Understanding how self-harm functions for individuals

The study aimed to develop a theory of the possible links between voice-hearing and self-harm.

Twelve semi-structured interviews were conducted with participants living in the community and in a secure forensic setting. All participants had experience of both voice-hearing and self-harm. A grounded theory of possible links was developed from participants’ accounts of their experiences.

All participants described self-harm as way of coping with negative voices and of regulating painful emotions. Some described it as a response to a fear of judgement from others, as a form of control or as a means of seeking help.

The results suggest that there are numerous links between voice-hearing and self-harm. Predominantly, self-harm seems to function as a way to cope with individual voice-hearing experience. Help should focus on triggers to distress and ways to cope. Training for healthcare staff could usefully be provided by service users, focusing on the importance of being non-judgemental. Future research could examine tactile and visual experiences in relation to self-harm too, clinician perspectives on the links between voice-hearing and self-harm, and service user perspectives on the emotional availability of clinicians.