Book contents
- Seminars in the Psychotherapies
- College Seminars Series
- Seminars in the Psychotherapies
- Copyright page
- Reviews
- Contents
- Contributors
- Foreword
- Preface
- Part I Therapy Theory and Practice
- Part II Applied Psychotherapeutic Thinking
- Section 1 Psychological and Psychodynamic Approaches to Psychiatry
- Chapter 13 Psychological Approaches to Affective Disorders
- Chapter 14 Psychological Approaches to Psychosis
- Chapter 15 Personality Disorder
- Chapter 16 Complex Post-traumatic Stress Disorder
- Chapter 17 Psychological Approaches to Medically Unexplained Symptoms
- Chapter 18 The Psychodynamics of Self-Harm
- Chapter 19 Psychodynamic Aspects of Suicide and Homicide
- Chapter 20 Forensic Psychotherapy
- Section 2 Work in Practice
- Section 3 Contemporary Developments
- Index
- References
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
- Seminars in the Psychotherapies
- College Seminars Series
- Seminars in the Psychotherapies
- Copyright page
- Reviews
- Contents
- Contributors
- Foreword
- Preface
- Part I Therapy Theory and Practice
- Part II Applied Psychotherapeutic Thinking
- Section 1 Psychological and Psychodynamic Approaches to Psychiatry
- Chapter 13 Psychological Approaches to Affective Disorders
- Chapter 14 Psychological Approaches to Psychosis
- Chapter 15 Personality Disorder
- Chapter 16 Complex Post-traumatic Stress Disorder
- Chapter 17 Psychological Approaches to Medically Unexplained Symptoms
- Chapter 18 The Psychodynamics of Self-Harm
- Chapter 19 Psychodynamic Aspects of Suicide and Homicide
- Chapter 20 Forensic Psychotherapy
- Section 2 Work in Practice
- Section 3 Contemporary Developments
- Index
- References
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.
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- Seminars in the Psychotherapies , pp. 234 - 246Publisher: Cambridge University PressPrint publication year: 2021