Helpful or Harmful? An Institutional Ethnography of Self-Injury and Mental Health Care
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Authors
Smith, Sarah E. K.
Date
Type
thesis
Language
eng
Keyword
self-injury , mad studies , gender studies , mental health , institutional ethnography
Alternative Title
Abstract
This dissertation is about people who self-injure, how they come to be understood as mentally ill, and the work they must do to “get well.” Using institutional ethnography and autoethnography as my methods of inquiry, I grapple with the disjunctures that exist between experiential and professional knowledges of self-injury and outline the material impacts that these disjunctures have on people who self-injure. Using semi-structured interviews and textual analysis, I trace people’s experiences with mental health care back to diagnostic and therapeutic texts which frame people who self-injure as manipulative, attention-seeking, and almost always suicidal – discourses which often do not align with people’s own perceptions of the meanings and motivations for their self-injury. I reveal how these discursive and definitional inconsistencies generate critical disconnects in the lives of people who self-injure as they become forced to navigate the stigma and iatrogenic harm imposed by these perceptions and illustrate how people’s experiences with self-injury and the mental health care system occur against a backdrop of misogyny and sanism. I argue that the deprivileging of experiential knowledge and the imposition of biomedical explanations for self-injury can lead to greater levels of mental distress, keeping people caught up in “the work of getting well” as they try to find the right supports within psychiatric services which are not always designed to help them flourish. This dissertation builds on a strong body of psychiatric survivor research and activism that has fought to frame experiential knowledge as legitimate and valuable and constructs a counter-discourse of self-injury that favours experiential knowledge and challenges epistemic injustice. I conclude by centring recommendations from my research participants as to how mental health care could be transformed and share ideas for future research, education, and activism about self-injury.
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Attribution-NonCommercial-ShareAlike 4.0 International
ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
Attribution-NonCommercial-ShareAlike 4.0 International