Living with the urge : a study exploring the experiences of people who self-injure

Abstract

Increasing rates of self-injury in the United Kingdom coupled with the apparent lack of understanding, highlights a need for research to be conducted in this area. A dearth of research illuminating the experiences of self-cutting, together with increased awareness of the differences in perspective between people who self injure and professionals, also provides a rationale for this study. This study aims to explore the experiences of people who self-injure in order to identify and understand the processes involved in self-cutting, and develop a theory which aids this understanding. A grounded theory approach is used to meet the aim of the study, generating data through in-depth interviews with 10 people who engage in self-cutting. Participants shared their experiences of self-injury emphasising both the meaning and function of cutting for them, and the struggle they face living with the behaviour. Although the experiences of participants were unique to each individual, clear commonalities in experience emerged during data analysis and were explored with subsequent participants,in keeping with the grounded theory method. As data generation and analysis developed, the aim of the study became more focused, resulting in an exploration of the urge to self-injure and how people who engage in self-cutting respond to this urge. Findings relate to the core category, living with the urge and main categories of experience namely underlying urge, triggering the urge, satisfying the urge and resisting the urge. Discussion of the findings offers a substantive theory, asserting that people who self-injure face a paradox of finding it very difficult to live with self-cutting, while simultaneously facing the challenge of living without the behaviour. This paradox can be understood within the context of the core category, living with the urge, a process which begins before the participants start self injuring, continues while they are cutting, through to when they are trying to live without cutting. The discussion contributes knowledge relating to commonalties between self-cutting and the experience of addiction; issues for prevention; repetitive nature of cutting; the relationship between people who cut and their cutting tools; and ultimately highlights how difficult it is for the participants to break-free from the world of cutting. Implications of the findings for health and social care practitioners, and education and training are discussed, and recommendations for research are made.