People who repeatedly self-harm evoke strong emotions. They are often very unpopular with NHS staff and are frequently seen as time-wasters. Tantam & Huband take this emotional baggage as their point of departure for a book that is rich in experience and common sense. It should be essential reading for junior medical staff. Even though the book deals primarily with that subset of people who repeatedly self-harm, there are lessons here for all staff who deal with people who self-harm whether once or repeatedly.
With self-harm getting such a negative press, it is perhaps unlikely that most will even pick up a book that tackles the area head on. The authors have spotted this. Their solution is to provide a series of 14 boxed key messages. My favourites are ‘the strength of other people's reactions to self-injury should not be under-estimated’ and ‘it is not always possible to pin down in words the clear function or meaning of self-injury’, so ‘immediate challenges for professional carers include assessing risk, deciding about safety and offering short-term coping strategies’. So relevant are they that the key messages from this book should probably be printed on a sheet of A5, laminated and stuck to the desks in GP practices, accident & emergency departments, and mental health teams.
The rest of the book provides the context through which to understand the key messages. That really sets the style of the work which mixes the experiential with the practical and a smattering of evidence. It's a case of horses for courses. Some medical books take an evidence-based approach to their subject matter; others draw on experience and expert opinion. Self-harm gives rise to difficult emotions and experiences: a book which provides the reader with support and therapeutic interventions when confronted with this sensitive issue is to be welcomed.