This thesis focuses on general psychology and is further more placed in a primarily theoretical frame of both science and the history of psychology.
This thesis had two main aims. The first aim was to shed light on how non-suicidal self-injury (NSSI) can be understood. The second aim was to investigate whether compassions-focused therapy (CFT) could be effective in treating NSSI. If this was found to be the case a research design was to be developed to examine the effect of CFT on self-mutilation.
It was found that self-mutilation as a phenomenon has existed throughout the history of human existence. However it seems like the number of self-mutilators has been increasing and still is. Self-mutilators have been characterized as being hard to treat, which can be a reflection of a lack of knowledge. Therefore the overall aim of this thesis was to contribute to new knowledge in treating NSSI.
Even though there is no acknowledged diagnosis on NSSI yet there is a tentative diagnosis in DSM-5.
The analysis showed that self-mutilation can be categorized as either culturally ac-cepted or pathological. This thesis is concentrated on the pathological self-mutilation. Moreover self-mutilation exists as a direct and indirect form. The direct methods involve cutting, biting, hitting and burning whereas the indirect methods for self-mutilation involve eating disorders and substance abuse.
In the present thesis self-mutilation was put in a developmental psychological frame. This means that that self-mutilation is seen as a consequence of poor attachment to the primary caregiver and bad or absent metallization abilities. This means that the development has stopped at a pre-mentalistic stage. This can result in a need for a physical stimulation to be able to self- or affect regulate. In this case self-mutilation being the physical stimulation.
Furthermore it was found that self-mutilation might have a physiological base be-cause a possible connection between self-mutilation and low levels of opioids and serotonin levels was found.
The self-mutilating behavior can have many forms and functions since the population of self-harmers is heterogeneous. From an analysis of Nixon and Heaths (2009) four factor model it was found that there can be four overall motives. This being automa-
tic negative reinforcement, automatic positive reinforcement, social negative rein-forcement and social positive reinforcement.
Furthermore the analysis showed that a lot of self-mutilators are very self-critical, which elevates their urges to harm themselves.
To be able to provide new knowledge it is important to know what already exists.
Based on a thorough analysis of the theoretical and empirical literature surrounding CBT, DBT and MBT it was concluded that there was evidence for their effectiveness in treating NSSI.
Since a through literature research in libraries and online databases (e.g. PsycInfo and PubMed) revealed no studies on the effect of CFT in treating NSSI similarities between CBT, DBT and MBT and CFT was discussed. Based on this discussion CFT was evaluated as potential effective. Hence the fact that most self-mutilators are very self-critical CFT seems to offer a treatment program to these individuals in particular since the primary focus of CFT is on self-criticism and self-compassion.
Thus the needed theoretical and empirical argument for the development of the be-fore mentioned research design was present.
The research design is based on following research question:
Can CFT reduce self-mutilative behavior in individual with high self-criticism?
It is a randomized pre-test- post-test controlled group study. The treatment period is 4-5 months with a 9 month follow-up. The participants take part in a total of 20 ther-apy sessions; 12 group sessions and 8 individual sessions.
The treatment itself is based on the principles behind CBT, CFT and compassionate mind training (CMT).