APT -- eLetters for Nathan, 12 (5) 329-337

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Articles:
Jack Nathan
Self-harm: a strategy for survival and nodal point of change
Adv Psychiatr Treat 2006; 12: 329-337 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

The survivalist nature of self-harm: David M Brunskill (5 October 2006)

The survivalist nature of self-harm 5 October 2006

David M Brunskill,
Senior House Officer in Child and Adolescent Psychiatry
Exeter Rotational Training scheme (Devon Partnership NHS Trust)
Send letter to journal:
Re: The survivalist nature of self-harm

da5idmark{at}hotmail.com David M Brunskill

I thought this article was excellent, informative and thought provoking.I particluarly like the idea of Self-Harm as a relationship and the implications that this has (in terms of stopping the behaviour).
When exploring the reasoning of individuals who self-harm on an almost daily basis, I have become aware of an addictive quality to this behaviour (even to the extent of a possible withdrawal state should a day be missed). I have heard descriptions of Self-Harm as something which is cherished by the individual for being under their control even to the extent it can be planned.
I feel this sentiment is highly relevant to individuals whose early experiences involved traumatic processes way beyond their control. Indeed, this article highlights an individual experiencing ownership of Self-Harm as something which cannot be taken away.
In terms of understanding Self-Harm as a communication, I have wondered whether that as well as being an overt communication (as in the example given in the article), it can also be a covert communication between individuals in that it relates to an unconscious process.
In terms of counter-transference, I agree that being more attuned to to the survivalist nature of Self-Harm can help a clinician to negate responses which are either negative or rescuing, and I thank the author for highlighting this clinical point.