A transitional object for relatedness and self-development—A meta-synthesis of youths' experience of engagement in self-harm content online

Studies report an increase in self-harm, and engagement in risk content online has gained growing attention. This study aims to synthesize qualitative studies on youths' (12–25 years of age) engagement in self-harm content online (SCO). We conducted a systematic database search of studies on first-person experience and included 16 studies. The meta-synthesis resulted in two meta-themes: 1) “Belonging to a community – online engagement with peers who self-harm” and 2) “Self-development – online engagement to get to know myself”. Following Winnicott's (1953) thinking, digital activity is discussed as an extended peer arena with a “transitional” quality – neither completely internal, nor external, and potentially bridging an inner and outer world. Engagement in SCO is discussed as a transitional object or activity that enables relatedness and self-definition – important developmental experiences for the exploration of social roles, borders between self and others and self-identity during adolescence. However, engagement in SCO comes with a risk for deterioration of mental health. Clinicians should ask directly about digital activity and meet those engaged in digital risks with respect.