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Starting from scratch: an exploration of the narratives of the first episode of self-wounding

Anne-Laure Donskoy (Independent Researcher, based at Bristol, UK)
Rosemarie Stevens (User-Researcher in Mental Health, Independent Researcher, based at Swindon, UK)

Ethnicity and Inequalities in Health and Social Care

ISSN: 1757-0980

Article publication date: 17 June 2013




The purpose of this paper is to present some results of a qualitative study exploring people's memories of the pathways to the first episode of self-wounding. Specifically it will focus on the issue of “suicidality”.


In total, 11 participants, aged between 19 and 50, were described. They were asked to describe their first episode of self-wounding. The interviews were conducted using a semi-structured topic guide. An initial thematic and a subsequent narrative analysis were used to explore the participants’ stories.


The narratives of self-wounding show that the first episode occurs in a complex landscape of interactions between events and emotions. Even when participants were aware of suicidal feelings before self-wounding, the suicidal intention was abandoned as the self-wounding was shown to be an effective method for dealing with distress. For most of the participants the self-wounding was not associated with suicidality but with a strong need to gain or regain control of an emotionally charged and chaotic environment.

Practical implications

Focusing on the first episode of self-harm holds the key to a better appreciation of the underlying meanings of self-wounding as a complex and dynamic experience. It can provide health care practitioners with a new direction to understanding people's individual motivations rather than focusing relying on behaviour generalised assumptions.


This study provides a rare insight into the first episode of self-harm as a unique event. It is also a rare example of publicly funded service-user research with a focus on issues which are meaningful to them.



Donskoy, A.-L. and Stevens, R. (2013), "Starting from scratch: an exploration of the narratives of the first episode of self-wounding", Ethnicity and Inequalities in Health and Social Care, Vol. 6 No. 2/3, pp. 62-76.



Emerald Group Publishing Limited

Copyright © 2013, Emerald Group Publishing Limited

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