Self‐disgust and the body as a target in self‐harm and suicidal behavior: A narrative review

Self‐harm and suicidal behavior are commonly framed as failures of emotion regulation, yet the emotions that make the body the target of harm remain under‐specified. This narrative review synthesizes evidence on self‐disgust as a candidate mechanism in non‐suicidal self‐injury (NSSI) and in suicidal ideation and behavior. Self‐disgust is an aversive self‐directed emotion organized around the appraisal of the self, and often the body, as revolting or contaminated. Cross‐sectional studies consistently link self‐disgust with NSSI, suicidal ideation, and suicide‐risk scores, and qualitative accounts place it at the center of some suicidal crises. Longitudinal studies from China suggest it mediates reciprocal links between emotional abuse and suicidal ideation and a path from body‐image concerns to NSSI. Two prospective studies testing different roles did not support them, and the only induction study of self‐harm urges is equivocal. In some studies, self‐disgust explains variance beyond depression and constructs of the interpersonal theory of suicide. Its boundaries with shame and self‐criticism are contested, and, across disorders, associations shrink when other negative self‐referential emotions are controlled for. The central proposal, that the contamination‐and‐elimination logic of disgust explains why distress is enacted on the body, builds on earlier suggestions and remains an untested hypothesis. On this hypothesis, self‐disgust is an embodied emotion whose action tendency of cleansing and removal may correspond to the phenomenology of cutting and, in some people, to a wish to eliminate a self experienced as contaminated. Implications for assessment and intervention, which remain untested, are outlined with falsifiable predictions for research.