1. History of Self-Harm Activism, 1986 - 2004 Mark Cresswell For: The Survivor History Group

2. ∂ Key Periods 1986 – 1989 >>>>>>>> ‘Looking at Self-Harm’ Conference 1989 – 1995>>>>>>>>>>National Self-Harm Network (NSHN) 1995 - 2000 >>>>>>>Cutting the Risk: Self-harm, Self- Care & Risk Reduction

3. ∂ Why is self-harm activism necessary? Roger Jeffery’s 1979 research Self-Harmer’s classified as “rubbish” by nurses and “punished” for their behaviour

4. ∂ 2 roots of activism 1986 -1989 FeministPsychiatric Survivor ‘This is partly because we survive in societies which devalue…our personal experiences…But it is chiefly because we have survived an ostensibly helping system which places major obstacles across our path to self- determination’ (1992: 117);

5. ∂ Looking at Self-Harm Conference (05/09/89) Louise Pembroke Andy Smith Maggy Ross Diane Harrison

6. ∂ Survivor Definitions of Self-Harm “I’ll tell you what self-injury isn’t – and professionals take note...It’s rarely a symptom of so-called psychiatric illness. It’s not a suicide attempt…So what is it? It’s a silent scream…It’s a visual manifestation of extreme distress. Those of us who self-injure carry our emotional scars on our bodies” (Maggy Ross in Pembroke, 1994, p. 14).

7. ∂ 1989-1995 – formation of NSHN Personal Testimonies Louise Pembroke’s political analysis

8. ∂ National Self-Harm Network (NSHN) ‘start a national network of people who have experience of self harm…I’d like this network to become a campaigning organization’ (1995: 13).

9. ∂ National Self-Harm Network (NSHN) Louise Pembroke: “I could see the parallels between self-harm activism and that of other single issue groups such as the Hearing Voices Network; striving for recognition and validity of our expressions of distress and fighting for the right to self- determination and humane support. I saw this as a civil rights struggle”

10. ∂ National Self-Harm Network (1995-2000) The concept and practice of Harm-Minimisation: “Self-harm is a continuum and we are all on it.... We.. all have a responsibility to limit the effects of our distress and self-harm on others. Stopping doesn’t have to be a goal; rather the goal is managing it and finding the least damaging option.” (Pembroke, 1999, p. 39)

11. ∂ Harm-Minimisation Andy Smith: “the role of the safety kit in clipping the cycle” (in Pembroke, 1994, p. 19), “The role of professionals in my ceasing to self-harm is negligible... an integral part of the damage was the vilification by the Accident & Emergency staff, so I would carry a safety kit consisting of: a clean sterile blade with which to cut myself, a tube of antiseptic cream, cotton wool, Butterfly steri-strips, plasters and a Crepe bandage. With this I could successfully limit the damage to myself, my self-esteem and my reputation.”

12. ∂ NSHN, 1995-2000 - Milestones ‘Looking After You And Your Injury’ (1998:19) ; ‘Managing Other People’s Responses’ (ibid.: 20-24) ; ‘When You Feel Like Harming’ (ibid.: 45-47); ‘Hearing Voices, Seeing Visions, Other Unusual Experiences And Self-Harm’ (ibid.: 61-70). The ‘Hurt Yourself Less’ Workbook (1998) By Eleanor Dace, Alison Faulkner, Miranda Frost, Karin Parker, Louise Pembroke, Andy Smith

13. ∂ NSHN, 1995-2000 - Milestones 2 ‘Risk Reduction’ conferences in London and Manchester – “to promote the concept of harm minimisation” (Pembroke in NSHN, 2000: 6) Speakers included: Survivors Nurses Medical Students Plastic surgeon British Red Cross worker.

14. ∂ NSHN, 1995-2000 - Milestones Widening the scope of “allies”: General Practitioners Medical Students Plastic Surgeon British Red Cross Skin Camouflage Service The charity Changing Faces

15. ∂ NSHN and the achievement of “dialogue” (1989) ‘[t]he only way forward is to end the silence. For people with direct experience to share their experiences, and for a dialogue to start between self-harmers and service agencies’ (Pembroke, 1994: 3).

16. ∂ NSHN and the achievement of “dialogue” (1999) ‘[t]he conferences addressed a very wide range of issues…involving as many experts by experience and professionals as we could fit in…we didn’t want to get hooked into debating about the concept, we just wanted to get the information to the people’.

17. ∂ The Limits of Dialogue? 1995 – NSHN meet with Senior Medical Officer at DOH - No Result?

18. ∂ The Limits of Dialogue? Clinical Guideline 16 on Self-Harm: Louise Pembroke and Andy Smith had to resign from the Guideline Development Group Why?

19. ∂ Democratic Deficits and the ‘Evidence-Base’? So, where’s the evidence of direct experience? How can you have a “dialogue” when the collective experience of the social movement is disqualified?

20. ∂ The achievement – back to Maggy Ross If self-harm is a “silent scream” – not an experience that can be captured in a Randomised Controlled Trial - then the achievement of the movement is to have heard and done something about the “silent scream”