Treating Self-Injury: A Practical Guide

摘要

Self-injury accounts for a huge amount of both general medical and psychiatric input. Attitudes towards individuals who hurt themselves or repeatedly engage in self-destructive behaviour can be exceedingly pejorative - "attention seeking", "not really suicidal", "acting out", "playing games", "manipulative" etc - damaging to individuals and leading to a sense of therapeutic nihilism. It is unsurprising, given the extent and range of this bewildering phenomenon that much of literature focuses on it. As a lecturer to nursing students on self injury, Walsh's book will be both in my reading list for students and in practical material I distribute. Walsh's approach is not only cognitive, though this forms a large part of his treatment strategy, but also examines environmental, biological, affective and behavioural formulations of self-injury. He provides thoughts on body-image work - notably absent from most literature - and some insights into family work, psychopharmacological adjuncts to psychotherapeutic treatment, and on managing the reactions of carers and clinicians to acts of self-injury.