title: Emotion and self-cutting: narratives of service users referred to a personality disorder service.
abstract: Theory and existing research suggest that emotion regulation capabilities develop during the formative years. Emotion dysregulation is associated with psychological distress and may contribute towards difficulties such as personality disorder and self-harm. This study aimed to explore the contexts in which individuals' narratives of emotional experience and self-harm developed. Eight participants who cut themselves and were seen by a personality disorder service were recruited. Semi-structured interviews were carried out, and interview transcripts were analysed using a narrative approach. Five temporal themes were generated: 'Seen and not heard', 'A big release … to get rid of all the pain and hurt', 'A vicious circle', 'A different world' and 'Trying to turn my life around'. The findings highlight how early experiences may have led participants to perceive emotions as unacceptable and subsequently suppress emotion in adulthood. Suppression of emotions appeared to be related to appraisals of emotions and to secondary emotional distress. Furthermore, cutting was linked to suppression of emotions as well as negative self-beliefs formed during childhood and reinforced through subsequent experiences. The study emphasizes the need for therapeutic approaches to focus on emotions when working with individuals who self-cut. Furthermore, the findings indicate the need for compassionate and validating health services that may help service users develop more optimistic future narratives.
authors.affiliation: Psychological Therapies Services, Pennine Care NHS Foundation Trust, Ashton under Lyne, Lancashire, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Morris
authors.forename: Jane
authors.initials: J
authors.lastname: Simpson
authors.forename: Mark
authors.initials: M
authors.lastname: Sampson
authors.forename: Frank
authors.initials: F
authors.lastname: Beesley
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D059026:Diagnostic Self Evaluation; D056348:Emotional Intelligence; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D033262:Narration; D010554:Personality Disorders / Q000523:psychology* / Q000628:therapy*; D012017:Referral and Consultation; D012650:Self Disclosure; D016728:Self-Injurious Behavior / Q000523:psychology* / Q000628:therapy*
keywords: Emotion; Narrative Analysis; Personality Disorder; Self-harm