How self-injury affects psychotherapists: A qualitative study

Introduction

Interpretative phenomenological analysis (IPA) is used to explore how people make sense of their personal and social world, although a search of recent literature suggests that it has not been applied to better understand self-injury (SI). The goal of this paper was to employ an IPA methodology to gain a deeper understanding of the impact witnessing the physical manifestations of SI has on therapists.

Method

The study recruited a purposive sample of nine English-speaking psychotherapists. Questions designed to relate to the participant's experience of witnessing the physical manifestations of SI were piloted with non-participating psychotherapists whose experience matched those of the sample. Individual interviews were conducted by the primary researcher.

Data Analysis

Analysis involved the hermeneutic circle, moving between the part and the whole to capture and record the unique experience of the individual participants. This entailed the following: reading and re-reading the transcripts; initial noting; developing emergent themes; connecting emergent themes; and pattern identification across cases.

Results

Two superordinate themes were identified that encapsulated how participants experienced, perceived and understood their own reactions to clients’ SI presentation. The first, Shock, included the subordinate themes of Controlling reactions, Managing physical revulsion, Therapeutic holding and Revisiting and ruminating. The second, Responsibility, included the subordinate themes of Client responsibility, Professional responsibility, Personal responsibility and Responsibility for hope.

Implications

Implications relate to core training for psychotherapists, the focus on continuing professional development, and the policies and procedures needed to support psychotherapists.