The Psychodynamics of Self-Harm

doi:10.1017/9781108686976.020

Chapter 18 - The Psychodynamics of Self-Harm

from Section 1 - Psychological and Psychodynamic Approaches to Psychiatry

Published online by Cambridge University Press: 27 May 2021

Rachel Gibbons

Edited by

Rachel Gibbons and

Jo O'Reilly

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Summary

The act of harming oneself, causing pain, injury and scarring, can in a similar way to suicide appear deeply puzzling. It stands in stark contrast to more acceptable and seemingly understandable urges to protect and care for oneself. Yet violence directed against the self is common, and when an individual is in a disturbed and less rational state of mind, as described in the quote above from A Little Life, this action can seem reasonable. This chapter will explore the motivation, theoretical understanding and management of self-harm, with the aim of increasing understanding and improving outcomes.

Self-harm encompasses a broad spectrum of behaviour that is the ‘final common pathway’ [2] of many different emotional difficulties. Although it is most frequently associated with Emotionally Unstable Personality Disorder (EUPD) the majority of self-harm does not occur in those who have been diagnosed with mental illness of any sort, and as much as 80–90 per cent may not come to the attention of professionals [3]. For some patients, the behaviour is comparatively brief and discrete during a stressful time of life; for others, it is chronic and intertwined with the way they perceive themselves.

Type: Chapter
Information: Seminars in the Psychotherapies , pp. 234 - 246

DOI: https://doi.org/10.1017/9781108686976.020 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2021

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