Skip to the content

Self-harming behaviour: from lay perceptions to clinical practice

Rayner, G and Warner, S 2003, 'Self-harming behaviour: from lay perceptions to clinical practice ' , Counselling Psychology Quarterly, 16 (4) , pp. 305-329.

[img] PDF (Self-harming behaviour from lay perspectives to clinical practice)
Restricted to Repository staff only

Download (134kB)


    Self-harm is a complex phenomena that occurs in many different settings. Multi-factorial explanations predominate in the literature and accounts of treatment reflect this diversity, ranging through psychobiological and psycho-social theories.This study aims to identify, describe and interpret some of the accounts and understandings of self-harm from a cross section of the general population and then relate this to clinical practice. Q Methodology is used to explore various competing viewpoints of lay people in understanding and treating people who self-harm. Eight different accounts were produced from the Explanation Q-sort. All but the Biological account described self-harm as a coping strategy, utilized in response to feelings of helplessness following social interaction and were therefore psycho-social in nature. There were four treatment/policy viewpoints that were all psycho-social in nature. These were influenced by humanistic and cognitive types of therapy and were united by the importance of empathy, positive regard and empowerment. These viewpoints are fully explored in this study. Common themes and factors connecting the explanations and treatment Q-sorts are discussed. These findings are then discussed in terms

    Item Type: Article
    Uncontrolled Keywords: Self-harm Self-injury Q-sort methodology
    Themes: Subjects / Themes > R Medicine > RT Nursing
    Subjects / Themes > B Philosophy. Psychology. Religion > BF Psychology
    Health and Wellbeing
    Subjects outside of the University Themes
    Schools: Colleges and Schools > College of Health & Social Care
    Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences
    Journal or Publication Title: Counselling Psychology Quarterly
    Publisher: Taylor & Francis
    Refereed: Yes
    ISSN: 0951-5070
    Depositing User: Dr Gillian Rayner
    Date Deposited: 26 Nov 2009 09:40
    Last Modified: 20 Aug 2013 17:01
    References: ALFORD, B.A., & BECK, A.T. (1997) The Integrative Power of Cognitive Therapy. New York: Guilford Press. ARNOLD, L. (1994) Understanding Self-injury. Bristol: Bristol Crisis Service for Women. ARNOLD, L. (1995) Women and Self-injury, a survey of 76 women. A report on women’s experience of self-injury and their views on service provision. Bristol: Bristol Crisis service for women. ASCH, S.S. (1972) Wrist slashing as a symptom of anhedonia; a pre-depressive state. Psychanalytic Quarterly, 40, 603–613. BABIKER, G., & ARNOLD, L. (1997) The Language of Injury: Comprehending Self-mutilation. Leicester: The British Psychological Society. BALLINGER, B. (1971) Minor self-injury. British Journal of Psychiatry, 118, 535–538. BARNES, R. (1985) Women and self-injury. International Journal of Women’s Studies, 8, 465–474. BECK, A.T., RUSH, A.J., SHAW, B.F., & EMERY, G. (1987) Cognitive Therapy of Depression (3rd edn.). New York: Guilford Press. BOUDEWYN, A.C., & LIEM, J.H. (1995) Childhood sexual abuse as a precursor to depression and self-destructive behaviour in adulthood. Journal of Traumatic Stress, 8, 445–459. BRIERE, J., & RUNTZ, M. (1986) Suicidal thoughts and behaviours in former sexual abuse victims. Canadian Journal of Behavioral Science, 18, 413–423. BRIERE, J., & ZAIDA, L.Y. (1989) Sexual abuse histories and sequelae in female psychiatric emergency room patients. American Journal of Psychiatry, 146, 1602–1606. BROWN, G.L., EBERT, M.H., GOYER, P.F. et al. (1982) Aggression, suicide and serotonin: relationships to CSF amine metabolites. American Journal of Psychiatry, 139, 741–746. BROWN, S.R. (1971) The forced-free distinction in Q-technique. Journal of Educational Measurement, 8, 283–287. From lay peoples’ perceptions on self-harm to clinical practice 327 COOKSON, H.M. (1977) A survey of self-injury in a closed prison for women. British Journal of Criminology, 17, 332–334. COWDRY, R., & GARDNER, D. (1988) Pharmacotherapy of borderline personality disorder. Archives of General Psychiatry, 45, 111–119. COWMEADOW, P. (1994). Deliberate self-harm and cognitive analytic therapy. International Journal of Short-Term Psychotherapy, 9, 135–150. CULLEN, J.E. (1985) Prediction and treatment of self-injury by female young offenders. In D.P. TARRINGTON & R. TARLING (eds) Prediction in Criminology. Albany, NY: State University of New York Press. FAVAZZA, A. (1987) Bodies Under Siege. Baltimore, MD: Johns Hopkins University Press. FAVAZZA, A.R. (1989) Why patients mutilate themselves. Hosp Community Psychiatry, 40, 137–145. FELDMAN, M.D. (1988) The challenge of self-mutilation, a review. Comprehensive Psychiatry, 29, 252–269. FENICHEL, O. (1945) The Psychoanalytic Theory of Neurosis. New York: Norton. FERENCZI, S. (1956) The unwelcome child and his death instinct. In Final Contributions to the Problems and Methods and Psychoanalysis. New York: Basic Books. GARDNER, A.R., & GARDNER, A.J. (1975) Self-mutilation, obsessionality and narcism. British Journal of Psychiatry, 127, 127–132. GUPTA, M.A., GUPTA, A.K., & HABERMAN, H.F. (1986) Neurotic excoriations: a review and some new perspectives. Comprehensive Psychiatry, 27, 381–386. HARRISON, D. (1994) Vicious Circles, an Exploration of Women and Self-harm in Society. London, GPMH Publications, p. 81. INGRAM, R. (1989) Self-inflicted injury. Nursing Times, 85(1), 47–49. JONES, F.H., SIMONS, J.Q., & FRANKEL, F. (1974) An extinction procedure for eliminating selfdestructive behaviours in a 9-year-old autistic girl. Journal of Autism and Childhood Schizophrenia, 4, 241–250. JUREIDINI, J. (1990) Projective identification in general psychiatry. British Journal of Psychiatry, 157, 656–660. KERNBERG, O. (1987) A psychodynamic approach. Journal of Personality Disorders, 1, 344–346. KREITMAN, N. (1990) Research issues in the epidemiological and public health aspects of suicide and para-suicide. In D. GOLDBERG & D. TANTAM (eds) The Public Health Impact of Mental Disorder (pp. 73–82). Stuttgart: Hogrefe & Huber. LANSKY, M. (1988) The subacute hospital treatment of the borderline patient : an educational component. Hillside Journal of Clinical Psychiatry, 10, 24–37. LINEHAN, M.M. (1993) Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: The Guilford Press. LOVAAS, O.I., & SIMMONS, J.Q. (1969) Manipulation of self-destruction in three retarded children. Journal of Applied Behaviour Analysis, 2, 143–157. MARKOVITZ, P., CALABRESE, J., SCHULZ, S. et al. (1991) Fluoxetine in the treatment of borderline and schizotypal personality disorder. American Journal of Psychiatry, 148, 1064–1067. MCKEOWN, B., & THOMAS, D. (1998) Q Methodology. Beverley Hills: Sage. MCKERRACHER, P.W., & WATSON, R.A. (1968) Self-mutilation in female psychopaths. British Journal of Psychiatry, 114, 829–832. MORRISON, E.F. (1987) Determining social and therapeutic rules for psychiatric inpatients. Hospital and Community Psychiatry, 38, 994–995. OFFER, D., & BARLOW, P. (1960) Adolescent and young adult self-mutilation incidents in a general psychiatric hospital. Archives of General Psychiatry, 3, 194–204. PEDERSON, D.R., MORAN, G., SITKO, C., CAMPBELL, K., GHESQUIRE, K., & ACTON, H. (1990) Maternal sensitivity and the security of infant-mother attachment: a Q-sort study. Child Development, 61, 1974–1983. PEMBROKE, L. (1994) Self-harm Perspectives from Personal Experience. London: Survivors Speak Out. ROGERS, C.R. (1951) Client Centred Therapy. London: Constable. 328 Gillian Rayner and Sam Warner ROSENTHAL, R.J., RINZLER, C.,WALSH, R., & KLAUSNER, E. (1972) Wrist cutting syndrome: the meaning of a gesture. American Journal of Psychiatry, 128(11), 47–52. ROSS, R.R., & MCKAY, H.B. (1979) Self-Mutilation. Toronto: Lexington Books, p. 41. RYBACK, R.S. (1971) Self-mutilation during alcoholic amnesia: report of a case. British Journal of Psychiatry, 118, 533–534. RYLE, A., POYNTON, A., & BROCKMAN, B. (1989) Cognitive Analytic Therapy. Chichester: Wiley. SALKOVKIS, P., ATHA, C., & STORER, D. (1990) Cognitive behavioural problem-solving in the treatment of patients who repeatedly attempt suicide. A controlled trial. British Journal of Psychiatry, 157, 871–876. SEDNEY, M.A., & BROOKS, B. (1984) Factors associated with a history of childhood sexual experience in a non-clinical female population. Journal of the American Academy of Child Psychiatry, 23(2), 215–218. SILVER, D. (1985) Psychodynamics and Psychotherapeutic management of self-destructive character disordered patients. Psychiatric Clinics of North America, 8, 357–375. SIOMOPOULOS, V. (1974) Repeated self cutting: An impulse neurosis. American Journal of Psychotherapy, 28, 85–94. SPEARMAN, (1927) The Abilities of Man. New York: Macmillan. STEVENSON, W. (1935). Correlating persons instead of tests. Character and Personality, 4, 17–24. STRICKLIN, M. (1987–1992). Factor Analysis Programs for Q technique, PCQ Version 2.1. TANTAM, D., & WHITTAKER, J. (1992) Personality disorder and self-wounding. British Journal of Psychiatry, 161, 451–464. TRASKMAN, L., ASBERG, M., BERTILSSON, L. et al. (1981). Monoamine metabolites in CSF and suicidal behaviour. Archives of General Psychiatry, 38, 631–636. WALSH, B.W., & ROSEN, P.M. (1988). Self-mutilation: Theory, research and treatment. New York, Guilford Press. WEISSMAN, M.M. (1974) The epidemiology of Suicide attempts, 1960–1971. Archives of General Psychiatry, 30, 737–746. WINCHEL, R.M., & STANLEY, M. (1991) Self-injurious behaviour: A review of the behaviour and biology of self-mutilation. American Journal of Psychology, 148, 306–317. WOLF, M.M., RISLEY, T., JOHNSTON, M. et al. (1967) Application of operant conditioning procedures to the behaviour problems of an autistic child: A follow-up extension. Behaviour Research and Therapy, 5, 103–111.

    Document Downloads

    More statistics for this item...

    Actions (login required)

    Edit record (repository staff only)