Self Harm: Perspectives from Experience

Perhaps the most important book on self-harm ever to come to print, Louise Pembroke's book, subtitled 'Perspectives from Experience', helps to reduce the mystery and perverse glamour that surrounds this controversial issue. Self-harm is harrowing both for those who go through it and for those who watch while a loved one suffers. To most of us, it is inexplicable. This book attempts to answer the critical question - why? This collection of stories, written by self-harmers themselves, produces a clearer picture of what self harmers go through - how they think and react. This publication is an important text for anyone who has been through self harm or for those who work with them.

About the Author :
The Self-Harm conference was organised in 1989, by Louise Pembroke, then education officer for Survivors Speak Out with the Hackney Federation for Consumers of Mental Health Services. It was funded by Mind and The Kings Fund Centre. Survivors Speak Out is an organisation of people who have survived the psychiatric services. The organisation provides information to individuals and groups who are involved in establishing alternatives to the current services and campaigning against the many abuses within the system.

Review :
Louise Roxanne Pembroke edits this collection of 7 testimonies. She gives a clear and detailed account of treatment she was eventually given for her distress, in a hospital; this led to her first self-harm as she observed cruelty to fellow patients. Senseless diagnoses and descriptions that do not relate to the patients' experience are common to all testimonies. This is not peculiar to self-harm as a coping mechanism, but occurs throughout the system resulting in inappropriate treatments. Those like Maggy Ross, who died in this struggle against a system based on obsolete models of human function, blazon the need to rethink the language in which we are defined, the procedures with which we are treated, and the principles on which mental health care is practised and taught to the next generation. Dysfunction must depend on knowledge of the function that is supposedly 'abnormal'. Maggy said she wanted the chance to get in touch with the child in her, through psychodrama, and understand it from an adult perspective - and a lot of nurturing. She describes the relief, purging, when she sees the blood run; she has deflected the painful memories again. Each experience is different, as is always the way individual people cope with damage, even though there are common elements in the physical mechanisms. Each instance of self-harm has its own history and purpose. Louise is eloquent on the misuse of a convenient term 'attention seeking', borrowed from child development jargon in which it refers to a child's ploys to get desired attention from a carer. How this very useful skill becomes distorted when carers abuse their charge in various ways is part of the clinical misinterpretation. She also points out that many different kinds of altered perception are lumped together as 'hallucinations', and describes the reality of her own experiences. She speaks of alternatives, support groups, advocacy, crisis services, short-term sanctuaries without diagnosis/treatment/drugs/sections; she observes the increasing stress on undergraduates, homelessness, massive debt, and the possibility of unemployment after graduation. Sadly, we live in a society where stress is turned back on ourselves. Andy Smith says, "Major tranquillisers contributed enormously to my need to self-harm. The ability of these 'medicines' to limit one's range of expressions to monosyllabic muttering is astounding." Diane Harrison gives us a vivid poetry portrait of a denied abused child; also the mirroring effect that so often makes it impossible for another person to look lest they see themselves there. Marie, in a Special Hospital , tells us, you get stitched up without any painkilling injections. No one takes any interest in why we do these things. We're just another label and another number. Helen was bullied at school. Before she can stop self-harming she needs to feel self-worth and become assertive. Rosalind Caplin, after long exposure to the shared pain of a punitive regime, is at last making links between inner and outer reality. She sees this searing feeling as having a positive creativity, also her will to live. May we all encourage this 'will to live'.