1. Self-Injury Presentation This presentation has been kindly contributed to LifeSIGNS by Helen Butterfield. Helen prepared this presentation during her final year of a Psychology degree at the University of Huddersfield. 13 th March 2008

2. The scars remind me the past is real… A presentation on deliberate self – injury and young people’s perceptions of the above

3. This presentation will… First of all outline my main aim. Explain what deliberate self-injury is using background literature. Explain as to why I chose the method I did. Review ethical considerations. Allow for anyone to ask questions.

4. Deliberate self – injury… Please note that for the rest of this presentation deliberate self – injury will be referred to as DSI. The aim of my investigation is to achieve an understanding of how young people view DSI and whether or not there is any stigma attached to DSI.

5. Why is it important to study deliberate self – injury? Previous research in this area has mainly focused on the perceptions of health professionals (doctors and nurses). Why? Because a doctor or nurse will treat people who have issues with DSI and may be the first point of call for someone who’s engaging in DSI. However… Not all self – injurers go to see their doctor due to the negative stigma attached to DSI and they generally treat themselves (Pembroke, 1994).

6. Why are young people important? Young people are the peers of the individuals who engage in the highest frequency of DSI. Therefore, they should take a more sympathetic view towards DSI. If a negative view comes across this may hinder health seeking behaviour. For example, Anna goes to their friend, Ben and confides that they are engaging in DSI. Ben dismisses this as merely ‘attention – seeking’ and Anna does not go for help or tell anyone else. DSI should be viewed as a coping mechanism for the individual.

7. Why are young people important? Continued… A recent LifeSIGNS study found that over 85% of people who engage in DSI felt that their lives would be easier if more people understood DSI. This includes health professionals as there are still some health professionals out there now who see DSI as a ‘fad’ or ‘attention seeking’. It is possible that you will be the first person that someone who engages in DSI turns to… So what do we mean by DSI?

8. What is deliberate self – injury? “…the deliberate destruction or alteration of ones own body tissue without conscious suicidal intent”, (Favazza, 1992, page 18). NO! This definition does not take into account people who have body modifications (i.e., piercings and tattoos) who deliberately alter their own body tissue or people who may injure themselves through an accident. This definition only explains the behaviour of the act.

9. What is deliberate self – injury? Continued… “Self-injury is a coping mechanism. An individual harms their physical self to deal with emotional pain, or to break feelings of numbness by arousing sensation.” LifeSIGNS definition: www.lifesigns.org.uk/what/ It is clear in this definition that DSI is a coping mechanism. It rules out body modifications, suicide, accidents, masochistic acts and cosmetic surgery and focuses on the psychology behind DSI, …relieving emotional distress…

10. It is important to note…...that DSI is only a temporary solution to help with psychological issues and will not resolve the issues, but act as a coping mechanism when the issues become unbearable…

11. Types of deliberate self – injury. “In behaviour such as cutting, burning and hitting, the skin is directly damaged, and this is symbolically meaningful. After all our skin acts as a container for our sense of self and the most primitive parts of our personality, and is also a boundary between ourselves and others, and what is inside and outside ourselves”, (Gardener, 2001, page 33).

12. Types of deliberate self – injury. Continued… Martinson (2005) conducted an on – line poll asking people what their main method of DSI was. 26,940 people responded showing that many people engage in DSI. As you can see the method with the highest response rate was cutting. Method of DSI N° of respondents and % Cutting20, 052 (74%) Scratching3, 698 (14%) Burning1, 387 (5%) Hitting self597 (2%)

13. How can I study DSI? For the purposes of this investigation I have begun interviewing participants about their perceptions of DSI. Please note that I have not begun to properly analyse the data yet.

14. How can I study DSI? Continued… What is in the interview? Section 1 focuses on finding out what the interviewee thinks about DSI. Section 2 relates to previous research conducted on DSI by McAllister, et al (2002) who found that DSI was seen as an attention seeking behaviour. Section 3 is aimed at finding out if the interviewees have a stereotypical perception of DSI and those who engage in the act. Finally, section 4 is very important as it aims to see how the interviewee would react if a close friend/sibling confided in them that they DSI.

15. Analysis of interview transcripts A thematic analysis will be used to analyse the data. Emergent themes will be found in the data, for example, upon conducting the interviews an emergent theme of ‘pleasure’ has already been found in a few of the transcripts.

16. Ethical considerations Because this investigation is focused on a “touchy” subject, participants have been briefed on the subject and completed a consent form. Once the interview was completed helpline numbers were given. The interviewer did not know if the participant engaged in DSI themselves.

17. Conclusions… To conclude it seems that DSI is still a very common coping mechanism used and people do take a sympathetic view towards it. More research needs to be conducted on the perceptions of young people about DSI. Interview method was appropriate for this type of investigation.

18. Need help?? If anyone has been affected by the issues in this presentation then please contact either of the following: Samaritans (www.samaritans.org)www.samaritans.org 08457 909090 LifeSIGNS (www.lifesigns.org.uk)www.lifesigns.org.uk

19. Questions… Does anyone have any questions with regard to the presentation? Thanks for listening

20. Copyright 2008 Helen Butterfield This presentation is the property of Helen Butterfield; Published by LifeSIGNS with permission; You are free to refer to this document for personal use only. No liability is taken for the contents, and LifeSIGNS makes it available to you for information purposes only.