives, enhancing the credibility of the research findings (Collaco et al., 2021). Further, we used reflexive journaling and an audit trail to document any methodological and analytical decisions to enhance the credibility and dependability of the research findings. Positionality Statement Our research team comprises four researchers with backgrounds in psychology. Collectively, our work focuses on understanding the experiences of NSSI, especially relatively underexplored topics such as disclosure and stigma. Each member of the team brings personal or professional experience related to NSSI, either through having disclosed their own experiences of NSSI or having received disclosures from others. These experiences shape our sensitivity to the emotional and relational complexities involved in NSSI disclosure, and inform our commitment to conducting this research ethically with empathy and compassion. Participants Following ethical approval from the University’s Ethics Committee, the study was advertised to the university’s undergraduate participant pool. Any student who had ever voluntarily disclosed their NSSI was eligible. These participants were asked to invite someone to whom they had disclosed their NSSI to also participate in a separate interview. In total, 12 discloser-recipient pairs ( N = 24) participated in the study. To minimise breaches of internal confidentiality (where participants may recognise their partner in our descriptions), demographic details are intentionally kept brief. Disclosers and recipients were predominantly aged 18-25 years and consisted of people identifying as male, female, and non-binary, with representations from Western, Asian, and African cultures. The nature of relationships included friend, romantic partner, mentor, mother, father, cousin, and ex-partner. Procedure After providing informed consent, the first author interviewed the discloser-recipient pairs separately about their experience with NSSI disclosures. Two tailored semi-structured schedules were used to explore the process of disclosing NSSI or receiving a NSSI disclosure (see Appendix A). These schedules were developed dyadically to ensure specific topics were explored among dyads while also providing flexibility to probe relevant responses. To gather insight into the disclosure process, we focused on the antecedent factors, the disclosure event, and the perceived outcome of the disclosure. Participants were asked to reflect on the disclosure experience specific to their chosen partner. Interviews took approximately 60 minutes each and were audio recorded, transcribed (with identifying information deleted), summarised, and sent for member checking to ensure accuracy. All participants received resources with information on NSSI and available support services. Dyadic Analysis Our analysis was guided by Collaco et al.’s (2021) methodological framework for dyadic analysis, which allowed us to explore the experiences of NSSI disclosure within and across dyads. This methodological approach includes familiarisation with the data, identification of broad themes, and coding of themes within each transcript. Data were mapped into a matrix with a row for each participant and a column for each theme for analysis. Ideas discussed within each interview were charted, maintaining concepts and language used by participants. Charts were refined through an iterative process that involved continuously re-reading the transcripts and comparing the themes against the raw data. Categories were defined and reviewed using an iterative process, capturing meanings attributed by participants, enabling us to identify patterns within and across dyads. Dyadic codes were developed based on the themes and subthemes for each dyad. This stage involved exploring 1) the extent of agreement between the dyad’s experiences, 2) how each theme impacted each member of a dyad, and 3) how each member of a dyad appraised the disclosure process. New codes were generated to capture these dyadic codes, and themes were developed to reflect the codes. Transcripts were continuously revisited and coded into themes and subthemes to ensure a comprehensive analytical approach. The final themes were used to form a working analytic framework, which was applied across each dyad by indexing all dyadic codes under a relevant overarching theme in the framework. Results We identified seven major themes as salient in participants’ experiences with the NSSI disclosure process. The themes are structured under the key research foci: 1) antecedent factors, 2) the disclosure event, and 3) the perceived outcome of the disclosure. In the cases presented below, we use descriptions and quotations from participants who disclosed their NSSI and their recipients to exemplify how each theme was constructed from the data. To minimise breaches of internal confidentiality, each discloser and recipient has been assigned a unique identifier that does not correspond to their partner. For the same reason, gender-neutral pronouns are used throughout. Antecedent Factors Antecedent factors refer to characteristics that precede a disclosure. Within this theme, there are three subthemes that apply across disclosers and recipients alike. These include the role of relationships, the function the disclosure serves, and the anticipated reactions to the disclosure. Such factors are important considerations that shape one’s decision to disclose. The Role of Relationships Both participants who disclosed and those who received those disclosures discussed the role of relational factors in the decision to disclose NSSI. Specifically, when asked about the factors involved in the decision to disclose, both disclosers and recipients highlighted the importance of trust, openness, and emotional safety. For example, Discloser 9 recounted, “ I trusted them with a lot of information, whether it was about my personal life or mental health. They’re always open to listening to me, and that just strengthened the level of trust and emotional connection we have with each other. ”. Supporting this, Discloser 10 stated, “ The sense of emotional safety developed to the extent that I felt comfortable opening up about my personal experiences with self-injury .”. Similarly, participants who received disclosures discussed the role of relational factors such as trust in facilitating one’s decision to disclose NSSI: “Prior to them disclosing their self-injury, our relationship had a foundation built on a lot of trust. We don’t feel that element of judgment. We can openly talk about anything. That’s why they told me about their self-injury.” [Recipient 2]. In a similar line of thought, these participants also perceived a lack of trust and openness as a barrier to disclosing NSSI. However, as seen in Recipient 10’s experience, overcoming those barriers cultivated a shift towards disclosures; “ They were not open about [their self-injury] at first. But once we passed that stage, they understood me more. They found trust in me, so they started to open up a bit more. But before, they tried to hide it .” Function of Disclosure Disclosers and their recipients often shared similar views regarding the reasons behind NSSI disclosures. The function of NSSI disclosures can be mapped onto an intrapersonal-interpersonal continuum, with self-expression on the intrapersonal end and relationship development on the interpersonal end. Disclosers driven by self-expression often described disclosing as a way to “ get it off my chest ” [Discloser 1], with others elaborating on this by saying, “ I need to just get it out and vent it out. The more I do that, the more I’ll feel better ” [Discloser 4]. Participants who received disclosures shared similar views, acknowledging the disclosers’ need to express their emotions: “ From my understanding, talking about something makes you feel less alone, and maybe talking about it allowed them to share the pain so that it’s not something that’s built up emotionally inside of them .” [Recipient 2] Participants who disclosed to strengthen relationships sought to increase the relational intimacy with the person to whom they disclosed: “ I wanted to tell them more about myself to help them know me better so we can move forward with our relationship ” [Discloser 2]. According to Discloser 11, “[Self-injury] is part of me, and who I’ve become. If I want my relationship to develop, I actually have to allow myself to be a person who my partner knows entirely ”. Similarly, recipients noted relational development as a key tenet underlying their discloser’s desire to share their NSSI: “ I think a big reason why they told me was to be open about their past and to feel accepted for who they were. That was important in strengthening our relationship .” [Recipient 2]. Discloser 9 also discussed how sharing their NSSI was a way to see how their recipient would react so they could “ understand them more” and “ learn more about their character ”, which was important in progressing the relationship. Anticipated Reactions Both participants who disclosed and their recipients acknowledged the importance of considering the anticipated reactions to disclosing NSSI. Disclosers’ anticipated reactions were dependent on their relationship with their recipient, such that those with a supportive relationship with their recipient anticipated them to respond in a supportive and non-judgmental manner. At times, disclosers’ anticipated outcomes were informed by the recipients’ reactions to similar topics (e.g., mental health) and knowledge of the recipients’ own lived experience of NSSI; “ Based on my past experiences with sharing things of a similar nature, there was no doubt in my mind that the information would be completely safe with them. There was no fear of judgment.” [Discloser 9] and “ We both had experiences with [self-injury], so I knew they would understand and not judge me. There was a sense of security knowing they went through the same thing and could understand what I was going through ” [Discloser 4]. Many participants who had disclosed spoke of the intense fear of being perceived differently or judged for their NSSI, despite acknowledging the potential for their recipient to respond positively. In these instances, the expectations were typically grounded in socialised beliefs of NSSI and stemmed from stigmatising views of NSSI held by society. Participants’ concerns regarding anticipated stigma were rarely discussed in the context of their recipients and generally reflected the disclosers’ self-stigma from various sources. For example, Disclosers 7 and 9 expressed concerns about anticipating stigma and being perceived as “ weak ” or “attention-seeking” due to the negative portrayal of NSSI in media, social outlets, books, and observations of stigma towards other people who have self-injured. Despite the strong pertinence of anticipated stigma in the decision to disclose NSSI, it was often overlooked from the recipients’ perspectives. Rather, participants who were disclosed to commonly believed their relationship fostered a safe and non-judgmental space, which was sufficient for disclosers to openly share their experiences with NSSI. For example, Recipient 5 noted, “ I don’t think there’s anything they can’t tell me because they knew they could always talk to me ”, and “ There’s nothing that actually stopped them from telling me about [their self-injury], we can always have reasonable discussions about anything .” These contrasting perspectives indicate that people who receive disclosures often underestimate the challenges that people who self-injure experience when disclosing their NSSI. It further demonstrates the pervasive impact of stigma surrounding NSSI. The Disclosure Event Social Reaction toward Disclosure Participants who received disclosures of NSSI responded in a variety of ways; some took action to help facilitate the discloser’s recovery, whilst others reacted in ways that were deemed less helpful (e.g., strong emotional reactions). Disclosers’ and recipients’ perceptions of what constitutes a helpful or unhelpful response were mostly congruent. When recounting what aspects of the recipients’ response were helpful, many described the importance of providing a safe, non-judgmental space. Often, this was achieved through active listening, providing support, and conveying empathy toward the person who had disclosed: “It was helpful that they didn’t treat me like I was fragile. It was important for them to take a step back and listen. It allowed me to talk and provided that safe space to continue sharing my experiences to the extent I felt comfortable”. [Discloser 4] Participants who were disclosed to often put themselves in the discloser’s perspective and responded in ways they wished others to respond if they were to disclose personal topics. Although not in the context of NSSI, these participants also discussed how past experiences with broader disclosures shaped their response to the disclosure of NSSI. This was apparent from Recipient 2, “They’re not looking for a solution. They’re just looking for someone to listen to them. I kept that in mind when they disclosed their self-injury to me.”. When asked about the reasoning behind their response, Recipient 2 said , “I just reacted in a way that I would want others to react if I told them about personal stuff ”. While many recipients of the disclosures provided space for the discloser to steer the conversation, others took a different approach by providing more tangible steps or advice. Participants who disclosed often described feeling supported when their recipient encouraged them to seek professional support or contact them if they had future urges to self-injure. However, there was some divergence between disclosers’ perspectives when recipients leaned into a protective role through active efforts to stop them from self-injuring. These protective behaviours took the form of removing the means to engage in NSSI or constantly checking in with the discloser. Some found this to be a positive reaction; “ They stopped me from self-injuring by taking away different things. So, in a way, it did help ” [Discloser 10]. In other cases, these protective actions were met with resistance. Based on what disclosers shared in the current study, ceasing NSSI was never their primary goal of disclosing. Therefore, the recipient’s desire to stop the behaviour often left participants who disclosed feeling misunderstood and invalidated. These contradictory perspectives provide another example in which recipients underestimate the difficulties associated with disclosures by seeking to stop the behaviour without consideration of the function it serves (e.g., regulating emotions). Over time, this dynamic can contribute to emotional distance between disclosers and their recipients. For example, Discloser 6 responded by acting more secretively and refusing to discuss their NSSI with the recipient for some time, “ they struggled to understand why I would do that to myself. It was hard for both of us, and we ended up not talking for a bit ”. As the relationship between the pair became further estranged, the discloser reported feelings of sadness, isolation, and worthlessness. Emotional Experiences of NSSI Disclosures In exploring the emotional experience of NSSI disclosures through a dyadic lens, it was evident that participants who disclosed and their recipients had vastly different emotions attached to the disclosure event. Participants shared three emotional experiences that illustrate the nuanced emotional experiences unique to dyadic analysis: emotional relief, emotional toll, and the role of preparedness. Emotional Relief. Emotional relief was a recurrent theme throughout the disclosers’ recollection of the disclosure event. Many participants who disclosed described the emotional burden of concealing their NSSI, the fear of burdening their recipient, and the constant fear of receiving a stigmatising response for their NSSI. These factors left disclosers feeling conflicted in their decision to tell others about their NSSI. However, upon receiving a helpful and non-judgmental response, many described experiencing a great sense of relief: “ I definitely felt relief getting that information out there because when talking about my self-injury, it didn’t feel as emotionally heavy as keeping a secret. I definitely felt the release of pressure and a bit of catharsis.” [Discloser 9] Despite the initial fear of disclosing, many participants who disclosed their NSSI described how the positive response increased their confidence to disclose their NSSI in the future. For some, disclosing was perceived as therapeutic, as it allowed them to express their experiences with NSSI to a safe and supportive person. Some spoke of the relief in knowing they had someone who understood and accepted them. At times, this cultivated a safe atmosphere where participants felt comfortable reaching out to the recipient to manage future urges to self-injure. Through this, many participants who disclosed their NSSI described how they were able to successfully resist engaging in the behaviour. Upon reflecting on the disclosers’ perspective, recipients discussed the release of ‘built-up emotions” from sharing such a personal detail of their life. In terms of experiencing emotional relief themselves, recipients described the sense of relief in knowing the discloser was comfortable enough to share their experiences with NSSI. For example, Recipient 2 noted, “I felt satisfied that they could trust me and tell me about [their self-injury]”. Emotional Toll. Disclosers’ and recipients’ perceptions greatly diverged around discussions of the emotional toll of NSSI disclosures. While recipients reported immense fear, sadness, and concern, participants who disclosed their NSSI rarely discussed how psychologically taxing the disclosure was for the recipient. Recipients’ emotions were predominantly rooted in concern for the discloser, with Recipient 12 recalling, “ I was worried and concerned for them and a bit scared and anxious ”. Some described these emotions more intensely: “ It sent me into a state of panic for the whole day; I was crying for weeks. I think after experiencing that, it’s not something you can get used to .” [Recipient 1]. This concern often stemmed from the fear that NSSI could escalate in severity or lead to suicide. These emotions were exacerbated when recipients struggled to fully understand the nature of NSSI, as noted by Recipient 7: “ I was scared, I didn’t know how to help… people have different sorts of coping mechanisms, but [self-injury] was an unfamiliar coping mechanism to me because it just logically doesn’t make sense .” For other recipients, they connected their emotions with motivations to support the discloser: “ Of course, you don’t want to hear your partner doing stuff to hurt themselves. So as much as I hurt to hear them doing something like that to themselves, I was also trying to understand why they did this.” [Recipient 2] The feeling of guilt was also a common theme across disclosers and recipients’ accounts. Some participants who disclosed mentioned the guilt of burdening the recipient with such a sensitive topic. For participants who received the disclosure, many expressed guilt for not recognising the extent to which their discloser was struggling. Recipient 4 recalled, “ I just thought to myself about whether I could have seen this coming, if I should have paid more attention, or if I should have said something earlier ”. Similarly, some described a degree of shock and guilt for how little they really knew about the discloser. Despite many disclosers describing their recipients’ response as ‘perfect’ and ‘just what I needed’, some recipients spoke to the guilt and self-doubt stemming from beliefs that they could have provided a more helpful response. Preparedness in NSSI disclosures . The role of preparedness was key in driving the emotions experienced by disclosers and their recipients, albeit in different ways. The degree of preparedness varied across disclosers, and the outcome differed accordingly. Some described the importance of rehearsing how they would articulate their disclosures and identifying the right time and place for the disclosure to occur. Others spoke about the need to prepare for their recipients’ reactions. Overall, those who felt more prepared to disclose reported the disclosure to be less daunting and more aligned with the outcome they envisioned. Conversely, some participants who disclosed discussed how their lack of preparedness contributed to less helpful outcomes for both them and their recipient: “ I didn’t prepare or replay in my head the potential consequences that would happen. In hindsight, I should have thought about how I would disclose to them in a way that would benefit both of us .” [Discloser 10] Differences were apparent in how disclosers and recipients perceived the preparedness of recipients in responding to the NSSI disclosure. Participants who disclosed rarely mentioned the preparedness of their recipient in responding to the disclosure. Some even alluded that their recipient must have felt prepared, given their competency in responding to previous disclosures of other topics. This was in stark contrast to the recipients’ perspectives, in which most discussed feeling ill-equipped to respond to the disclosure. Recipient 10, like many, stated, “ I don’t think anybody is ever prepared for a conversation like that ”. This was followed by discussions of feeling “ put on the spot ” and a “ loss for words ”. Indeed, recipients often reported not knowing how to respond, leaving them uncomfortable and fearful that they had not provided an appropriate response. Many also expressed the need for more support or resources in responding to disclosures of NSSI. Outcome of NSSI Disclosures Impact on Relationships Disclosers and recipients commonly shared similar views regarding the impact of the disclosure on their relationship. Many believed that the disclosure strengthened the relationship through enhancing the degree of trust and openness. For example, Discloser 2 described, “ It has strengthened our relationship because being able to disclose something so personal to someone, it adds a layer of trust and really builds that emotional connection ”. This theme was also expressed by participants who were disclosed to, with many experiencing greater trust and openness within their relationship following the disclosure: I think now I feel even more comfortable talking about my experiences. Now we can have closer conversations about even more personal stuff, which we’ve already been doing. But I feel like now knowing about their self-injury, I can say or disclose anything about myself as well. [Recipient 1] Although relational impacts were predominantly positive, some dyads discussed how there was no impact on their relationship. In these cases, participants described how their relationship was strong to begin with, which remained unchanged following the disclosure; this was seen in a positive light by both disclosers and their recipients. Recipient 3 recalled, “ Our relationship is literally the same. It’s not different because I don’t see them any differently, and I think that was important for them ”. Akin to this, Discloser 3 said: “I didn’t want them to treat me differently. I just want to be accepted, so them treating me the same way, like nothing changed, is exactly what made it better, which definitely made both of us happier.” However, some participants reported negative impacts on their relationships post-disclosure. In these cases, the emotional toll of learning about their discloser’s NSSI put a strain on the relationship. Recipients reported needing time away from the discloser at the time of the disclosure, given they had not stopped self-injuring despite their best efforts to support them in their recovery. Some recipients also felt as though the relationship became ‘one-sided’ and solely focused on the discloser’s needs. This, at times, contributed to a relationship breakdown: “ I prioritised their needs over mine because I felt that whatever I went through in comparison to whatever they had been through was nothing. I just felt like I should suck it up and prioritise their needs, which meant I just felt undervalued.” [Recipient 3] Growth Following the Disclosure of NSSI Growth in the form of newfound knowledge about NSSI and self-empowerment was common throughout participants’ testimonies. Recipients emphasised how their knowledge regarding NSSI drastically increased following the disclosure. Prior to the disclosure, some admitted to endorsing stigmatising beliefs about NSSI. However, learning about their discloser’s NSSI shifted their understanding of why people may self-injure. The disclosure event also brought about new knowledge that NSSI can happen to anyone, particularly to those who they least expected. This prompted recipients to be more compassionate when communicating about NSSI. Following the disclosure, many recipients also took it upon themselves to read about NSSI to better understand the behaviour and learn ways to support the discloser. For others, the mere disclosure experience contributed to increased understanding of how they should respond to future disclosures of NSSI, as Recipient 1 described: “I realised that I can’t give advice. Back then, I was always like “What is the best advice I can give?, What is the best way to fix this?” Then now, realising that I can’t fix it and they don’t even want me to fix it, they just want me to listen, and that’s it.” From participants who shared their NSSI, many believed that the act of disclosing catalysed their intrapersonal growth and contributed to their recovery. For example, Discloser 2 shared, “I have definitely grown as a person, and I think part of disclosing and sharing my self-injury with others was definitely part of that growth ”. Others expressed how the disclosure prompted them to consider their NSSI in a more compassionate manner; “I never realised why I ever [self-injured] until I was talking to them… In that conversation, I realised I wasn’t crazy for doing it in the first place ” [Discloser 4]. For many, the disclosure of NSSI also contributed to self-empowerment, which was key in preventing the internalisation of stigma and led to a sense of personal fulfilment in supporting others: “The more I disclosed, the more empowered I felt. I disclosed my experience of self-injury, and through that, I have gained so much empowerment. Being able to use my story to help others has empowered me to accept my self-injury and empowered me to not internalise those self-stigmas that I had. I can have more self-compassion and treat myself as I would treat others if they disclose to me.” [Discloser 10] Discussion The current study adopted a dyadic approach to explore the interpersonal nature of NSSI disclosures through the perspectives of both individuals who disclosed their NSSI and the recipients of those disclosures. We identified seven major themes that were present across three distinct phases of the NSSI disclosure process: antecedent factors, the disclosure event, and the perceived outcomes. The current findings position NSSI disclosure as a complex, socially dynamic process, shaped by relational context, emotional preparedness, and societal stigma. While many of the findings align with existing literature, the use of a dyadic approach offered novel insights into the interpersonal dimensions of NSSI disclosures that have been largely overlooked in research focused solely on the individual perspective. One of the most prominent themes across dyads was the central role of relationship quality in the decision to disclose NSSI. Participants who disclosed often weighed the decision to share their experience against concerns about burdening others or altering the relationship dynamic; concerns that have been reported in previous literature (Mirichlis et al., 2024; Rosenrot & Lewis, 2018). This apprehension was similarly reflected in the emotional responses of recipients, who reported feelings of anxiety and worry following receiving a disclosure (Park et al., 2020). However, in relationships marked by trust, emotional closeness, and mutual support, NSSI disclosures were more likely to occur and to be perceived as positive (Simone et al., 2023). The findings indicate that individuals who self-injure may be more inclined to confide in informal supports than in formal ones, in part due to the emotional safety these relationships offer (Simone & Hamza, 2020). Importantly, the fear of anticipated stigma remained a pervasive barrier to disclosing NSSI, even within high-quality relationships. Many participants who disclosed their NSSI described an underlying fear of judgment, rejection, or pathologisation, which persisted despite expectations of a supportive reaction. This fear reflects broader societal stigma and beliefs surrounding NSSI and was often internalised and expressed by participants who had self-injured (Rosenrot & Lewis, 2018). In contrast, recipients frequently underestimated the impact of stigma, assuming that their established relationship with the discloser would buffer against fears of negative evaluation and stigmatisation. This disconnect represents a critical gap in understanding, whereby recipients may fail to appreciate the vulnerability inherent in disclosure, and as a result, may inadvertently respond in ways that reinforce silence or shame (Tan et al., 2024). Although some anti-stigma efforts around NSSI have been initiated (e.g., psychoeducation; Lewis et al., 2019), the present findings highlight the continued need for stigma reduction around NSSI to foster disclosures, as well as increase understanding of the behaviour among potential recipients (Lewis et al., 2019). A key novel insight from this study was the disconnect between disclosers and recipients’ perceptions of preparedness to respond to the disclosure of NSSI. While individuals who self-injured rarely commented on the recipient’s readiness to respond, recipients frequently reflected on their concerns about being underprepared to respond appropriately. In line with current literature, some recipients drew on prior experience or relevant training to navigate the disclosure, but most felt ill-equipped and uncertain about how to provide meaningful support (Fisher et al., 2017). This lack of preparedness not only heightened emotional distress for recipients but can also have negative implications for the quality of support offered (Park et al., 2020). The findings support growing calls for community-level psychoeducation and training initiatives aimed at enhancing the understanding of NSSI and improving lay responses (Mirichilis et al., 2024). Across dyads, the most effective and helpful responses were those characterised by empathy, acceptance, and emotional validation. In line with the current literature, such responses were seen to facilitate open communication and reduce feelings of shame and vulnerability (Tan et al., 2024). Encouragingly, such responses are consistent with clinical best practices for responding to disclosures of NSSI (Klonsky et al., 2011; Lewis & Hasking, 2023; Tan et al., 2024). Indeed, current clinical guidelines underscore the importance of responding to NSSI disclosures with empathy and without judgment and further recommend addressing both the behaviour and the accompanying emotional experiences in a calm, low-key, and validating manner (Lewis & Hasking, 2023; Tan et al., 2024). Based on the current findings, it appears that even in informal settings, emotionally attuned and supportive communication can align with therapeutic principles. This alignment between lived experience and clinical guidance provides support for the broader dissemination of these evidence-based response strategies beyond professional mental health contexts. Finally, while disclosures were generally described as meaningful and, in some cases, a catalyst for growth, the emotional toll on recipients was greater than anticipated. Many described prolonged worry and emotional strain resulting from their support efforts. Although recipients described the psychological toll of these experiences, disclosers rarely acknowledged the burden their disclosure may have placed on others, perhaps due to their own emotional experience or the recipient’s efforts to mask their distress (Fisher et al., 2017; Park et al., 2020). This disconnect points to an important area of concern in which recipients are left to provide critical emotional support in the absence of professional guidance yet may themselves lack the necessary resources or outlets. Further, without adequate preparation or guidance, recipients may feel ill-equipped to respond, increasing the risk of distress and, in some cases, the inadvertent normalisation or social reinforcement of the behaviour (Tan et al., 2024). Thus, the disclosure of NSSI should be understood as a bidirectional process that affects both the individual disclosing and the recipient, both emotionally and relationally. The findings also imply that public health initiatives should focus not only on supporting individuals who self-injure but also on equipping potential recipients with the knowledge needed to respond effectively (e.g., Lewis et al., 2019). Implications The current findings underscore the value of NSSI disclosure when met with positive responses. Participants described disclosure as a turning point, fostering greater self-awareness, emotional relief, and strengthened interpersonal relationships. These outcomes suggest that supporting safe, intentional disclosures may be a promising clinical and preventative target. Structured interventions such as decision-aid tools, which help individuals weigh the risks and benefits of disclosure and plan how to disclose, could be particularly beneficial in this context (Kassandra Hon et al., 2025). Decision-aid tools have been shown to increase disclosure rates, reduce decisional conflict, foster psychological growth, and support disclosure decisions that align with an individual’s values and preferences (Kassandra Hon et al., 2025). Given that self-realisation is also a key component of NSSI cessation (Claréus et al., 2021), decision-aid tools may offer a valuable pathway to facilitating recovery through more positive and empowering disclosure experiences. Moreover, the findings highlight the importance of supporting not only individuals who self-injure but also those in their support networks. Many disclosures occur in informal settings, and recipients are often untrained and unprepared (Park et al., 2020). Interventions aimed at increasing public awareness, reducing stigma, and providing accessible resources for informal supporters may help ensure that disclosures are more likely to result in beneficial interactions and reduce the likelihood of negative outcomes (Gayfer at al., 2018). Our findings also align with the Disclosure Process Model (Chaudoir & Fisher, 2010), which suggests that the response to a disclosure can significantly shape future disclosure behaviour. Participants who experienced validating and empathetic responses were more open to future help-seeking, while those met with silence or discomfort were more likely to withdraw and conceal their NSSI. Promoting positive disclosure experiences may therefore play a critical role in fostering ongoing communication and engagement with support networks. This process also reflects principles of Social Cognitive Theory, which emphasises the role of social learning and outcome expectancies in shaping behaviour (Bandura, 1997). When individuals experience supportive responses to NSSI disclosure, they are more likely to develop positive expectations about future disclosures, thereby increasing the likelihood of disclosing again (Katrina Hon et al., 2025). In contrast, negative experiences can contribute to avoidance and self-concealment, as individuals come to anticipate judgment or harm based on previous interactions. Thus, disclosures appear to be a learned, socially reinforced behaviour informed by interpersonal outcomes (Katrina Hon et al., 2025). Importantly, the study also illustrates the value of adopting a dyadic methodology when examining an inherently interpersonal phenomenon such as NSSI disclosures. By gathering insights from both participants who disclosed and their recipients, we were able to capture the relational dynamics and emotional interactions that shape how disclosures are experienced and interpreted. This approach moves beyond individual-level accounts and emphasises the mutual meaning-making involved in disclosure events. At the same time, the use of dyads highlights the need for recovery and support frameworks to adopt a relational lens that recognises disclosures as shared experiences that can shape both disclosers and recipients in significant and lasting ways. Limitations and Future Research The current findings should be interpreted within the context of the study’s limitations. First, we recruited a volunteer sample of dyadic matched pairs. By virtue of still being in relationships and their willingness to participate in an interview on the topic, the disclosure experiences and relational quality discussed by participants were overwhelmingly positive. Despite relationships generally being of better quality, separate interviews did allow us to gather some negative appraisals of relationships and social reactions. Another potential limitation is the study’s reliance on retrospective accounts of disclosure experiences. Although some participants shared disclosures that happened recently, others recalled experiences that had occurred years ago. Such accounts may therefore be subject to participants’ memory biases or errors in recall. The retrospective design may have allowed time for participants to gain perspectives on their disclosure experience and the relational impact it may have had. However, future studies using real-time or longitudinal methods could capture the disclosure process and its effects more immediately. Extending from the current study, future research should aim to gain a more comprehensive understanding of the role of cultural factors that may influence NSSI disclosure experiences and responses. For example, people from marginalised communities are less likely to seek help for mental health concerns, including NSSI (Ammerman et al., 2021). They also experience less favourable responses when accessing support and seeking help (Narendorf et al., 2018). The current study did not focus on any particular cultural or racial group; rather, it recruited a diverse range of participant identities. Accordingly, future research is needed to specifically explore the intersectionality between NSSI disclosure and marginalised identities, with the aim of further promoting disclosure in these communities. Future research should also explore whether first disclosure experiences differ from subsequent disclosures. This may result in different findings given evidence indicating that the first disclosure experiences are characterised by increased fear of stigmatisation, which can significantly alter the trajectory and approach to future disclosures (Sheehan et al., 2019). Therefore, it is possible that the same response may be perceived differently depending on whether it was the first disclosure experience or not. Examining how the disclosure experiences evolve over time could provide important insight into how best to support individuals throughout the disclosure journey. Conclusion The disclosure of NSSI has traditionally been studied through an individual perspective, which falls short of capturing its true interpersonal nature. Our study presents an important extension to current literature by gathering insight into the disclosure process through a dyadic lens. The findings underscore NSSI disclosures as a relational process wherein disclosers and recipients continuously draw on interpersonal factors to interpret and find meaning in their experiences with the disclosure of NSSI. 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Keywords non-suicidal self injury self-disclosure Authors Affiliations Kassandra Hon Curtin University School of Population Health View all articles by this author Stephen Lewis [email protected] University of Guelph Department of Psychology View all articles by this author Mark Boyes 0000-0001-5420-8606 Curtin University School of Population Health View all articles by this author Penelope Hasking 0000-0002-0172-9288 Curtin University School of Population Health View all articles by this author Metrics & Citations Metrics Article Usage 361 views 134 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Kassandra Hon, Stephen Lewis, Mark Boyes, et al. The Disclosure of Non-Suicidal Self-Injury: A Qualitative Dyadic Study. Authorea . 16 August 2025. DOI: https://doi.org/10.22541/au.175533675.50865109/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. 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