Self-harm and the positive risk taking approach. Can being able to think about the possibility of harm reduce the frequency of actual harm?

Abstract

Background. This article presents the results of an audit of self-harming across three women's units over a period of 6 years. All three units use a positive risk-taking approach to self-harm whereby the risk that this behaviour presents is considered in an effort to reduce actual harm.

Aims. To explore patterns and frequency of self-harm across three units within a women's service.

Method. Incidents of deliberate self-harm were collected from incident forms completed across the units from 2004 to 2009.

Results. Frequency graphs show a reduction of self-harm over the course of admission, and parametric analyses show that there was a significant difference in the frequency of self-harm during the first and last 3 months of admission.

Conclusions. These results are discussed within a psychoanalytical framework, with particular reference to relational security and the value of positive risk-taking.

Keywords:

• Personality disorder
• self-harm
• women's health

Acknowledgements

The third author, is a member of the NICE Guideline Development Group for Self-harm longer term management. The views expressed in this article are that of the author, not those of the NICE group.

Declaration of interest:

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.