Psychological processes and abilities for ceasing sex as self-injury– a qualitative study

Abstract Background The term sex as self-injury (SASI) refers to sexual behaviors that are used as a means of self-injury, with motives such as emotional regulation comparable to other self-injurious behaviors, including burning or cutting the skin. The aim of this study was to explore which psychol...

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Main Authors: Cathrine Apelqvist, Tove Irmelid, Linda S. Jonsson, Cecilia Fredlund
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-07029-2
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author Cathrine Apelqvist
Tove Irmelid
Linda S. Jonsson
Cecilia Fredlund
author_facet Cathrine Apelqvist
Tove Irmelid
Linda S. Jonsson
Cecilia Fredlund
author_sort Cathrine Apelqvist
collection DOAJ
description Abstract Background The term sex as self-injury (SASI) refers to sexual behaviors that are used as a means of self-injury, with motives such as emotional regulation comparable to other self-injurious behaviors, including burning or cutting the skin. The aim of this study was to explore which psychological processes and abilities that made it possible to cease SASI, to contribute to the knowledge that underpins psychological interventions and treatments. Method The study was based on an open-ended questionnaire published on the websites of Swedish NGOs offering help and support to women and youths. In total 196 individuals with experience of SASI were included in the study. The age of the participants was 15–64 years (mean age 27.9 years), and most of the participants were women. Thematic analysis was used for the study, with the preunderstunding of cognitive behavioral therapy treatment and functional analysis. Results Five abilities were seen as important for cessation of SASI; (1) Revised core beliefs about the self which were achieved through new experiences or cognitive restructuring. (2) Evolved emotional competence achieved through understanding or acceptance of emotions or new coping skills. (3) Increased relational competence via new relationship experiences or new communication skills. (4) Acquired meta-perspective through insight and knowledge of SASI. (5) Strengthened psychological empowerment through new relationships to the body and sexuality, transfer of responsibility or norm-critical perspective. Conclusions Based on the results regarding psychological processes, acquired abilities and alternative behaviors, proposals for therapeutic interventions that may activate these processes were discussed.
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spelling doaj-art-7d7a573e90d94dd1a6c7de21c83801862025-08-20T03:45:34ZengBMCBMC Psychiatry1471-244X2025-07-0125111210.1186/s12888-025-07029-2Psychological processes and abilities for ceasing sex as self-injury– a qualitative studyCathrine Apelqvist0Tove Irmelid1Linda S. Jonsson2Cecilia Fredlund3Department of Psychology, University of GothenburgDepartment of Psychology, University of GothenburgDepartment of Social Sciences, Marie Cederschiöld UniversityDepartment of Psychiatry in Linköping, Department of Biomedical and Clinical Sciences, Barnafrid- Swedish National Center on Violence Against Children, Linköping UniversityAbstract Background The term sex as self-injury (SASI) refers to sexual behaviors that are used as a means of self-injury, with motives such as emotional regulation comparable to other self-injurious behaviors, including burning or cutting the skin. The aim of this study was to explore which psychological processes and abilities that made it possible to cease SASI, to contribute to the knowledge that underpins psychological interventions and treatments. Method The study was based on an open-ended questionnaire published on the websites of Swedish NGOs offering help and support to women and youths. In total 196 individuals with experience of SASI were included in the study. The age of the participants was 15–64 years (mean age 27.9 years), and most of the participants were women. Thematic analysis was used for the study, with the preunderstunding of cognitive behavioral therapy treatment and functional analysis. Results Five abilities were seen as important for cessation of SASI; (1) Revised core beliefs about the self which were achieved through new experiences or cognitive restructuring. (2) Evolved emotional competence achieved through understanding or acceptance of emotions or new coping skills. (3) Increased relational competence via new relationship experiences or new communication skills. (4) Acquired meta-perspective through insight and knowledge of SASI. (5) Strengthened psychological empowerment through new relationships to the body and sexuality, transfer of responsibility or norm-critical perspective. Conclusions Based on the results regarding psychological processes, acquired abilities and alternative behaviors, proposals for therapeutic interventions that may activate these processes were discussed.https://doi.org/10.1186/s12888-025-07029-2Sex as self-injuryNonsuicidal self-injurySexual violenceSexual abusePsychological interventions
spellingShingle Cathrine Apelqvist
Tove Irmelid
Linda S. Jonsson
Cecilia Fredlund
Psychological processes and abilities for ceasing sex as self-injury– a qualitative study
BMC Psychiatry
Sex as self-injury
Nonsuicidal self-injury
Sexual violence
Sexual abuse
Psychological interventions
title Psychological processes and abilities for ceasing sex as self-injury– a qualitative study
title_full Psychological processes and abilities for ceasing sex as self-injury– a qualitative study
title_fullStr Psychological processes and abilities for ceasing sex as self-injury– a qualitative study
title_full_unstemmed Psychological processes and abilities for ceasing sex as self-injury– a qualitative study
title_short Psychological processes and abilities for ceasing sex as self-injury– a qualitative study
title_sort psychological processes and abilities for ceasing sex as self injury a qualitative study
topic Sex as self-injury
Nonsuicidal self-injury
Sexual violence
Sexual abuse
Psychological interventions
url https://doi.org/10.1186/s12888-025-07029-2
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