Countertransference and self-injury: a cognitive behavioural cycle

Rayner, G, Allen, S ORCID: and Johnson, M ORCID: 2005, 'Countertransference and self-injury: a cognitive behavioural cycle' , Journal of Advanced Nursing, 50 (1) , pp. 12-19.

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Countertransference and self-injury: a cognitive behavioural cycle Aim. This paper discusses the emotional, cognitive and behavioural effects of selfinjury on nurses as helpers, and shows the usefulness of a cycle that can affect care provision for this group of people. Background. People self-injure for many different reasons, such as feeling angry, sad, guilty or frightened and these emotions are often linked to feeling helpless, powerless or out of control. Self-injury has often been reported as a coping strategy to gain control. Psychoanalytic and cognitive behavioural concepts have been used to understand why people self-injure and also inform intervention strategies. Unfortunately, negative emotional responses in professionals may interfere with the effectiveness of any therapeutic relationship. Discussion. Negative emotional responses from nurses can affect the way they think about and behave towards clients who self-injure. During clinical supervision or education, nurses’ thoughts can be challenged to become less negative, so that their resulting behaviour can also become less punitive. Non-punitive or more positive behaviour can in turn challenge some of the negative self-beliefs of clients. Conclusions. Knowledge about countertransference when working with people who self-injure may reduce nurses’ negative thoughts and behaviours, which may result in improved client care.

Item Type: Article
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: Schools > School of Health and Society > Centre for Applied Research in Health, Welfare and Policy
Schools > School of Health and Society
Journal or Publication Title: Journal of Advanced Nursing
Publisher: Wiley-Blackwell
Refereed: Yes
ISSN: 0309-2402
Depositing User: Dr Gillian Rayner
Date Deposited: 26 Nov 2009 09:51
Last Modified: 15 Feb 2022 15:36
References: Allen S. & Beasley S. (2001) Suicide/self-harm. In Forensic Nursing and Mental Disorder in Clinical Practice, Chapter 5 (McClelland N., Humphreys M., Conlon L. & Hillis T., eds), Butterworth- Heinemann, Oxford. Arnold L. (1994) Understanding Self-injury. Bristol Crisis Service for Women, Bristol. Babiker G. & Arnold L. (1997) The Language of Injury: Comprehending Self-mutilation. The British Psychological Society, Blackwell Publishing, Oxford. Beck A. & Freeman A. (1990) Cognitive Therapy of Personality Disorder. Guilford Press, New York, London. Clarke L. & Whittaker M. (1998) Self-mutilation: culture, contents and nursing responses. Journal of Clinical Nursing 7, 129–137. Cleary M. (2003) The challenges of mental health care reform for contemporary mental health nursing practice: relationships, power and control. International Journal of Mental Health Nursing 12, 139–147. What is already known about this topic • People self-injure as a coping strategy to deal with difficult emotions and situations. • Nurses’ have found psychoanalytic and cognitive behavioural approaches useful when working with people who self-injure. • Professionals often feel angry, sad, rejected or ‘a failure’ when working with people who self-injure. What this paper adds • Consideration of nurses’ countertransference reactions to people who self-injure. • An illustration of psychoanalytic concepts in cognitive behavioural terms. • A cognitive behavioural cycle for understanding how clients’ and nurses’ emotions, cognitions and behaviours may influence each other. G.C. Rayner et al. 18 2005 Blackwell Publishing Ltd, Journal of Advanced Nursing, 50(1), 12–19 Connors R. (2000) Self-injury: Psychotherapy with People Who Engage in Self-inflicted Violence. Aronson, New York. Davidson K. (2000) Cognitive Therapy for Personality Disorder: A Guide for Therapists. 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