“Starting From Scratch”:An Exploration of the Narratives of the Pathways Leading up to the First Episode of Self-Wounding

Abstract

Self-wounding is part of the self-harm spectrum. As a practice, it is still difficult for most people, clinicians included, to understand and accept, often leading to negative attribution. While there is an abundance of studies investigating the nature and functions of self-harm, means of prevention and treatment options, links with specific diagnoses, association with suicide etc., there has been no research focusing specifically on the first episode. A first episode is by definition a unique event that cannot be reproduced, taking place in between a "before" and an "after" period; ignoring it and the pathway(s) to it, leads to crucial elements continuously being missed. Starting from Scratch, grounded in the user researcher's personal experience of self-wounding, is an attempt at addressing this issue. The study used a qualitative, mix-narrative approach, using first person accounts, with a sample of six men and five women recruited from the community and the local NHS Mental Health Trust. The research found that the first episode is indeed a unique learning event as participants were surprised by the effects of self-wounding (relief of tensions and release of emotions) to the extent that a strong memory was created and used at subsequent episodes. The research also found that narratives were important in furthering our understanding of self-wounding by producing a more accurate and experiential landscape of narrative journeys, where turning points (both positive and negative) could move the story in many directions. Implications for health practitioners include skilled training in self-wounding issues and severing the link with suicide ideation. Key words: self-wounding, first episode, unique event, learning, memory, relief, release, narratives, meaning, journeys. 1EThOS - Electronic Theses Online ServiceGBUnited Kingdo