A new book argues that you can’t throw people pulling their hair out and people cutting themselves into the same category.
This post originally appeared on VICE UK
The summer I was 21, I burned my arms several times. I used to hold a kitchen knife over the gas stove for a minute or so, grit my teeth, and then press the blade flat on my skin for as long as I possibly could. The strangest thing about the sensation was that the knife would slip, the skin becoming almost soapy as it scalded. That’s what it felt like anyway. Then a large clear blister would develop over the wound, eventually becoming a scar. I remember that these acts gave me a sensation of release, but I still don’t know what it was that I was trying to get rid of, or why I thought that the only way to let something out of my mind was to mark it on my skin.
There are as many meanings to self-harm as there are self-harmers, Sarah Chaney explains in her new history of the phenomenon, Psyche on the Skin. Reading the archives from the Bethlem asylum in London, Chaney noticed that staff would record whether new patients were "suicidal or otherwise inclined to self-injury."
To Chaney, this phrase seemed strangely familiar, at odds with her assumption that self-harm was a contemporary phenomenon. Indeed, the words from the Bethlem archives were remarkably similar to those used in the American Psychiatric Association’s manual (usually called the DSM), which describes "non-suicidal self-injury" as a distinct condition.
In the book, Chaney sets out to understand the history of self-harm. As she explains, deliberately hurting oneself has a long history—for example, self-flagellation for religious reasons—but the category of "self-harm" as a distinct behavior that is related to mental distress is an invention of the 19th century. According to Bethlem patient records from the 1850s, Sophia W. had "a disposition to injure herself by knocking her head against the wall and biting herself," while Henry M. had sores all over his head, face, and legs from "picking and scratching himself."
Ever since these "perverted impulses" were identified, some psychiatrists have tried to explain them in universal terms. The American psychoanalyst Karl Menninger argued in Man Against Himself (1938) that self-harm was an unconscious redirection of suicidal impulses and therefore (at least according to some of his followers) proof of the Freudian model of human psychology.
But Chaney argues that the idea of an overarching category of self-harm doesn’t really work. "Since the late Victorian period, almost every medical category of self-harm [has assumed] that there is some kind of equivalence between behaviors and that there is some kind of universal meaning," she told me. "But why should someone trying to cut off their own hand be somehow the same as someone pulling out their hair?"
In contemporary British society, self-harm is most often portrayed as an individualized, private behavior that expresses the inner turmoil of the self-harmer in some way, whereas in other eras it tended to be understood in terms of the environment or the role of the family.
Self-harm should be understood as emerging from a cultural context, not simply from a solitary mind. Researchers like Armando Favazza, who came to psychiatry after first studying anthropology, believes that some forms of self-injury represent "an attempt at self-healing." Globally, he pointed out, culturally sanctioned forms of self-mutilation are widespread.
Even Menninger was deeply influenced by the circumstances of his time. "His view of self-mutilation and suicidal behavior as evidence of the Freudian death instinct was very much bound up in his view of what was happening in the world. As he put it [in some of his other writing], ‘What suicide and self-harm is for the individual, so war is for the nation.’ He was using these cases to prove a self-destructive path for humanity, not just the individual."
For that reason, Chaney is convinced that prevailing ideas around self-harm actually say a lot more about the people who express them, or the culture that gives birth to them, than they do about the behavior itself. In contemporary British society, self-harm is most often portrayed as an individualized, private behavior that expresses the inner turmoil of the self-harmer in some way, whereas in other eras it tended to be understood in terms of the environment or the role of the family. What Chaney suggests is that the focus on private personal turmoil "reflects an increasingly individualized understanding of how human beings function."
When we spoke, Chaney was cautious on the subject of self-harm and its prevalence in Britain today, but said that it has probably increased in the past two decades. It’s very difficult to say so with any certainty, though. National Health Service statistics are inconsistent, sometimes based on self-reporting and other times based on access to emergency services—which obviously favors certain, more severe, kinds of harm. There’s little reason to believe that cutting yourself (or burning yourself, for that matter) causes the same level of harm as a near-fatal overdose or comes from the same place psychologically.
One thing we can be sure of is that self-harm is more visible than it has ever been. As with so many things, this can largely be attributed to the internet. "The types of quite public conversations that people might have on a forum are not the kinds of public conversations that you could view before that," Chaney explains. "If people were having them with friends, they weren’t recorded."
Though events like the disappearance of (famous self-harmer) Manic Street Preachers’ guitarist Richey James triggered an outpouring of emotion in the letters pages of the music press, "it was the NME and Melody Maker that decided what to print and when." Now self-publication gives people who want it the power to create their own narrative. While in itself this won’t necessarily reduce levels of self-injury, it might help some people find their way out of an impasse that has been clouded by the fog of stereotype and misunderstanding.
If you or someone you know is affected by any of the issues in this piece, please find help at Self-Injury Outreach & Support.