Interpersonal processes and self-injury: a qualitative study using Bricolage

Abstract

Introduction: Literature on self-injury has recognized the impact on the relationship between clients and staff.

Rationale: There is an absence of a detailed account of interpersonal processes surrounding self-injury.

Aim: A Bricolage qualitative research approach was carried out in the United Kingdom that explored the interpersonal processes surrounding self-injury.

Method: Three pairs of clients and staff were interviewed about an incident of self-injury. The interviews were thematically analysed and then synthesized producing a deeper exploration of the relationship between the client and staff.

Findings: An interpersonal trigger followed by anger and shame, resulted in self-injury to 'numb' these experiences.

Discussion: Self-injury is conceptualized as a safety behaviour to avoid shame and anger and then as a maintenance cycle that traps the client in a reinforcing and rejecting relationship. Staff interviewed were able to reflect with the clients and help them reframe these experiences.

Implications for practice: Mental Health Nurses can work with clients to understand their own interpersonal cycles of self-injury. They can then reflect on their own roles in this process and avoid reinforcing the clients' negative beliefs. WHAT THE STUDY ADDS TO INTERNATIONAL EVIDENCE: This is the first international paper to explore the interconnection between the client and a professional helper in their lived experiences of self-injury.

Keywords: Bricolage; interpersonal processes; self-harm; self-injury; shame.