The social life of self-harm in general practice

Amy Chandler, Caroline King, Christopher D Burton, Stephen Platt

Research output: Contribution to journalArticlepeer-review

Abstract

Research engaging qualitatively with clinical practitioners’ understanding of, and response to, self-harm has been limited. Self-harm offers a particularly compelling case through which to examine the enduring challenges faced by practitioners in treating patients whose presenting symptoms are not clearly biomedical in nature. In this paper, we present an analysis of 30 General Practitioners’ (GPs’) accounts of treating patients who had self-harmed. Our analysis demonstrates the complex ways in which GPs seek to make sense of self-harm. Illustrated through three common ‘types’ of patients (the ‘good girl’, the ‘problem patient’ and the ‘out of the blue’), we show how GPs grapple with ideas of ‘social’ and ‘psychological’ causes of self-harm. We argue that these tensions emerge in different ways according to the social identities of patients, with accounts shaped by local contexts, including access to specialist services, as well as by cultural understandings regarding the legitimacy of self-harming behaviour. We suggest that studying the social life of self-harm in general practice extends a sociological analysis of self-harm more widely, as well as contributing to sociological theorisation on the doctor-patient relationship.
Original languageEnglish
Pages (from-to)240-256
JournalSocial Theory & Health
Volume18
Issue number3
Early online date8 May 2020
DOIs
Publication statusPublished - 30 Sep 2020

Keywords

  • self-harm
  • general practice
  • primary care
  • doctor-patient relationship
  • qualitative

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