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Wadman, Ruth and Vostanis, Panos and Sayal, Kapil and Majumder, P. and Harroe, C. and Clarke, David and Armstrong, Marie and Townsend, Ellen (2018) An interpretative phenomenological analysis of young people’s self-harm in the context of interpersonal stressors and supports: parents, peers and clinical services. Social Science & Medicine . ISSN 0277-9536 (In Press)

Abstract

Rationale: Self-harm in young people is of significant clinical concern. Multiple psychological, social and clinical factors contribute to self-harm, but it remains a poorly understood phenomenon with limited effective treatment options. Objective: To explore young women’s experience of self-harm in the context of interpersonal stressors and supports. Method: Fourteen adolescent females (13 – 18 years) who had self-harmed in the last six months completed semi-structured interviews about self-harm and supports. Interpretative phenomenological analysis was undertaken. Results: Themes identified were: 1) Arguments and worries about family breakdown; 2) Unhelpful parental response when self-harm discovered and impact on seeking support; 3) Ongoing parental support; 4) Long-term peer victimization/bullying as a backdrop to self-harm; 5) Mutual support and reactive support from friends (and instances of a lack of support); 6) Emotions shaped by others (shame, regret and feeling ‘stupid to self-harm’); and 7) ‘Empty promises’ - feeling personally let down by clinical services. These themes were organised under two broad meta-themes (psychosocial stressors, psychosocial supports). Two additional interconnected meta-themes were identified: Difficulties talking about self-harm and distress; and Impact on help-seeking. Conclusion: Parents and peers play a key role in both precipitating self-harm and in supporting young people who self-harm. The identified themes, and the apparent inter-relationships between them, illustrate the complexity of self-harm experienced in the context of interpersonal difficulties, supports and emotions. This has implications for improving support from both informal and clinical sources.

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