Introduction:
Self-harm research often prioritises quantitative approaches, which do not
facilitate a deeper understanding of the subjective experience and significance
of self-harm. Extant qualitative studies of self-harm have tended to focus on
community samples of self-injurers. Therefore, the current study explored the
accounts of self-harm patients who have engaged in repeated self-harm with a
variety of self-harm methods. The study was intended to build a deeper
understanding of the subjective experience of self-harm, of the meaning of
repetition of self-harm, and of participants’ experiences of medical treatment
of self-harm.
Methods:
The current study involved in-depth interviews
(average duration: 60 minutes) conducted with ten self-harm patients shortly
after discharge and again at three months’ follow-up. Patients were
recruited through liaison psychiatry teams in two hospitals in Cork City,
Ireland. The data were analysed using interpretative phenomenological
analysis, which emphasises individuals’ experiences and the meaning ascribed to
those experiences.
Results:
The major themes that were generated in the
analysis of these participants’ accounts were “long-term vulnerability”,
“self-harm as contextual”, “agency through self-harm”, “self(-harm) as socially
aberrant”, and “road to recovery”.
Conclusions:
For these participants, self-harm was a personal
experience that reflected their own long-term vulnerability and agency, but was
an act that involved social precipitants and adverse social consequences.
Nonetheless, the participants felt that the most recent act had effected change
that allowed them to begin engaging in recovery. The interactions between
interpersonal and intrapersonal aspects of self-harm have implications for psychosocial
interventions to prevent repetition of self-harm, such as hospital management
and psychotherapy.