What are “functional social supports” and how do they impact the desire to self harm in individuals who have a history of intentional self harm?

Abstract

Background: Intentional self-harm is a phenomenon which has become an international public health issue around the world, and one which has a extensive financial and social impact within communities. Poor relationship dynamics have been shown in the literature to have a negative impact on the psyche of a person, which is capable of increasing anxiety and decreasing self-esteem, both of which have been shown to be significant contributors to self-harm behaviours. As such, individuals who self-harm have been marginalised within society, and often feel alienated from their peers. In contrast, positive social supports, have been discussed in the literature as potentially being a cost-effective and constructive approach in diminishing reliance on self-harm behaviours. Aims: This qualitative study investigated the aspects of professional, social, familial, and romantic relationships that people who have self-harmed identified as having a positive and constructive impact on their self-harm behaviour. Method: Twelve participants with a history of self-harming behaviours were recruited through free press advertising in primary care and interviewed. The participants ranged in age from 19 to 70 years old, and represented NZ European and Māori from across the Southern region of New Zealand. Findings: This study shows that constructive relationships which positively influence self-harm behaviours are characterised by participants’ perceptions of authenticity in the relationship, and that the other person genuinely cares. This was also what individuals who self-harm need from their health professionals in order to support the adaptation of damaged view of self, and enable formation of functional relationships within society. Based on the results of this study, greater understanding for health professionals, whanau and friends on the relationship needs of those who self-harm can be realised.