Self-Administered Acupuncture as an Alternative to Deliberate Self-Harm: A Feasibility Study

Abstract

The aim of this mixed methods feasibility study was to demonstrate the acceptability, practicality, and safety of training patients who regularly use deliberate self harm (DSH) to self-administer acupuncture as an alternative coping skill for emotional distress. Ten adult patients with a diagnosis of emotionally unstable personality disorder who regularly self-harmed were recruited to the study following baseline assessment by a psychiatrist. An acupuncturist taught participants to self-acupuncture. During the 6-week intervention participants recorded their emotional distress, coping behaviors, thoughts, and feelings in a diary. Face-to-face interviews were used to explore participants' motives for DSH and their experience of acupuncture. Framework analysis was conducted on interview transcripts and diary entries to identify common themes. Mood at baseline and six weeks was measured using the BDI and changes in the use of coping behaviors and acupuncture were measured using diary entries. Subjects used acupuncture regularly through the six-week intervention and over this period there was a reduction in the frequency of DSH. Qualitative analysis identified two broad themes relating to the process and the effects of acupuncture. There was wide variation in the effects experienced by subjects which broadly mapped onto to the wide range of motives behind DSH. BDI scores showed a near significant reduction (p = 0.055) from 44.4. to 34.4 over the 6-week intervention. Patients presenting with deliberate self harm can be safely trained to self-administer acupuncture as an alternative coping skill. Acceptability and effectiveness may vary between patients depending on the complex motives underlying their self-harming behavior. While the pilot study was designed to explore the feasibility of the intervention, results from this limited sample suggest that use of self-administered acupuncture may reduce the frequency of self harming behavior and reduce emotional distress as measured using the BDI.

Accentuate the positive, eliminate the negative? The variable value dynamics of non-suicidal self-hurting

“…At the same time, their engagement with downsides, not always articulated in the social science literature, offers suggestions as to how education, health and social services might engage more constructively with self-hurting. Firstly, services can offer a more structured approach to reducing medical risks associated with self-hurting (Davies et al, 2011), although harm reduction strategies can be criticised for legitimating behaviour which is often ultimately self-defeating (Gutridge, 2010). Secondly, through documenting the risks of self-hurting turning sour over the longer term, service providers can help individuals to consider possible futures which they might not otherwise be able to envisage, as argued by Slovic (2012).…”

“…through fashionmodelling size zero, climbing Everest, extreme sports, religiously legitimated selfhurting, would not be framed as medical problems. A small amount of clinical work has been concerned with providing safer outlets for self-hurting such as selfadministered acupuncture (Davies et al, 2011). But most has started from the unexamined presupposition that self-hurting is an inherently adverse event, and therefore a risk which needs to be assessed and reduced as much as possible.…”

Selbstakupunktur Aus Wissenschaftlicher Sicht

“…Das Ziel einer Machbarkeitsstudie von Davies u. Mitarb. [ 9 ] war es, die Akzeptanz, Praktikabilität und Sicherheit des Akupunkturtrainings von Personen zu demonstrieren, die regelmäßig bewusste Selbstnadelungen anwenden, um sich selbst Akupunktur als komplementäre Therapieoption für emotionale Belastungen zu verabreichen. 10 erwachsene Patient*innen mit der Diagnose einer emotional instabilen Persönlichkeitsstörung, die sich regelmäßig selbst akupunktierten, wurden nach einer Ausgangsbewertung durch einen Psychiater für die Studie rekrutiert.…”

Home Electroacupuncture for Persistent Postsurgical Pain: A Patient's Report

“…2 Since then, self-acupuncture has been written about but never defined in the context of a therapy in the healthcare setting. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In the absence of a standard definition for SHA, we define it as follows: 'Self-acupuncture or home acupuncture is acupuncture performed by a patient or patient's acupuncture partner following assessment and appropriate training by their attending regulated healthcare professional'. SHA is potentially controversial; one of the issues seems to be whether it is safe to teach patients or their caregivers to perform acupuncture.…”

“…16 7 There is a limited amount published for therapists, and very little for patients and caregivers. 23 More recently, self-administered acupuncture has been studied in relation to deliberate self-harm, 18 and self-acupuncture has been assessed in the management of cancer-related fatigue. 20 21 The literature in this area is limited in relation to SHA.…”