‘Why can’t you just be fine?’: An autoethnography of self-harm from a lived experience and nursing perspective

Psychiatric discourse problematises self-harm as a psychopathological behaviour indicative of individualistic deficiency. This guides clinical priorities in treatment whilst negating salient components and individual preferences. Conversely, survivor-controlled research emphasises underacknowledged aspects of self-harm, such as its embodied emotionality as embedded within sociocultural context. This suggests a need for re-theorisation. Autoethnography (AE) utilises the researcher as the main source of data to elucidate social phenomena. Through AE, I consider my lived and professional experiences, as a registered general nurse, of self-harm by referring to my medical notes, memory reflections and personal diary entries as contextualised to self-harm literature. This lived experience (LE) perspective of self-harm is derived from subjective experience and contemporary literature, framed within survivor epistemology. This novel understanding argues that people with self-harm may experience immersive, aversive embodied emotionality arising from sociocultural and relational conflict. It considers self-harm as supporting the person to (1) be an integrated whole; (2) employ self-care; and (3) connect with oneself and others. This LE perspective directly critiques dominant psychiatric conceptualisations, instead compassionately framing self-harm as socially implicated. This could improve societal understanding, reduce pejorative attitudes and benefit people with LE.