Prairie Women, Violence and Self–Harm

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Self-harm among women is a serious heath concern in Canada. In recent years, the Elizabeth Fry Society of Manitoba, in its work with women in conflict with the law, recognized an alarming increase in the number of women who identify as self-injurers and the need for expanded research and understanding.

Informed by the women's narratives, staff perceptions and accounts, and a review of the interdisciplinary literature, self-harm is defined as “Any behaviour, be it physical, emotional, social of spiritual, that a women commits with the intention to cause herself harm. It is a way of coping and surviving emotional pain and distress, which is rooted, in traumatic childhood and adult experiences of abuse and violence. It is a meaningful action which fulfills a variety of functions for women in their struggle for survival.”

Adopting a feminist approach to research methodology, this study generates new knowledge about self-harm as an important health issue for women. Unlike earlier studies, it demonstrates an equally significant relationship between adult experiences of abuse and self-harm and those in early childhood. This finding represents an important contribution to an interdisciplinary literature on women's health in general as well as in particular contexts, such as correctional institutions.

On the basis of these findings, researchers are able to make specific recommendations for correctional and community staff working with women who self-harm as well as concrete suggestions for policy development. They also highlight the imperative of establishing women-centred policies that account for their unique histories and socio-economic and political circumstances, and the ways in which individual and structural factors contribute to women's ‘choice’ of self-harm as a way of coping and surviving emotional pain and distress.

Considerable insight and understanding have been gained about the needs, supports, and services of women who self-harm while incarcerated and in the community. Special awareness has been attained in these areas regarding the importance of the Aboriginal culture. An important outcome is the examination of helpful and unhelpful responses to self-harm in these two settings.

There is a general agreement that self-harming behaviour is especially prevalent among women in prison. The study findings are significant because they examine critical events in the women's childhoods and adult lives that preceded their involvement in self-harm. These life experiences are typically characterized by poverty, sexism, racism and/or discrimination. Within this broader framework, the researchers examined how some women cope and survive the violence and emotional pain in their lives by self-harming. This approach led to a view of self-harm as a necessary way — although in an unhealthy was — of responding to emotionally distressing and oppressive conditions in the women's lives.

The greatest likelihood of self-harm occurs among women with a history of highly unstable and unsupportive families. This history can include frequent moving and intermittent or permanent placement in foster and group homes; absent, weak or traumatic bonds with primary caregivers (especially the mother); unmet emotional and social needs; childhood abuse and violence, primarily by a partner. The majority of women endured traumatic experiences.

Although institutional staff identity a relationship between highly unstable and unsupportive families and self-harm, they do not report a recognition of the relationship between adult experiences of abuse and violence, and self-harm.

The women express several functions of self-harm which help them cope and survive emotional pain and distress. These include a cry for attention and nurturing, a form of self-punishment and self-blame, a way of dealing with isolation and loneliness, a means of distracting and deflecting emotional pain, a response to an abusive partner, a cleansing and release of emotional pain, an attempt to regain a sense of reality and a felling of ‘being alive,’ a communication or message signifying painful life experiences, and an opportunity to feel a sense of power and control.

The women's perceptions of their needs and the kinds of supports and services they require to address self-harm are complex. They include communication as an avenue to express emotional pain and distress, acquiring a sense of control and empowerment in their lives, attention to issues of both childhood and adult abuse and violence, an understanding about their choice of self–harm as a way of coping with emotional pain and distress, and exploring healthier and safer alternatives, implementing an integrated and comprehensive care plan to promote healing, and a sensitivity to the role of Aboriginal culture in healing.

In general, the most important risk factors identified by the women are personal losses and trauma — such as loss of children, followed by institutional conditions — like segregation. Staff risk factors focus on interpersonal factors and institutional conditions, such as stressful relationships with other incarcerated women and a lack of outlets for them to communicate their distress.

Women in the community emphasize personal factors while community workers identify situational and social factors. The most important factor identified by women is partner abuse, followed by personal loss, isolation and loneliness. The central role of partner abuse in the women's self-identified risks is significant, as it is not highly recognized in existing literature, nor was it identified by staff in either community or institutional settings.

On the basis of these findings, researchers are developing policy recommendations for women who self–harm in both correctional institutions and in the community, and for those who provide services for them. These will be informed by the women's discerning and perceptive reflections about self–harm as well as staff 's professional experiences.

Policy recommendations will consider actions for changing existing paradigms concerning women and self–harm, as well as implementing programmatic change with the empowerment of women as an underlying theme.

Based on the Executive Summary by Debbie Blunderfield for the Prairie Women's Health Centre of Excellence and the Elizabeth Fry Society of Manitoba.

Cathy Fillmore is a researcher at the University of Winnipeg; Colleen Anne Dell is at Carleton University. Complete report—PWHCE Project #44—is available from The Elizabeth Fry Society of Manitoba for $10. To order, call (204) 589-7335. For more information on this study, and on other matters related to women's health, contact The Prairie Women's Centre for Excellence at (204) 982-6630 or visit the Website at www.pwhce.ca.