A Descriptive Study of Feelings of Arrested Escape (Entrapment) and Arrested Anger in People Presenting to an Emergency Department Following an Episode of Self-Harm.
OBJECTIVE
To explore the role of elevated feelings of anger and desires to escape (fight/flight), which are experienced as inhibited, blocked, and arrested (i.e., arrested anger and arrested flight/escape leading to feelings of entrapment). This descriptive study developed measures of arrested anger and arrested flight and explored these in the context of a recent self-harm event in people presenting to a Hospital's Emergency Department (ED).


METHODS
Fifty-eight individuals presenting to an ED following an act of self-harm were recruited. Participants completed newly developed measures of arrested flight, arrested anger and anger with self in regard to self-harm, and suicide intent and depression.


RESULTS
Ninety-three percent of participants presented after self-poisoning. The majority (95%) reported having experienced high escape motivation that felt blocked (arrested flight) with 69% reporting feeling angry with someone but unable to express it (arrested anger). For many participants (53.7%), strong desires to escape from current situations and/or to express anger did not diminish immediately after the act.


CONCLUSIONS
As with many studies, a select group of participants agreed to take part and we did not keep records of how many refused. There are no other validated measures of arrested escape and arrested anger and so for this study, our short item-focused measures rely on face validity.


CONCLUSIONS
Arrested defenses of fight and flight, and self-criticism are common in those who have self-harmed and may continue after acts of self-harm. Many participants revealed that talking about their experiences of escape motivation and blocked anger (using our measures) was helpful to them.
Feelings of entrapment and arrested anger are common in people who self-harmClinicians could benefit from increased awareness and measures of arrested flight and arrested angerDiscussing these concepts and experiences appears to be useful to people who have self-harmedFurther research is needed on how best to help people with such experiences.
Research and Development Centre, Kingsway Hospital, Derbyshire Healthcare NHS Foundation Trust, Derby, UK; Nottinghamshire Healthcare NHS Foundation Trust, University of Nottingham Innovation Park, Nottingham, UK.
Martin
M
Clarke
Cardiff University School of Medicine, Neuadd Meirionnydd, Heath Park , Cardiff , UK.
Kirsten
K
McEwan
Research and Development Centre, Kingsway Hospital, Derbyshire Healthcare NHS Foundation Trust , Derby , UK.
Jennifer
J
Ness
Research and Development Centre, Kingsway Hospital, Derbyshire Healthcare NHS Foundation Trust , Derby , UK.
Keith
K
Waters
Centre for Compassion Research and Training, College of Health and Social Care Research Centre, University of Derby , Derby , UK.
Jaskaran
J
Basran
Centre for Compassion Research and Training, College of Health and Social Care Research Centre, University of Derby , Derby , UK.
Paul
P
Gilbert
anxiety; arrested anger; arrested escape; depression; entrapment; self-criticism; self-harm; shame
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