Editorial

Behind every act of violence towards the self there is an experience of psychic pain. Even though self-harm is concretely directed towards the self it always also impacts powerfully on others. For these individuals, self-harm's underlying destructive relatedness to self and others can be hard to reflect on; instead, the body violently expresses their distress. For some, the attack on the body and what it unconsciously represents may become more compelling than life itself.

The psychoanalytic study of self-harm focuses squarely on its relational meaning. Where self-harm is present it invariably tells a story about a troubled relationship. As several of the papers in this issue poignantly illustrate, this is typically a story without words. How we can help such individuals to tell their story provides the theme for this issue of the Journal, the idea for which grew out of a conference organized by City and Hackney Psychotherapy Department.

Those individuals who pose a risk to themselves and/or to others invariably also pose considerable challenges to the staff working with them. The success of this conference probably reflects this as we all need thinking spaces to process the impact such patients can have on us. The conference not only provided this kind of space, but it also did so through inviting professionals working from different theoretical orientations. In so doing it created one of those all too rare opportunities to learn about other therapeutic modalities (Cognitive Analytic Therapy, Dialectical Behaviour Therapy, Psychoanalytic, and Group Analytic perspectives) and to think together about how to most effectively help this group of patients. We have included modified versions of four of the main papers from the conference in this issue. These contributions, albeit couched in different theoretical languages, nevertheless converge on a central issue, namely, and to use Feigenbaum's evocative title, that self-harm is perceived by the patient to be ‘the solutio