Behandeling en stigmamanagement bij opzettelijke zelfverwonding: het smalle pad tussen te veel en te weinig interveniëren

Opzettelijke zelfverwonding wordt gedefinieerd als de intentionele directe beschadiging van het eigen lichaam, zonder bewuste suïcidale intentie. De behandeling varieert van gedwongen opname in een psychiatrische instelling (in het Britse Gemenebest), tot een permissieve aanpak zonder behandeling en uiteenlopende behandelingsmogelijkheden er tussenin. Eerst wordt de gepastheid van de mate van interveniëren besproken in functie van verschillende diagnosen. Het tweede gedeelte van het artikel bespreekt het advies dat door hulpverleners verstrekt wordt aangaande de omgang met wonden en littekens en aangaande de mogelijkheden voor een (gewezen) zelfverwonder om het stigma van een deviante identiteit te vermijden. Een rondvraag bij Belgische hulpverleners bracht aan het licht dat velen onder hen adviseren om littekens te verbergen, terwijl er anderzijds aanwijzingen zijn dat niet-verbergen een teken van herstel is. Aangezien verbergen en smoesjes verzinnen ook kunnen leiden tot de instandhouding van een deviante identiteit, wordt gewezen op meer gepaste vormen van stigmamanagement

Self-harming behaviors in prison: a comparison of suicidal processes, self-injurious behaviors, and mixed events

Self-harming behaviors occurring in prison disproportionately consume resources and cause considerable disruption. To date, theoretical paradigms have explained self-injurious behaviors and suicidal processes either via a continuum or dichotomy of self-harm. This current study examines all documented acts of self-harm (n=1,158) occurring in South Carolina's 28 prisons over a 50 month period. We test and find support for a tripartite schema of self-harm; differentiated with regard to suicidal processes, self-injurious behaviors, and a 'mixed group' of self-harming behaviors. These groups of behaviors were distinct with regard to situational variables (i.e. body part targeted, injury severity) as well as institutional responses (i.e., medical treatment needed, employment of suicide protocols). Findings indicate that self-injurious behaviors are likely to result in physical injury and/or hospitalizations

Seeing beyond the battled body - An insight into self-hood and identity from women's accounts who self-harm with a diagnosis of borderline personality disorder.

noBackground: Self-harm (self poisoning and self-injury) is broadly characterised as any act intended to harm one's own body, without a conscious intent to die. Research indicates that when practitioners encounter self-harm they often remain anxious, fearful, frustrated, and challenged about such individuals, principally because they are constrained to understand and respond to self-harm almost exclusively within a problematised discourse (Walker, 2006). That is, a problem that must be diagnosed and contained. Women who self-harm with a diagnosis of BPD are often portrayed as being risky, chaotic and their identity can be unstable. The aim of this study was to examine and explore the subjective experiences of women who self-harm with a diagnosis of BPD. Participants: Four women who had a history of self-harming behaviour with the diagnosis of BPD volunteered for the study. Method: Face-to-face, in-depth narrative interviews were undertaken and were analysed within a framework which drew upon aspects of the ¿performance¿ (Langellier, 1989; 2001) and ¿narrative thematic¿ approaches (Reissman, 1993). Findings: Two of the participant's accounts illustrate how their self-harming appeared to have affected their selfhood and sense of agency. They discuss how the external signs of self-harm may take over their identity and how others communicate and interact with them. Despite the problematic nature of self-harm implications for practice are highlighted which practitioners may draw upon in their work around self-harm