The somatization of structural friction: deciphering the surge of adolescent self-harm in post-transition China

In the third decade of the 21st century, the mental health landscape of Chinese adolescence has undergone a profound and disturbing transformation. The dominant clinical idiom of distress has shifted from the passive, fatigue-based somatic complaints of "neurasthenia" (shenjing shuairuo) common in the late 20th century, to active, tissue-damaging behaviors, specifically non-suicidal self-injury (NSSI). Recent epidemiological data indicates that NSSI prevalence among Chinese adolescents has risen to levels significantly exceeding global averages, signaling a unique public health crisis that defies standard psychiatric categorization. This perspective article proposes that this surge cannot be adequately explained solely by individual pathology or biological vulnerability. Instead, we suggest it may be more productively understood through the lens of "Structural Friction", the grinding interface between macro-societal stagnation (characterized by neijuan or involution), high-control family dynamics, and the disembodied nature of digital existence. We propose the "Reverse Somatic Anchoring" model to explain the functional mechanism of NSSI in this specific cultural context. Unlike traditional somatization, where the body passively reflects distress, Reverse Somatic Anchoring suggests that adolescents utilize pain to actively "anchor" a drifting self back into biological reality amidst a crisis of ontological erasure. This article analyzes the tripartite engines of this friction, namely socioeconomic, familial, and technological, and argues that effective intervention requires moving beyond symptom management to address the somatic and structural roots of the crisis.