Clare Shaw clareshawconsultancy.co.uk clareshaw.co.uk

 relieving feelings/improving mood  to achieve a sense of control/ power  to feel alive/ connected

 to punish the self/ resolve feelings of guilt and self-hatred  to express distress and/or communicate a need for support

“We all survive in different ways and if self-harm didn’t serve a function then we wouldn’t do it” (Walker 2004)

Self-harm: a dysfunctional or pathological behaviour; a symptom of mental illness or personality disorder or developmental disorder.

Self-harm: a way of surviving and communicating painful emotion arising from difficult experiences

Borderline Personality Disorder (BPD) (called emotionally unstable personality disorder, borderline type in the ICD-10) is a cluster-B personality disorder whose essential features are a pattern of marked impulsivity and instability of affects, interpersonal relationships, and self image. The pattern is present by early adulthood and occurs across a variety of situations and contexts. [1]ICD-10 personality disorderaffectsself image [1]

For a diagnosis of BPD to be made five of the following ‘symptoms’ should be present (DSM- IV 1997):  Instability and impulsivity  Intense interpersonal relationships verging between idealisation and devaluation  Affective instability and reactivity of mood  Inappropriate and intense anger

 Frantic efforts to avoid abandonment  Identity disturbance; unstable self-image  Suicidal and self-mutilating behaviours  Chronic feelings of emptiness  Transient stress-related paranoid ideas

“Positive staff attitudes; along with involvement and information are the most important factors affecting the satisfaction of service users who have self- injured” (Royal College of Psychiatrists 2007)

“[If ] I’d never come into contact with it and someone had validated and helped and cared and loved instead of immersing me in this… I wouldn't have tried to kill myself the second time. Because that’s what it did. If I had died, this would have been the cause as it escalated my suicidality into a realm previously unknown to me. It caused me to feel subhuman. It's lethal”. (Survivor of psychiatry talking about being diagnosed with BPD. Personal correspondence 2009)

Look to the living, love them, and hold on. (Douglas Dunn)