Bodily Transgressions: Ritual and Agency in Self-Injury

In between a life and the meanings that may be made in it, for and against that life is the wound. Meaning making begins in wounding, and the process of meaning making is wounding. —Robert Orsi, Between Heaven and Earth

Trauma … is always the story of a wound that cries out, that addresses us in the attempt to tell us of a reality or truth that is not otherwise available. —Cathy Caruth, Unclaimed Experience

Introduction

Self-injury is a widely known human behavior that appears in the historical record of numerous cultures, especially in contexts such as mourning, repentance, adept religious practice, and sacrifice. Psychological literature also recognizes a range of self-injurious behaviors, which may fall on a continuum or may bifurcate more neatly into two categories: suicide (attempted or completed) and non-suicidal self-injury. Non-suicidal self-injury, which I will call self-injury from here forward for the sake of brevity, is defined fairly consistently in the psychological literature as the “self-inflicted, direct, socially unacceptable destruction or alteration of body tissue that occur[s] in the absence of conscious suicidal intent or pervasive developmental disorder.”¹ Self-injury can take such forms as cutting, burning, or branding the skin, hair pulling, picking at skin or scabs, head banging, breaking bones, and hitting oneself. The psychological literature describes a number of functions for self-injury, including the suppression of overwhelming negative emotions or, conversely, the creation of feeling out of a state of numbness or dissociation; avoidance of unwanted social situations; and interpersonal rewards such as admiration or coolness² and attention to previously ignored underlying problems. Self-injury can also serve as a method for expressing inexpressible emotions.³

Within specific populations, such as among prison inmates and those with particular developmental disorders, self-injury has been studied for several decades. Research in the general population, however, is more recent and may parallel the growing awareness of self-injury.⁴ A number of questions about self-injury remain unresolved. Until the past few years, for example, there was a general consensus that more women than men self-injured. More recent research, however, has offered mixed results,⁵ and indicates that part of the gender difference may lie in the chosen form and style of self-injury.⁶ Little work has been done on the role of ethnicity or class in self-injury prevalence, though recent studies of predominantly white, economically privileged adolescents (see Yates, Tracy, and Luthar, 2008) and of Hispanic and African American girls (see Adler and Adler, 2007) have yielded comparable results. It’s estimated that between 1% and 4% of adults, between 17% and 38% of college students, between 12% and 21% of adolescents, and 7% of children self-injure.⁷

Clinical definitions and descriptions of self-injury are a clear example of the exercise of bio-power—the use of knowledge, especially scientific knowledge, to create and control populations.⁸ Here, self-injury is explicitly constructed as socially deviant, with all of the connotations of irrationality that accompany such a construction.⁹ Of particular interest in the clinical definition of self-injury is the specification that self-injurious practices include only those that are “socially unacceptable.” This is a deceptively simple boundary in the clinical literature, and isn’t even included all that often in the definition. Yet, if one removes that caveat, one is left with a curious definition: “self-inflicted, direct destruction or alteration of body tissue that occur[s] in the absence of conscious suicidal intent or pervasive developmental disorder.” How literally are we to take the term “self-inflicted”? At what point does pathology end and normativity enter? Why, for instance, is piercing one’s own ears not self-injury? What about body piercing in general, if self-administered? How does scarification differ from self-injury.¹⁰ What about extreme forms of food control, which fall under the related category of eating disorders in clinical literature? And this doesn’t even begin to touch, yet, religious phenomena involving the “self-inflicted, direct destruction or alteration of body tissue”: one thinks of ascetic practices in a number of world religions, ranging from severe food restriction among Buddhist, Taoist, Hindu, and Christian adepts, through the nail beds and hair shirts of the Christian ascetics, to practices such as the Sun Dance. These practices can’t be reduced to self-injury, yet the apparently clear boundary imposed by the words “socially unacceptable” turns out to be strikingly elusive.

Turning from the psychological literature to the sociological sheds light on self-injury from a different angle. Patricia and Peter Adler, who conducted in-depth interviews with eighty non-institutionalized participants who self-injure, as well as studying Internet communities for people who self-injure, take issue with what they see as a denial of agency in the clinical literature. “The psychomedical disease model,” they argue, “overlooks the way self-injurers use their customary and ordinary sociological decision-making processes.” Stressing the importance of self-expression, they add that “self-injury represents, in part, a complex social process of symbolic interaction rather than purely a medical problem.”¹¹ Self-injury creates, communicates, and absorbs meaning.

1. T.M. Yates, A.J. Tracy, and S.S. Luthar, “Nonsuicidal Self-Injury Among ‘Privileged’ Youths: Longitudinal and Cross-Sectional Approaches to Developmental Process,” Journal of Consulting and Clinical Psychology 76:1 (2008): 52-62. [↩]
2. P.A. Adler and P. Adler, “The Demedicalization of Self-Injury: From Psychopathology to Sociological Deviance,” Journal of Contemporary Ethnography 36 (2007): 537-570. [↩]
3. N. Alexander and L. Clare, “You Still Feel Different: The Experience and Meaning of Women’s Self-Injury in the Context of a Lesbian or Bisexual Identity,” Journal of Community and Applied Social Psychology 14 (2004): 70-84; K.L. Gratz and A.L. Chapman, “The Role of Emotional Responding and Childhood Maltreatment in the Development and Maintenance of Deliberate Self-Harm Among Male Undergraduates,” Psychology of Men and Masculinity 8:1 (2007): 1-14. [↩]
4. Adler and Adler, 537-570. [↩]
5. T.M. Yates, A.J. Tracy, and S.S. Luthar. [↩]
6. L. Claes, W. Vandereycken, and H. Vertommen, “Self-Injury in Female Versus Male Psychiatric Patients: A Comparison of Characteristics, Psychopathology and Aggression Regulation,” Personality and Individual Differences 42:4 (2007): 611-621. [↩]
7. M.J. Prinstein, “Introduction to the Special Section on Suicide and Nonsuicidal Self-Injury: A Review of Unique Challenges and Important Directions for Self-Injury Science,” Journal of Consulting and Clinical Psychology 76:1 (2008): 1-8. [↩]
8. M. Foucault, The History of Sexuality. (New York: Pantheon Books, 1985). [↩]
9.  In this regard, it is interesting to consider religious practices of self-injury around the world, and their fairly consistent representation in Western scientific discourse as the product of irrational and feminized cultures. [↩]
10. V. Pitts, “Visibly queer: Body technologies and sexual politics,” The Sociological Quarterly, 41 (2000). [↩]
11.  Adler and Adler, 559. [↩]