Time frames and self-hurting: That was then, this is now

In this article, we explore the different time frames through which 25 adults who have used non-suicidal self-hurting throughout their lives evaluate their experiences. Participants in the study on which this article is based were drawn from a non-clinical population recruited mainly through dedicated websites. All were interviewed in 2008 in South London. The participants all used time frames to structure their narratives about their use of self-hurting. Short time frames placed around the act of self-hurting itself let them focus on the immediate effects, including pleasure. Longer time frames enabled them to reflect on the causes of self-hurting, as a way of managing emotions and difficult social situations, and introduced consideration of the risks involved, such as escalation in use and fear of discovery. Looking back through a longer time frame, participants recognised how their use of self-hurting changed over time with some ceasing to use it and others using it less frequently. Reflecting on the use of self-hurting across their life span, some participants expressed regrets, but the majority described it as an important way of coping with intense feelings and intolerable situations, which could be seen as reasonable under the circumstances. Participant’s selection and use of time frames, whether short-, medium- or long-term, orientated towards the past, the present or the future had an important impact on how they assessed the balance between the risks and benefits of this behaviour and the shifting compromises that they made between them. Future research could focus on the use of time frames in different settings and on the likely consequences of choosing short-, medium- or long-term lens for calculating risk. In applied clinical settings it would be useful to find out whether strategies to encourage clients to see their behaviour and construct narratives bracketed by different time frames has therapeutic potential

Accentuate the positive, eliminate the negative? The variable value dynamics of non-suicidal self-hurting

Medical accounts mostly frame non-suicidal self-hurting as an adverse event, the frequency of which has supposedly increased to a current ‘epidemic’ level, and which can be predicted probabilistically in terms of risk factors. This set of presuppositions gives rise to the common stigmatisation of those who present to Accident and Emergency services as a result of self-hurting. It is now being challenged in a small but growing body of social science literature which emphasises the diversity of self-hurting, and its range of socially situated meanings for those who self-hurt, family and health professionals. The present paper contributes to this research strand by discussing the accounts of their self-hurting given by a sample of 25 UK adults who had not been in contact with health or other services for this reason. The analysis focused on three value issues: the positive gains which motivated research participants to self-hurt; their own active efforts to mitigate associated risks; and the longer-term downsides which some respondents identified

Values and health risks: An editorial

This special issue is the second in a four-part series Health Care Through the ‘Lens of Risk’ focussing on risk categorisation, valuing, expecting and time-framing, respectively, and published or to be published in 2012–2013. The present editorial introduces the issue of risk valuing in relation to an interview-based article and five substantial research papers (one appearing in a subsequent issue (14.6) due to space limitations). It will be argued that the notion of ‘adverse event’ projects negative value onto events themselves, directing attention away from the observer's active judgemental role. The relocation of value judgements in the perspectives of social actors allows their potential variability to be more clearly recognised. This issue will be explored in the editorial which introduces papers concerned with hard drug consumption, self-hurting, the community rehabilitation of forensic mental health service users who have committed serious offences against other persons, the treatment of anal cancer and the perspectives of young pregnant women. A common theme linking these papers is the positive valuing of risk-taking officially designated as unacceptable