The Functions of Self-harm: A Q-methodology study

Current knowledge on the functions of self-harm understands this phenomenon as serving numerous, complex, contradictory and varied functions for individuals. Using Q-methodology this study sought to explore participant’s subjective viewpoint on the functions of self-harm that are outlined in the current existent academic literature. Q-methodology is a mixed methods approach to the scientific study of people’s viewpoint on a topic (their subjectivity). Using this approach, the current knowledge on the functions of self-harm was presented as a set of statements to people who self-harm. Twenty participants (aged 21-57, 14 female and 6 males) were recruited through the NHS, online forums and a third sector support group. These participants were asked to sort, rank and comment on these functions according to whether they agreed and disagreed with these as a personal reflection of their own functions for self-harm. The Q-methodology factor analytic findings revealed consensus between the participants on some of the functions of self-harm; specifically agreement was evident in self-harm managing negative internal experiences and disagreement was evident in self-harm serving sexual functions. The factor analytic findings also revealed two distinct and statistically robust factors. These two factors allow for an appreciation of differences in degree of agreement and disagreement on some of the functions of self-harm. These differences in viewpoint found that Factor 1 (named ‘increasing the positive’) endorsed positive and validating functions to a greater extent than Factor 2. In contrast, Factor 2 (named ‘removing the negative’) appeared to view the cleansing and self-punishment functions as more relevant. Additionally, Factor 2 also agreed with self-harm as a greater way to switch off memories and terminate depersonalisation. Such findings need to be considered in the context of the study’s strengths and weaknesses yet the findings have clinical implications for people who wish to reduce or stop self-harming. These include the flexible use of the factors as a clinical heuristic or framework during therapeutic assessment and formulation to help guide intervention. Implications are also evident for future research and the current understanding of the functions of self-harm.