Books

This is a list of books which may be of interest to people who self-injure and their friends and those who work with them. I will gradually add to it, and add my opinions on some more of the books. Links are to Amazon.co.uk, but if you want a book second-hand, try ABEBooks.

Books on self-injury

Academic books

• Bodies Under Siege: Self-mutilation and Body Modification in Culture and Psychiatry, by Armando Favazza

  This is something of a classic—the BUS online support group is named after this book, and it seems that Favazza was one of the earliest to realise that rather than "attention-seeking", self-injury is actually an attempt to cope. It's an interesting read, with lots of information on all manner of forms of self-injury from tribal rituals and body modification to the kinds seen in psychiatric clinics. It is rather descriptive though, method-wise, so make sure you're safe before reading it.

• Self-Injurious Behaviors: Assessment and Treatment, edited by Daphne Simeon and Eric Hollander

  This is a collection of papers covering not just typical self-injury but also the kinds found in psychotic patients and in developmentally disabled patients. Both psychotherapy and medication are given thorough discussion.

• Self Injury: Psychotherapy with People Who Engage in Self-inflicted Violence by Robin Connors

  Hmmm I didn't like this one much, but that's maybe because I am sceptical about psychotherapy at the best of times. Much talk of "repairing the self-boundary", with a helpful wee diagram of a dotted circle beside a complete circle. Yeah right.

• Hidden Self-harm: Narratives from Psychotherapy by Maggie Turp

  This is a book written by a psychoanalyst, and aimed at those in the caring professions who encounter self-harm in various forms. I myself have self-harmed for some years, and recently in ways that would not be described as "hidden", and moreover have not found talking therapies much help. However, this book managed to overcome my scepticism considerably.

  The author argues for a continuum model of self harm, with deliberate cutting and burning at one end and and "culturally acceptable self-harming activities" such as smoking, tattooing etc at the other. Within this spectrum she discusses a wide range of behaviours, including eating disorders, "invited" accidents and risk-taking, overwork, over-exercising, repeated damaging relationships, repeated unwanted pregnancies, and failure to seek treatment for physical ailments including severe eczema and RSI. She suggests that a recognition of these behaviours might enable early intervention before more visible self-injury has occurred, and also that it might reduce the stigma associated with the more visible forms too. Indeed, her portrayal of those who cut or burn is unusually sympathetic.

  However, for me, the fascinations of the book are the detailed observations of clients with whom she has worked. Of the twelve chapters, five are devoted to individuals and include verbatim exchanges together with interpretation. Interspersed with this are observations of child development illustrating how healthy or unhealthy attitudes to self-care may arise, linking the case studies with the earlier theoretical section of the book.

  In the final chapter she discusses the healthcare system, and I cannot agree with her apparent belief that "talking treatment" is right for everyone. But the perceptiveness of her accounts, some of which hit very close to home for me, have persuaded me to drop my belief that psychoanalysis is the most bizarre kind of therapy imaginable, and to admit that it might in fact have more merit than those services usually offered.

Self-help

• The Scarred Soul: Understanding and Ending Self-inflicted Violence, by Tracy Alderman

  This is a decent enough self help book, if a bit American at times. It's important to do the exercises.

• Healing the Hurt Within: Understand and Relieve the Suffering Behind Self-destructive Behaviour, by Jan Sutton

  This is OK, although I didn't like it as much as Alderman's book, mostly because it seems to be full of case studies, few of which sounded anything like me. It covers not just self-injury but also eating disorders, alcohol abuse etc. The author's website SIARI is well worth a visit.

• A Bright Red Scream: Self-mutilation and the Language of Pain, by Marilee Strong

  This popular book is written by a journalist. I found it a good read, although there seemed to be too much emphasis on sexual abuse as the main cause of self-injury.

Leaflets

• Understanding Self-harm, by Diane Harrison

  If you are someone who self-harms, this leaflet is probably a useful one to give to family and friends, simply because its having been produced by MIND gives it a more official look than many other, probably better, introductions which can be downloaded from the Net.

  This leaflet itself is online at MIND's website, but cannot be printed.

  The content is very clear, and non-sensational, but unfortunately focuses on abuse as the main cause of self-harm and "talking-treatments" such as counselling as the main kind of help. So it neglects to mention that some self-harmers are suffering from a mental illness which can be treated with medication. However, the leaflet rightly dispels a few myths: recognises that men as well as women self-harm, and distinguishes the act from a suicidal one.

  If you self-harm, this leaflet probably won't tell you anything you don't already know. But it may be worth giving to family and friends.

  I originally wrote this review for Amazon.co.uk

Books for Christians with mental health problems

• A Practical Workbook for the Depressed Christian, by John Lockley

  As a Christian sufferer of depression, I was apprehensive picking up yet another book on the subject. Although it promises not to repeat all the usual "You just ought to pray more" type of unhelpful advice, I was sure the book would be heavy-going and add to my burdens yet more things I ought to be doing.

  But, right from the first pages this book just glows with warmth and understanding. The author points out that reading large chunks may be too much when you are depressed. The first of his "exercises" is a great relief—basically stop trying so hard: don't pray tonight unless you really really want to, and don't feel guilty!

  That is not to say that Christian ideals are compromised—not at all. A great many issues, including sexuality, bereavement, anger, fear, even the "Unforgivable Sin", are tackled in a way which is theologically sound while also being very loving and caring. The topics which can be a source of guilt to the depressed person are not dodged but are dealt with in an intelligent and understanding way.

  The central theme is that depression is an illness, not a sin, and may in fact be God's way of preparing someone for work ahead. Besides that, it is an immensely practical book. I suggest you buy several copies, not just for yourself and your church library, but so that every time a Christian friend is diagnosed with depression you can send them one. It will be much appreciated!

  I originally wrote this review for Amazon.co.uk

• I'm Not Supposed to Feel Like This: A Christian Approach to Depression and Anxiety, by Chris Williams, Ingrid Whitton and Paul Richards

  The subtitle of this book—"A Christian Self-help approach to Depression and Anxiety" is accurate: the emphasis is on self-help (although professional help is not opposed), and covers in detail not just depression but related psychological problems such as anxiety, panic attacks, even self-harm.

  The book is essentially a workbook—there are blank spaces to fill in and worksheets to photocopy. It differs from Lockley's "A Practical Workbook for the Depressed Christian" in that it is based almost entirely on Cognitive Behaviour Therapy (CBT), with medication and other therapies covered in only a single chapter.

  Thus the book teaches techniques for challenging negative thoughts and skills for problem solving. The main tools are the "Five areas assessment"—Feelings, Physical symptoms, Thinking, Behaviour, and Relationship/Practical—and the "Seven Step Approach"—Define problem, Brainstorm, Assess advantages and disadvantages, Choose solution, Plan, Carry out, and Review. These tools, and the worksheets, are repeated throughout the book, which is helpful to depressed readers whose concentration may be impaired. Rather annoyingly however, the book has no index!

  All three authors are Christians; one is a pastor while the other two are psychiatrists. The Christian view is cleverly interwoven with the CBT making the book palatable to those with a natural suspicion of psychology. Most of the assertions are backed up with Bible verses, and many of the case examples have a Christian context. The chapter on "Maintaining your walk with God" is particularly useful. In a chapter aimed at church leaders, the negative attitudes to mental illness sometimes found in the church are addressed.

  Overall, the book is not as comprehensive as Lockley's, and may seem little coldly logical at times, but has far more detail on ways to combat negative thoughts and behaviours. Perhaps both books should be used together, or this one alone for milder depression which might remit through self-help alone.

  Certainly as an introduction to CBT for Christians, this book is unrivalled.

  I originally wrote this review for Amazon.co.uk

• On the Edge—Wrestling with God in depression, by Peter Brice

  Brice is a former school principal who has suffered repeated episodes of depression over many years. His treatment has comprised both medication and psychotherapy. The book focusses on the latter, with a frankness unusual among male authors in this country at least, and includes a large number of poems written by him during the various stages. He deals with unhappy family experiences, including bereavements, one by suicide; with the loss of his career because of depression; and especially with how he feels attitudes within the Church, and of his own father who was a minister, have contributed to his condition. The book charts his journey towards a new understanding of himself and of God.

  Theologically, I find the conclusions he reaches uncomfortably liberal. But the open honesty of his searching give much food for thought, and may give hope to others who feel hurt or marginalised by evangelical Christianity. Indeed, the title "On the edge" refers not so much to being on the edge of sanity but the edge of the church because of his doctrinal doubts and the edge of society following the loss of his career. The book ends not with a conclusion that he has now recovered but gives more the impression of an ongoing search. This, too, will give hope to many who find that many of the quick fixes offered for depression do not do what they claim.

  I originally wrote this review for Amazon.co.uk

• Depression: a Rescue Plan, by Jim Winter

  I didn't find this book much help. On a superficial level, I was irritated by mis-spellings, bizarre use of italics, and criminal abuse of exclamation marks. But more importantly, despite its subtitle "A practical Christian response to depression", this just isn't a practical book at all.

  This is because the author (a pastor and counsellor) is really writing about very mild depression. He lists the DSM-IV criteria for a major depressive episode but then goes on to "reassure" the reader that very few people experience anything that bad, and fewer still require treatment from their GP or a psychiatrist, let alone hospital admission. So if, like me, you are already in that category, look elsewhere.

  There are inaccuracies on the medical side too: he misunderstands the meaning of the terms "endogenous" and "reactive", and worryingly perpetuates the myth that antidepressants cause addiction. Professional help is considered only in a single late chapter, and the author clearly believes that depression usually has a spiritual cause, which should determine the treatment.

  The bulk of the book is thus taken up with what might be described as "Theology of Depression"—a very biblical look at sin, confession, guilt, self, Satan, assurance, perspective, suffering. All very sound, but if read through depressed eyes could so easily cause a sense of condemnation. Eg, he mentions that depression can be the conviction of sin preceding conversion, and that some sufferers may thus not be truly converted. Then there is a lengthy diatribe on "not keeping the Sabbath" as another cause. He is rightly critical of "selfist" psychology, but in pointing out that self-hate is a form of self-centredness, he could again lead to more feelings of blame.

  In other places, however, he does admit that the Church's attitudes can cause harm, that God may in fact be at work in depression, and a chapter at the end for friends, family and church is indeed practical. But overall I see this book more as a bible study on the low moods we all experience, or perhaps as prevention of depression, not as a "rescue plan" for anyone who is actually ill.

  I originally wrote this review for Amazon.co.uk

• Seeing Beyond Depression, by Jean Vanier

  I read this book as I was recovering from depression. On first read I found it incredibly annoying as it appeared to be saying that everyone gets depressed, and that it's a normal part of life, and you just have to "come to an acceptance" etc etc. On second reading (it's very short by the way—10,000 words at most) it seemed that wasn't quite what the author was saying.

  Certainly, this is not a book of practical advice—for that try John Lockley's book "A Practical Workbook for the Depressed Christian". Nor, in fact, is it a Bible study: the Bible is barely mentioned. Instead, it is a rather poetic treatise on depression as part of the "rhythm of life". Some will enjoy reading these kind of platitudes, others will not, and I rather suspect that anyone actually suffering from depression will read into it the idea that if they were stronger, more godly, then they could just take the suffering with a smile.

  The author firmly believes that depression has its roots in childhood and that talking things over with someone who will "walk beside you" is the key. But his main advice seems to be "saying Yes to life" and "remembering that you are part of a beautiful Universe".

  This book may have some value for those who have recovered and are seeking to make sense of what has happened to them. But while actually suffering from the illness a more practical approach such as Lockley's is what is needed.

  I originally wrote this review for Amazon.co.uk

• Nervous Christians by L. Gilbert Little.

  I'll review this properly when I get the chance. It's an old book, likely to be out of print. It is firmly in the "Christians should not have psychiatric problems" camp, although it's not actually as unsympathetic as that makes it sound.

Books on Suicide

• Night Falls Fast: Understanding Suicide, by Kay Redfield Jamison

  Essential reading. Focused on suicide in younger people, the book contains a lot of facts and statistics but also compassionate insight. The author is a clinician who has herself attempted suicide.

• Suicide and Attempted Suicide, by Mark Williams
  Cry of Pain, by Mark Williams

  These books are similar ("Cry of Pain" is earlier, and "Suicide and Attempted Suicide" an updated edition) and actually discuss self-injury as well as suicide, and despite the first title don't perpetuate the idea that self-injury is necessarily a suicide attempt, or intended to look like one. Williams argues for such acts to be seen as a "cry of pain" rather than a "cry for help", in view of the connotations of attention-seeking that the latter entails. The book covers history of suicide, and a lot of facts and figures, plus some philosophising about whether suicide can be rational. Most of this is directed towards an understanding of suicide that will help prevent it, and help treat those at risk. There is discussion of the availability of means of suicide as a risk factor, the effect of the media and "contagion", and the roles of genetics, selective memory, hopelessness etc (unusually, studies with animals are described in this context). The book ends with discussion of Dialectical Behaviour Therapy.

• Death Wishes?: The Understanding and Management of Deliberate Self-harm, by H. G. Morgan

  This is an older book, might be out of print. Despite the title it is really about suicide.

• Contemplating Suicide: Language of Ethics and Self-harm, by Gavin Fairbairn

  An interesting book on the various motivations behind suicide.

• I Can't Face Tomorrow: Help for Those Troubled by Thoughts of Suicide, by Norman Keir

  It's been a while since I read this so I can't remember much about it, sorry.

• Suicide and Attempted Suicide, by Erwin Stengel

  Old book, classic.

• The end of hope: A social-clinical study of suicide, by Arthur Leon Kobler

  An unusual book, examining the factors involved in a cluster of suicides in a particular hospital. Probably hard to find—I randomly read it because it happened to be in my local library, bizarrely.

• Suicidal Behaviour, by J Wallace McCulloch and Alastair E Philip

  Another obscure one that I read ages ago.

• A Special Scar: The Experiences of People Bereaved by Suicide, by Alison Wertheimer

  Although aimed at the relatives of someone who has died, this makes interesting reading if you are feeling suicidal.

Depression and Bipolar

• Surviving Manic Depression, by E.Fuller Torrey and Michael B. Knable

  This book describes itself as "a manual on bipolar disorder", and it is exactly that: almost 400 pages packed with information on everything you could want to know, arranged in a clear, easy-to-find format.

  The emphasis (rightly in my opinion) is firmly biological; the authors frequently describe manic-depression as "a brain disease" and clearly see medication as the mainstay of treatment. Two chapters are devoted to medication, one on mood stabilisers and the other on antidepressants, anti-psychotics, tranquillisers etc. A large number of individual drugs are discussed (seven mood-stabilisers, unlike most books which only cover the usual three) and there are useful tables comparing their properties, side-effects and interactions. Their safety in pregnancy and in very young or old patients is discussed.

  This is only an example—the other parts of the book, dealing with causes, risk factors, prognosis etc are similarly comprehensive. To the educated non-expert at least, it seems scientifically sound with plenty of references. It also seems up-to-date, discussing recent research with the necessary note of caution that so much is not yet understood. The material can be technical in places, but is helpfully summarised in lists and tables.

  This is not to say that the book is all facts and figures either—the illness "from the inside" is sympathetically and vividly portrayed. And there is a great deal of practical advice for patients and families on self-help measures, insurance issues, medication non-compliance, substance abuse... An appendix lists a large number of books, videos, websites and other resources, all with comments as to their content and usefulness.

  Given the biological standpoint of the authors, it is not surprising that there is little on psychotherapy, although it is not opposed, and the work of voluntary support groups is praised highly. The link with creativity is discussed a bit dismissively, but with further reading suggested.

  Care is taken to distinguish bipolar disorder from other diseases with similar symptoms, and from "unipolar depression". However, I still found the book of interest even though my own diagnosis is uncertain in this last regard. I would say this is essential reading for anyone interested in mood disorders from a biological point of view.

  I originally wrote this review for Amazon.co.uk

• Beat Depression and Reclaim your Life, by Alexandra Massey

  This book is very different from most others on depression, in that it is firmly against medication (claims it "delays recovery"), is not CBT-based, but rather insists that the cause of depression is repressed anger and the need to "grieve".

  After a short introduction outlining what depression is, and the author's views on it, the book is in two main parts. The first consists of "10 suggestions" to do when very depressed, plus a little more material tagged on; while the second is a "14-day plan to beat depression". However, the second part seems to be nothing more than an expanded version of the first. The structure of headings and subheadings is rather hard to follow (for example, a passage on acupuncture appears to be a subsection of the part entitled "Food Plan"), there is no index, and the sections vary hugely in length, so that one "day" of the plan could be anything from 2 to 17 pages long. The running headers at the tops of pages attempt to clarify the structure, but I found the use of different coloured paper for different chapters off-putting: the bulk of the book is in black type on a pink background.

  The content has two main themes. The first is "Surrender", which involves letting go of responsibilities and taking time to explore feelings; the second is "No more surrender", involving plans and goals. Some parts are very practical, such as a diet plan with recipes, and a script for you to record your own relaxation tape, but I felt that the table showing how many hours of crying was appropriate for various life events was going a bit too far.

  There is useful advice on how to find a therapist; indeed, many of the exercises, such as confronting one's parents, are hard to carry out alone. Also there is much emphasis on visualisation, seeing oneself in the roles of Adult, Parent or Child, or as Victim, Perpetrator or Rescuer. These ideas pervade the book, but I found them rather strange, particularly when it is asserted that "Your Child lives in your torso" and "Your Parent sits across your shoulders". Other strange things include the statement that looking at the ceiling helps us to think while looking at the floor helps us to feel, the insistence on acupuncture when no other complementary therapies are discussed, and the quasi-religious talk of a Higher Power.

  Overall, I would say this is worth reading simply because its approach is so different from that of other books. However, I personally didn't find it much help.

• The Psychological Treatment for Depression: A Guide to the Theory and Practice of Cognitive Behaviour Therapy, by Mark Williams

  Although perhaps a bit old, this gives a good account of the rationale behind CBT and surveys the evidence for its effectiveness. It is designed for psychologists to read, but you can always "cut out the middle man" . Particularly useful are the various questionnaires included, such as the Hamilton Depression Scale, Beck Depression Inventory, Dysfunctional Attitude Scale, Hopelessness scale etc.

Personal Accounts

• The Quiet Room: Journey Out of the Torment of Madness, by Lori Schiller and Amanda Bennett

  This is Schiller's account of her schizophrenia, which seems to have been severe and disabling until the arrival of Clozapine, to which she responded well.

• An Unquiet Mind, by Kay Redfield Jamison

  This is a great book by psychiatrist Kay Jamison about her own manic-depression.

• Depression and How to Survive It, by Spike Milligan and Anthony Clare

  I wasn't sure whether to put this book under "Personal Accounts" or "Depression and Bipolar". Some of it is about depression in general, explained in lay terms but a bit out of date, while other parts are more personal anecdotes about Milligan's bipolar illness. It's an easy and at times entertaining read, as one would expect from a book cowritten by a comic writer/actor and the presenter of Radio 4's "In the psychiatrist's chair".

• Girl, Interrupted, by Susanna Kaysen

  A young woman's account of her time in a psychiatric hospital. It's very short and easy to read.

Women

• Wednesday's Child, by Antonia Bifulco and Patricia Moran.

  The subtitle of the book is "Research into Women's Experience of Neglect and Abuse in Childhood and Adult Depression" and is pretty accurate.

• The Father-daughter Dance, by Barbara Goulter and Joan Minniger
• Reviving Ophelia: Saving the Selves of Adolescent Girls, by Mary Pipher

Miscellaneous

I might get round to categorising these books eventually.

• Families and How to Survive Them, by Robin Skynner and John Cleese
  Life and how to survive it, by Robin Skynner and John Cleese

  These take the form of a dialogue between Cleese (as his usual comical self) and Skynner the psychotherapist. It serves as an amusing guide to mental health from the perspective of family therapy. I liked the first book a lot, though am not keen on the "learned helplessness" theory of depression. The second one was ok. They are easy and fun to read so it's worth doing, and often public libraries have copies.

• Surviving Schizophrenia: A Family Manual, by E. Fuller Torrey

  Comprehensive and up-to-date: see my review of "Surviving Manic Depression" above.

• Thriving Under Pressure, by Philippa Davies.

  I got this very short (72pp.) book free with a subscription to OpenMind. It has four chapters: Understanding Pressure (about causes and signs); Preparing to Handle Pressure (covers exercise, diet, lifestyle); Coping with Everyday Pressures (such as your routine, and interpersonal conflicts); and Managing Major Life Changes (specific things such as bereavement). Each chapter consists of a number of very short (2 page) sections - so, for example, bereavement is covered in only this much space. The style is not really like a book, more like a magazine feature or a pamphlet, since much of the space is taken up by colour photos, diagrams, quotes and checklists. It is true that most of the advice here is common sense, but then at least it means that the goals are practical and do-able.

• Managing Intense Emotions and Overcoming Self-Destructive Habits: A Self-Help Manual, by Lorraine Bell

  I am reading this at the moment and will review it when I get a chance.