Written on the body: Deliberate self-harm as communication

The inability to manage distress would be problematic at any time; but it is especially problematic when distress is accompanied by (or made up of) feelings of rage, cruelty and self-hatred. I will argue here that people who self-harm are communicating rage and hostility to themselves and others in ways that often leave them frustrated and hopeless; and leave professional carers aghast. I will conclude with some ideas about psychological therapies that may help such people; drawing very much upon the work of colleagues in the forensic psychotherapy field: especially Anne Aiyegbusi (2004 Aiyegbusi, A. 2004. “Forensic mental health nursing: Care with security in mind”. In A matter of security: The application of attachment theory to forensic psychiatry and psychotherapy, Edited by: Pfafflin, F. and Adshead, G. 167–192. London: Jessica Kingsley.  Google Scholar]), Anna Motz (2008 Motz, A. 2008. The psychology of female violence: Crimes against the body, 2nd edn, Hove: Brunner Routledge.  Google Scholar], 2009 Motz, A. 2009. Managing self harm: Psychological perspectives, London: Routledge.  Google Scholar]) and Estela Welldon (1992).