Harm, Interrupted: Self-Injury Narratives and Same Sex Attraction
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This study addresses a significant clinical and social issue: self-injury among gay men. Self-injury can be understood as any act undertaken by the self to cause physical damage to the body without the conscious intent to die. The existing self-injury literature tends to focus on self-injury as a problem for women. That is to say, because more women than men self-injure, research focuses more strongly on their motivations and treatment needs. The literature that explores self-injury as it relates to gay men is not well developed and focuses strongly on suicidality and the risks associated with various self-injurious behaviours. This has produced useful information for some areas of practice such as risk management and public health suicide prevention strategies. What this literature has not done is explore the contexts and meanings of self-injury for this particular group. This study is a narrative inquiry, which explores gay men’s self-injury through their experiences in context. This thesis therefore tells the stories of gay men who participated in the study and reveals their self-injury across a landscape of time, context, experiences and interactions. This study sought to address gaps in available knowledge by examining how gay men are self-injuring and what their self-injury means in the context of a life lived in relationship with self and others. Self-injury for the gay men in this study was enacted, according to their stories, through similar methods to those reported for other populations. The men’s stories illustrated how self-injury also helped them to manage their distress and cope with a social world that can be invalidating. Through attending to the similarities and differences in experience, as they are told in the men’s stories, this thesis introduces two narratives that shape the way self-injury is known. The first, the harm narrative, is a conventional plotline derived from dominant explanations of the risk, pathology and irrationality of self-injury. This narrative has allowed stories of self-injury to be told and re-told in clinical and social contexts that foreclose alternative readings of an apparently destructive behaviour. The second narrative presented in this thesis is a moral narrative of self-injury. The moral narrative arises by holding the harm narrative to the margins, while allowing the stories of the men to emerge and be thought about narratively, that is to say their self-injury is viewed as part of a life story that is not simply reduced to harm. The moral narrative for the men in this study operates in two ways. The first is to show how, for some of the men, their self-injurious actions have moral value. The second way is to show how acts of self-injury create moral spaces in which the men are able to experience self-care and caring for others. This moral narrative represents a new way of thinking about self-injury as it occurs and is experienced in context. The thesis concludes with ideas and suggestions for working with gay men and others who self-injure. The suggestions are that nurses defer immediate risk-based responses in order to allow clients to explore the contexts in which their self-injury occurs in order to prevent care from becoming a risk factor for further self-injury. Recommendations for further research are also made, which expand on the insights regarding self-injury and moral narratives, the health care experiences of gay men who self-injure and how self-injury exists in relationship with masculinity.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Item Access Status
Same sex attraction