Psychopathology: Theory and Practice

28 November 2019 – Dr Maggie Turp

Drawing on infant observation extracts, clinical practice and service user testimony, we will consider both the history and intentionality of acts of self-harm. With regard to history, a well-functioning capacity for self-care is identified as a protective factor in relation to the destructive and self-destructive tendencies that are part of our human make-up. We will endeavour to identify the building blocks of such a capacity within parental care and consider how psychotherapy practice can best address early damage or deficit in this area of development. With regard to intentionality – and bearing in mind that the most common reason given for self-harm is a desire to ‘cope’ – we will consider self-harm as an extreme attempt at self-regulation. Bick’s theory of psychic skin functioning offers a perspective that links self-harm of various kinds to difficulties in the management of the psychic skin boundary between self and others, a perspective that will be explored with the help of clinical examples. We will also consider possible reasons for the gender imbalance in acts of self-harm and the recent increase in incidence among teenage girls.