A dor que transcende à pele e as marcas que contam histórias: casos de autolesão não suicida na adolescência atendidos em um centro de atenção psicossocial

Abstract

Nonsuicidal Self-Injury (NSSI) is characterized by the act in which an individual resorts to self-inflicted harm without suicidal intent, seeking to alleviate emotional pain through physical pain. It is a phenomenon that emerges predominantly during adolescence. Forms of self-injury vary, such as cutting, burning, or hitting oneself, and cannot be reduced to a single meaning or explanation. As a multifactorial phenomenon, its motivations must be understood from the singularities of each adolescent and from the relational, social, economic, and historical dynamics that shape their experiences. Thus, studying NSSI implies recognizing that the act expresses meanings produced in the encounter between subject, context, and relationships, and not simply a symptom or isolated disorder. This study investigates NSSI in adolescence based on the experiences of adolescents assisted at the Psychosocial Care Center (CAPS II) in Parintins, Amazonas, and on the perspectives of the multidisciplinary team. Anchored in a qualitative approach and in Socio-Historical Psychology, the research employed participant observation, narrative interviews, semi-structured interviews, sociodemographic questionnaires, and field notes. This set of instruments made it possible to capture meanings produced at the intersection of subjective dimensions and the social, cultural, and institutional contexts that constitute the daily lives of the adolescents and the service. The results reveal that NSSI arises as an attempt to generate relief in the face of experiences marked by neglect, situations of violence, grief, family conflicts, and silenced emotional suffering. The narratives of the adolescents “Coração de Ouro” and “Darwin” show how physical pain is mobilized to regulate emotions, create a sense of control, feel oneself, and make their suffering visible. Thus, NSSI is reaffirmed not as an expression of a desire for death, but as a form of resistance and communication in the face of pain. At the institutional level, the analysis of the daily dynamics at CAPS II highlights structural challenges related to high service demand, work overload, and fragile coordination with families. These elements affect the care process but do not overshadow the centrality of the ethical and humanized commitment of the multidisciplinary team. The professionals emphasize the importance of qualified listening, nonjudgmental care, and the construction of bonds that consider the adolescents’ historicity and narratives. The study reinforces the need to understand NSSI beyond pathologization, challenging interpretations that reduce adolescents to diagnostic categories and obscure the social, relational, and cultural dimensions that shape the phenomenon. These challenges intensify in the context of the Amazon region and the diverse adolescences that compose it, particularly regarding access to mental health services. Although the adolescents participating in this study reside in Parintins, it is essential to recognize that mental health care in the Amazon is affected by broader structural barriers, such as long distances between municipalities, reliance on river transport, and resource limitations. These elements must be considered in the formulation of public policies and in the implementation of care practices that strengthen the need to acknowledge the territorial, cultural, and social specificities that shape the lives of Amazonian adolescents.