Citation

Rayner G, Warne T. J. Psychiatr. Ment. Health Nurs. 2015; 23(1): 54-65.

Affiliation

Nursing, Midwifery, Social Work & Social Care, University of Salford, Salford, UK.

Copyright

(Copyright © 2015, John Wiley and Sons)

DOI

10.1111/jpm.12277

PMID

26686549

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Personal experiences of self-injury and staff reactions have been published. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: There is an absence of a detailed account of the interpersonal processes surrounding self-injury within a specific helping relationship. This paper is the first to explore the in-depth relationship between self-injury and shame. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This research identifies a cycle of shame in which people come to expect negative responses from others, which further reinforce their negative beliefs and supports a continuing cycle of harm. Mental Health Nurses may work with clients to understand the interpersonal processes and consequences of their self-injury in the helping relationship. ABSTRACT: Introduction Literature on self-injury has recognized the impact on the relationship between clients and staff. Rationale There is an absence of a detailed account of interpersonal processes surrounding self-injury. Aim A Bricolage qualitative research approach was carried out in the United Kingdom that explored the interpersonal processes surrounding self-injury.

METHOD Three pairs of clients and staff were interviewed about an incident of self-injury. The interviews were thematically analysed and then synthesized producing a deeper exploration of the relationship between the client and staff.

FINDINGS An interpersonal trigger followed by anger and shame, resulted in self-injury to 'numb' these experiences.

DISCUSSION Self-injury is conceptualized as a safety behaviour to avoid shame and anger and then as a maintenance cycle that traps the client in a reinforcing and rejecting relationship. Staff interviewed were able to reflect with the clients and help them reframe these experiences. Implications for practice Mental Health Nurses can work with clients to understand their own interpersonal cycles of self-injury. They can then reflect on their own roles in this process and avoid reinforcing the clients' negative beliefs. What the study adds to international evidence This is the first international paper to explore the interconnection between the client and a professional helper in their lived experiences of self-injury.

Language: en