Context and complexity : counselling psychology, deliberate self-harm and substance misuse
This study aimed to explore the lived experience of the hidden population of young adult males in managing their deliberate self-hann. Semi-structured inten"iews were conducted either face-to-face (n=5) or online (/1=3) with male participants aged between 18 and 26 years old recruited from self-harm message boards online and a newspaper advertisement. Transcripts of the interviews were subjected to an interpretative phenomenological analysis which revealed four superordinate themes reflecting a journey from negative self-evaluation to self-acceptance: the invalidated self, the struggle for control, validation of the selfby others and learning to live with a new self Participants' experiences reflected the use of deliberate self-harm as a means of emotional regulation, however the management of deliberate self-harm appeared problematic from the outset. Despite the behaviour's subjective benefits it also served to increase participants' emotional distress and increase the likelihood of further self-harm. While gender was not an explicit concern participants nevertheless appeared to make an effort to maintain an illusion of self-control to confonn to a male stereotype. Their struggle to manage their own behaviour met with limited success however and it was not until they were able to seek help and support from others that most were able to manage it more effectively. Despite the hidden nature of the behaviour empathic and validating relationships of support and especially reciprocal relationships were a core feature of all accounts. Even after abstinence from the behaviour was achievedparticipants appeared reluctant to abandon the behaviour altogether and keen to maintain self-harm as a last resort if necessary. Participants' experiences appear to reflect the tension between professional priorities and the needs of those who self-harm for autonomy and responsibility for their own behaviour. The study provides a unique insight into the lived experience of young men in managing self-harming behaviour that may help inform counselling psychologists who encounter male self-harm in their practice.
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