| Summary: | Most interventions in health and social care settings reside within a therapeutic relationship. However if the staff member is experiencing difficult emotional reactions or thoughts this can interfere with the process of caring or helping. Staff and client perspectives are split into different articles by different authors, or within different chapters of a book. This has reinforced the difference between clients and staff. Arguably professionals are increasingly viewed as human beings with their own reactions to events, rather than detached unemotional helpers. However, the reactions of staff are often not linked to clients. Within the literature on self-injury this has not been clearly described. This thesis makes an original contribution to recognising the interpersonal processes involved when a person self-injures. Three pairs of clients and staff were interviewed about a specific incident of self-injury, with a focus on thoughts feelings and behaviours before during and after the self-injury. They were all also asked about helpful and unhelpful interventions. The data from the interviews was thematically analysed and then synthesised. This resulted in specific and common client perspectives and specific and common staff perspectives. Then each of the client and staff dyads were analysed together with a focus on the interpersonal process. This then produced an account of a synthesised process of these two experiences. Themes included description of self-injury as a cycle of shame, which begins as shame avoidance and then becomes a shame eliciting behaviour, based on other peoples' reactions. Staff and clients described similar emotional reactions, thoughts and psychological defences. Projective identification was used as a method of demonstrating the interpersonal processes between the dyads, with some similar and some contrasting internal experiences. These themeswere discussed in depth linking to relevant literature and key implications for practice were then produced.
|
|---|
