Self-Harm ‘Survivors’ and Psychiatry in England, 1988–1996

This paper considers aspects of language and its relation to political practices in psychiatry. It analyses the ways in which groups of psychiatric patients – self-defined ‘self-harm survivors’ – have resisted psychiatry's power to define their experiences in terms of the ‘official’ category, ‘Deliberate self-harm’ (DSH). DSH refers to self-inflicted injurious acts that do not result in death, including drug overdose and self-lacerations of the forearms and wrists. DSH is today considered a significant public health problem. Politically, the paper focuses upon a deployment of language in the form of metaphor: ‘survivors’ re-articulate their experiences as a ‘silent scream’, expressive of their trauma and distress, and they oppose this to the hegemony of psychiatric definitions (eg the label DSH). Utilizing key texts of survivors, the paper analyses the history of this deployment between the years 1988 and 1996 in England. The analysis is framed within the context of survivors' political struggle with psychiatry, a struggle which takes its impetus from a confluence of mental health and feminist movements. Theoretically, approaches to ‘discourse’ are engaged, drawing upon the works of Michel Foucault and Ernesto Laclau.