Trauma, borderline personality disorder, and self-harm : a counselling psychology perspective

• Main Author: Silcock, Caroline
• Published: City University London 2010
• Subjects: 155; BF Psychology
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.520809

This research study aims to explore how self-harm is being constructed within available discursive resources in contemporary western society. A Foucauldian Discourse Analysis was conducted on a sample of professional documents on self-harm and interview transcripts: these included 6 interviews with people who self-harm (or have self-harmed in the past), and a focus group with 5 health professionals working within a residential unit for people who self-harm. The analysis generated three major discursive themes in relation to the object of self-harm within expert text and discourse: pathology (external ‘other’ and internal dysfunction); risk and danger; and choice, addiction and morality. Participants who self-harmed were seen to struggle within available discourses, most notably between utilising a discourse of confession and keeping the behaviour secret within a wider moral discourse of recovery. Using psychological discourses provided a valid reason for self-harm, constructing it as genuine as opposed to attention-seeking, and resulted in more compassionate behaviour from others; but it also created a tension when it resulted in being attached to the person as a label, and as indicative of permanent internal dysfunction and damage. Finally, constructions of self-harm as risk and danger were strongly resisted by participants; however, they were also utilised to construct the behaviour as needing to be taken seriously by health professionals, therefore ‘genuine’, subsequently allowing access to treatment. The struggles evident in the participants’ constructions of their self-harm behaviour were strongly apparent, resulting in a constant shifting between discourses, as each subsequent position was found to be disempowering. Ideas for future research and developments with Counselling Psychology practice are discussed in light of this analysis: particularly the need for psychology to adopt a depathologising approach to therapeutic care and distress, by paying more attention to the social and contextual factors involved, and develop a critical awareness of the powerful impact that language can have upon people’s experiences.