Electronic Letters to:

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]
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Electronic letters published:

[Read eLetter] The survivalist nature of self-harm
David M Brunskill   (5 October 2006)

The survivalist nature of self-harm 5 October 2006
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David M Brunskill,
Senior House Officer in Child and Adolescent Psychiatry
Exeter Rotational Training scheme (Devon Partnership NHS Trust)

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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.