Rethinking self-harm: a psychoanalytic consideration of hysteria and social contagion*

ABSTRACT

This paper discusses the steep increase, in recent years, of self-harm presentations in adolescent clinics in the UK. It explores this increase, particularly evident in adolescent girls, in the context of a number of parallel developments: the gradual desexualisation of psychoanalysis; the dwindling mental health resources after the 2008 financial crisis with the pressures that adds to young people’s stress levels, sense of identity and mental health; the impact of social contagion in adolescents, with both offline and online pressures. The classic psychoanalytic notion of hysteria, as it overlaps with these developments, is suggested as a theoretical and clinical framework to consider for the child psychotherapist working with self-harming adolescents.

KEYWORDS:

• Self-harm
• hysteria
• social contagion
• adolescent psychotherapy
• adolescents
• CAMHS funding cuts

Acknowledgments

I want to thank Mrs Ruth McCall for her support when I wrote the first version of this paper in the context of the MSc in theoretical psychoanalytic studies at UCL in 2003. I also thank Flavia Ansaldo, Ioanna Vrouva, Joshua Holmes, Deborah Marks, Alexandros Ilias and the JCP anonymous peer reviewers for more recent input into this paper.

Disclosure statement

No potential conflict of interest was reported by the author.

Additional information

Notes on contributors

Maria Papadima

Maria Papadima trained as a child and adolescent psychotherapist at the British Psychotherapy Foundation (IPCAPA), after completing a PhD on trauma and psychoanalysis at the Department of Psychosocial Studies (UEL). She currently works at the SAFE clinic, a specialist adolescent team forming part of Enfield CAMHS in North London. Maria has a longstanding interest in therapeutic work with adolescents and their families, building on her pre-training experience of holding an honorary post for two years at the Brent Centre for Young People in London. In addition to her clinical work, Maria has an interest in editing, teaching and writing in her field.