The SASH Research Project:

Social Aspects of Self-Harm

Dr Amy Chandler

Centre for Research on Families and Relationships/Centre for Population Health Science

University of Edinburgh

a.chandler@ed.ac.uk

Overview

• Methods

• Findings:

• Young people explaining why they self-harm

• Young people trying to access help for self-harm

• Barriers and solutions

The SASH Research Project

• Sociological perspective

• Building on earlier, narrative work with adults (Chandler 2012, 2013, 2014)

• 5 in-depth interviews (2 M, 3 F aged 14-17)

• 6 focus group discussions (33 young people: 2 mixed gender, 1 male only, 3 female only, aged 14-16)

• 88 responses to a qualitative online survey

How do young people

explain their self-harm?

• “Coping mechanism”

• Self-punishment

• Expressing emotion

(especially anger)

• Feeling alive

• Feeling better/happy

• Hurt others

• Get attention/help

• Communicate distress

to others

• Repel others/keep

people away

• Addiction

Emotions: managing emotions

“The feeling of being able to just let go for a few moments is absolutely wonderful, even if it results in more guilt afterwards … cutting gives me relief from all the pressure I have to deal with on a daily basis” (Andy, 16, survey)

“I tried healthier methods of releasing my built-up emotions but they would never work…. Now I do it whenever I get the chance, am angry, excited, bored, stressed or sad” (Sidney, 15, survey)

Emotions: happiness?

“I self-harm because I like to see blood flow from my body, it makes me happy (endorphin release)” (Dean, 15, survey)

“I have depression. Self-harm numbs the pain for a while. For some reason it makes me feel happy. Because of my depression I usually feel numb, empty and dead inside. Cutting makes me feel alive” (Leanne, 16, survey)

Emotions: Anger – self/others

“I especially used it if

angry at

someone/something/myself

and I used it a lot when I

was stressed … it becomes

a coping mechanism” (Jay,

16, survey)

“I self-harm because I am

often angry about myself

and don’t know how to deal

with it otherwise” (Vivien,

16, survey)

“I really f***ing hated

myself” (Kevin, 15, survey)

Social context and

emotions

“I hate this shell I’m in

and want to destroy it I

hate me, and I hate what

people did to me and I

want to make them suffer

by seeing me suffer”

(Rachel, 16, survey)

• Abuse/trauma

• Bereavement

• Bullying

• Pressure from

school/parents

• Lack of alternative

‘outlets’

Attention seeking?

“I think of it like this: if you don’t really know them and you know they are self-harming, it’s for attention. If they talk about it openly in front of everyone, it’s for attention [….] but not everyone is doing it to get people’s attention” Greta, 13

“Everyone who self-harms does it for attention it’s a cry for help; its just those who show it off that is attention seeking and wrong it’s a mental illness not a fashion statement” Darcy 14

(What’s wrong with)

attention seeking?

“attention is the wrong word. I think some self-harmers are looking for affection and understanding, definitely, and they might present as slightly attention seeking to the uninformed, but it’s usually with a good reason” Jay, 16.

(What’s wrong with)

attention seeking?

‘I think most people

who self-harm do not

want people to find out,

however it can be a nice

feeling for people to ask

about it because it feels

like they care’ Nick, 17.

What helps?

• Listen, or be available to listen (whatever your role)

• Take young people’s actions and words seriously

“[My teacher] was very helpful because he just came across as if he really cared, and he said he had a lot of respect for me talking to him, which boosted my confidence with talking to people. CAMHS however made me feel like "one of the others" and were kind of patronising with the way they spoke to me, which made me feel as of they didn't care, which didn't help” Katie, 15

What helps?

• Work on your reactions

• Horror

• Disgust

• Minimising

• Ignoring

• Consider supporting and respecting young people’s privacy and autonomy

“I told one of my friends and she thought I was joking and called me an emo, I few months ago I told someone at school and she told my parents behind my back; that's when my parents found out. they didn't understand and started shouting at me, eventually they just left it and acted like nothing happened. I felt hurt on all these times and I felt betrayed” Cara, 14

What helps?

Be conscious and critical of

the view that self-harm

is/should be ‘private/secret’

…

and that if it is not it might

be ‘attention-seeking’

Further reading

• Adler, P., & Adler, P. (2011). The Tender Cut: Inside the Hidden World of Self-Injury. New York: New York University Press.

• Brossard, B. (2014). Fighting with Oneself to Maintain the Interaction Order: A Sociological Approach to Self-Injury Daily Process. Symbolic Interaction, 37 (4), 558-575.

• Chandler, A. (2012). Self-injury as embodied emotion-work: Managing rationality, emotions and bodies. Sociology, 46(3), 442-457.

• Chandler, A. (2013). Inviting pain? Pain, dualism and embodiment in narratives of self-injury. Sociology of Health & Illness, 35(5), 716-730.

• Chandler, A. (2014). Narrating the self-injured body. Medical Humanities, 40(2), 111-116.

• Crouch, W., & Wright, J. (2004). Deliberate Self-Harm at an Adolescent Unit: A Qualitative Investigation. Clinical Child Psychology and Psychiatry, 9(2), 1359-1045.

• Gratz, K. L. (2007). Targeting Emotion Dysregulation in the Treatment of Self-Injury. Journal of Clinical Psychology, 63, 1091–1103.

• Hill, K., & Dallos, R. (2012). Young people’s stories of self–harm: A narrative study. Clinical Child Psychology and Psychiatry, 17(3), 459-475.

Further reading

• Klineberg, E., Kelly, M., Stansfeld, S., & Bhui, K. (2013). How do adolescents talk about self-harm: a qualitative study of disclosure in an ethnically diverse urban population in England. BMC Public Health, 13(1), 572.

• Lupton, D. (1998). The Emotional Self: A Sociocultural Exploration. London: Sage.

• McDermott, E., Roen, K., & Piela, A. (2013). Explaining Self-Harm: : Youth Cybertalk and Marginalized Sexualities and Genders. Youth & Society.

• O'Connor, R. C., Rasmussen, S., Miles, J., & Hawton, K. (2009). Self-harm in adolescents: self-report survey in schools in Scotland. British Journal of Psychiatry, 194(1), 68-72.

• Scourfield, J., Roen, K., & McDermott, E. (2011). The non-display of authentic distress: public-private dualism in young people’s discursive construction of self-harm. Sociology of Health & Illness, 33(5), 777-791.

• Whitlock, J., Powers, J., & Eckenrode, J. (2006). The Virtual Cutting Edge: The Internet and Adolescent Self-Injury. Developmental Psychology, 42 (3), 407-417.

More on the SASH Project

https://sashresearchproject.wordpress.com/