Non-spoken stories
: an ethnographic account of the emotional lives of three teenagers with severe learning disabilities who sometimes self-injured

Student thesis: Doctoral ThesisDoctor of Philosophy (PhD)


Self-harm has long been associated with overwhelming emotions and distress. However, if a person with learning disabilities hurts themselves, it is more likely to be considered a way of communicating a need in relation to their immediate environment. Thus, the concept of self-harm as a response to overwhelming emotions or distress is often relegated for people with learning disabilities. The association between overwhelming emotion and distress has been established, in part, through research asking people who self-harm about their direct experiences. However, there is a dearth of research seeking the direct experiences of people with severe learning disabilities, particularly in relation to self-harm.

An eight-month ethnographic project conducted 188 hours of participant observation with three young people with severe learning disabilities who sometimes self-injured. Drawing on psychodynamic theories, the research sought to understand the participants’ emotional experiences, with reference to presentations of self-injury.

The three participants demonstrated that they had a wide array of rich, nuanced emotional experiences. The data presented a picture of the participants’ emotional lives as strongly influenced by their relationships (whether well-attuned or disconnected); current and past relationships, including experiences of separation, loss and bereavement, were significant to their emotional lives.
In addition, the experiences of lost or compromised safety (relationally, psychologically or physically) provoked feelings of anxiety, stress, distress and anger; these emotions sometimes led to physical expressions of overwhelming emotion, including self-injury. Experiences of lost safety could be correlated to both experiences in the moment and associated stress or distress from past

The research concludes with recommendations for policy, practice and research, stressing the importance of wedding trauma-informed approaches with the current dominant biobehavioural approaches. This allows for the consideration that previous adverse experiences and past relationships might also be factors in current presentations of distress, including self-injury.
Date of Award20 Jun 2023
Original languageEnglish
Awarding Institution
  • University of Bristol
SupervisorSandra Dowling (Supervisor) & Pauline Heslop (Supervisor)


  • learning disabilities, self-injury, self-harm, emotion, experience

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