| Prairie Women, Violence and Self-Harm
Fillmore, C. A. Dell & The Elizabeth Fry Society of Manitoba
Self-harm among women is a serious health 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 identified themselves as self-injurers and the need for expanded research and understanding. The link between childhood experiences of violence and abuse (physical, sexual, emotional, neglect) and self-harm is well-documented in the research literature. An unexamined focus is the relationship between adult experiences of abuse and violence and self-harm. This study addresses two areas of self-harm that have received little attention: (1) the needs, supports and services of women in conflict with the law in both the community and institutional settings, and (2) Aboriginal women in conflict with the law. Each of our data sources offered a unique perspective from which to address the research focus: interviews with women, both in the community and correctional institutions; a focus group with incarcerated women; community agency and correctional staff interviews; correctional staff surveys; and review of community and correctional institute policies. Our study concentrated on the Prairie Region of Canada.
Considerable insight and understanding has been gained in this research regarding the needs, supports and services of women who self-harm while incarcerated and in the community. This study has enabled us to examine helpful and unhelpful responses to self-harm in these settings. Special awareness has been attained in these areas regarding the importance of Aboriginal culture in responding to the needs, supports and services of women who self-harm.
The narratives of the women in the community and correctional institutions were combined for the data analysis. The main reason was that all women, with one exception, had a history of conflict with the law, with the majority having experienced a period of incarceration. Particular attention was paid to Aboriginal women's experiences of self-harm. As well, information gathered on community and correctional staff members was combined due to the limited number of staff respondents and the close similarity between the two groups. Where feasible, however, general references are made to denote whether a community or institutional context applies.
Informed by the women's narratives, and supported by staff perceptions and accounts and a review of the inter-disciplinary literature, our definition of self-harm evolved in this research as: Any behaviour, be it physical, emotional, social, or spiritual, that a woman 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.
A diversity of women's experiences of self-harm were uncovered and classified into a Holistic Model of Self-Harm. This model represents the inter-connected and complex nature of women's self-harm. It was evident from our findings that there are no clear boundaries in defining self-harm, nor is there any one explanation. The Model demonstrates the wide range of conduct that involves the body in the expression of emotional pain and distress, from inflicting external physical forms of harm, such as slashing the skin to less visible, internal forms of harm, such as substance abuse. The Model is framed within a woman-centered approach and incorporates the connection between a woman's individual life experiences and her position in the broader social structure. This fills an important gap in the literature which frequently overlooks the relationship. Our study examines critical events in the women's childhood and adult lives that preceded their involvement in self-harm. These life experiences are typically characterized by a marginalized status, one portrayed by poverty, sexism, racism, and discrimination. Within this broader framework, we examined how some women coped and survived the violence and emotional pain in their lives by self-harming. Self-harm is viewed as a necessary though unhealthy way of responding to distressing and oppressive conditions in the women's lives.
Antecedents/Origins of Self-Harm
Coping and Survival Functions
Most of the functions of self-harm identified by the staff correspond closely with those specified by the women. The main difference was the degree of importance assigned to some functions. Key departures from the women's perceptions were: minimalization of the women's need for attention and nurturing; expanded interpretation of control to include women influencing others to take control for them; less significance given to the role of isolation and loneliness in the women's lives; lack of recognition of self-harm as a means to express painful life experiences; and the inclusion of self-harm as a form of manipulation.
Needs of Women Who Self-Harm
Women's Agency & Creative Ways of Coping and Surviving
Risk Factors for Women's Self-harm
Helpful and Not Helpful Responses to Women's Self-Harm
Recommendations for Working With Women Who Self-Harm
Suggestions for Policy Recommendations and GuidelinesOn the basis of our findings, we were able to make several concrete policy and guideline recommendations for women who self-harm in both correctional institutions and the community. The women's insightful reflections about self-harm as well as the staff's professional experiences informed these suggestions. A central underlying theme is the empowerment of women. The suggestions are: a broader and more holistic definition of self-harm which accounts for its origins, antecedents and functions; education and training based on a broadened and more holistic definition of self-harm; appreciation of the social portrait of women who self-harm; evaluation of responses to self-harm and acknowledge helpful and unhelpful responses identified in this study and current research which adopts a holistic approach; assessment of staff supports and incorporate necessary changes; and enhancement of Aboriginal cultural support, programs, and services.
This study has uncovered significant findings as well as directions for future research. During the process of interviewing the women in the community, it became clear that in future research it would be important for us to increase our community focus. This would entail an expansion of staff interviews across a broad spectrum of community agencies as well as with probation and parole officers. Increasing the number of interviews with women on probation and parole would further strengthen the research design to more adequately address the needs of women upon release from a correctional institution.
New knowledge, specifically that about the relationship between self-harm
and adult experiences of violence and abuse, was gained in this research
and has important implications for women's health. The findings have
facilitated the development of policy recommendations on self-harm as
a serious health concern for women within the community and correctional
institute settings. There is a clear need for women-centred policies
that account for women's unique histories and present circumstances
which contribute to their "choice" of self-harm as a way of coping with
emotional pain and distress.