Self Harm Through the Window of the Internet

This is a research paper I wrote in December 1999 for the college class 'The Body in American Culture'. You can use the following links to navigate easily:

The topic of this research paper is self-injury (SI), also called self-harm, self-mutilation, self-inflicted-violence and self-cutting. In simple terms, this refers to the practice of cutting, burning or otherwise damaging the body to provide relief from otherwise unbearable thoughts and feelings. There are culturally sanctioned practices of self-injury, such as rituals of healing, spirituality and social order and in modern American culture, body piercing. However, this paper is concerned with what Favazza terms "deviant pathological self-mutilation". Favazza further breaks down this category into major, stereotypic and moderate/superficial self-injury. Major SI is the removal of a major body part, for example self castration; stereotypic SI is repetitive injury including head banging and is often associated with mental retardation, autism and tourette syndrome. This paper will deal mainly with moderate/superficial self-injury. This can be defined as the cutting, burning or otherwise harming of one's body, usually the skin, as a psychological release which achieves a calming, pleasant, numbing effect or other gratifying feelings. It is important to note that there is no suicidal intent.

This has become a widespread phenomenon in American culture, "recent estimates are that 1000 per 100,000, or 1%, of Americans self-injure" (Secret Shame website). In Reviving Ophelia Mary Pipher discusses SI and proposes that "behaviors that arise independently and spontaneously in large numbers of people often suggest enormous cultural processes at work." This paper will examine how cultural and societal influences have led to the emergence of self-injury, but will also argue that this coping mechanism is more than just a reflection of cultural attitudes in the 1990s. It is also a result of biological and psychological factors.

Self-injury was an under-researched, taboo subject in the area of cultural psychiatry until Favazza published Bodies Under Siege in 1987. In the preface to the second edition of this book, Favazza discusses how he was unable to find any mention of self-injury in "two extensively annotated bibliographies I had published on themes in cultural psychiatry from 1925 to 1980. Over five thousand books and articles were cited." Favazza later states that the first exploration of self-injury as distinct from suicide was by Karl Menniger in a chapter of his 1938 book Man Against Himself. Bodies Under Siege is the definitive scholarship on self-injury, as it covers the full spectrum of self-injury from limb castration to "delicate" cutting. Later scholarship, such as Steven Levenkron's Cutting and Marilee Strong's A Bright Red Scream deal with moderate self-injury exclusively, whilst in Women Who Hurt Themselves Dusty Miller examines the prevalence of self-injury amongst the female population. Scholarship has also extended to self-help books, most notably Tracy Alderman's The Scarred Soul.

However, the most recent research into and exploration of this topic is on the Internet. Wonder grrrl's site lists over 750 self-injury links and many Internet support groups exist to compensate for the lack of face to face programs. It is interesting to note that doctors and experts in the field of psychiatry have written most, if not all, of the published scholarship in this area, although work on the internet is almost exclusively based on personal experience.

I believe I can offer an interesting insight into this topic, as I have used self-injury as a coping mechanism for the past four years. I have cut my skin with various sharp instruments, though I prefer to use razor blades. In order to understand my behaviour, I have read all that I can find relating to self-injury, in print and on the Internet. I am also a member of an Internet self-injury support group; where daily we share our experiences, thoughts and feelings and offer each other both short term and long term advice and encouragement.

Two million or more Americans regularly cause intentional damage to their bodies by hitting, cutting or burning their skin.*1 Yet there is a significant lack of self injury (SI) research and the practice is often misunderstood. The idea that somebody would bruise, bleed or blister their body on purpose,in an attempt to feel better horrifies most people. It seems to defy logic. Yet, millions of people have turned to this form of self-healing, many of them independently. Several of these people now injure themselves on a regular basis, as SI is an addictive behaviour. (Favazza terms this 'repetitive self mutilation syndrome' *2. Yet, the DSM-IV *3 does not include SI as a unique disorder that stands alone.) Self injury often increases in frequency or intensity, for example deeper cuts, as the self injurer strives to achieve the positive outcome to which she*4 is accustomed. This leads to guilt, shame and feelings of despair and hopelessness. These feelings intensify depression and may lead to thoughts of suicide. After all, the self injurer knows that she is capable of inflicting damage on her body. However, I would like to stress that people do not SI because they want to die. They cut*5 to stay alive, to cope with life. SI is a coping mechanism without suicidal intent. Yet, this coping mechanism is by no means healthy or ideal. Therefore, it is essential to conduct further research in this area to deepen the understanding of this behaviour and thus help the men and women who self injure.

"Cutters have also created their own virtual support group in cyber-space…They support and encourage one anothers' struggle against self-harm; synopsize journal articles; offer information on treatment programs and medication; and let off steam about lost jobs, lovers' quarrels, bad days that might otherwise result in cutting."*6

I have been a member of a self injury Internet support group*7 over the last eight months, during which time I have learned a great deal about SI. I can bring my own four-year history of self injury together with the shared experiences of my Internet friends, or SIsters*8, to form a unique perspective on the prevalence and meaning of SI. In particular this paper will look at:

• What causes a person to turn to SI? How do people discover that injuring themselves will bring a positive outcome? This section will include the recollections of several SIsters first experience of self injury.
  
• An investigation into the importance of the Internet as a supportive place for the voices of self injurers to be heard.
  
• An examination of one woman, Naomi's, personal struggle with cutting.
  
• Extracts of an online interview with one woman, who goes by the name of 'fallenstar', as she shares her thoughts on cutting her wrist as SI and not as a suicide attempt.
  

Before exploring these issues, it is important to clarify the diagnostic criteria of SI. Steven Levenkron gives a useful classification in his book Cutting*9 :

• Recurrent cutting or burning of one's skin.
• A sense of tension present immediately before the act is committed.
• Relaxation, gratification, pleasant feelings, and numbness experienced concomitant with the physical pain.
• A sense of shame and fear of social stigma, causing the individual to attempt to hide scars, blood or other evidence of the acts of self-harm.

This is the subject of one of the discussion threads on the message board, inviting people to share the memories of their first SI experience. The following are extracts from replies to this question:

• "my first time, i was about 11 years old i think, my dad and mom got divorced when I was 10 but i handled it fine because my dad did not move out until i was 11. i got upset (i don't remember exactly what started it, i guess everything) and broke a full length mirror with my fist and cut my hand up, then i just picked up a piece of glass almost like instinct and started. i cut both my forearms. my thighs, and my face, the right side of my face." - jinx, age 21.

• "I had gotten into a huge fight with my dad and was in my room, sitting against the wall, crying and wishing he was dead. I picked up a bobby pin off the floor and dug it into my wrist, then twisted it around and dragged it across the skin. I didn't realize what I was doing. I made about three cuts, then noticed that I was bleeding and that I had the pin in my hand. At first, I wasn't sure what had happened, but then I began to piece together the events of the past few minutes, which made me cry harder. I had heard about SI before, and although I didn't think of it as a 'freak thing', I never in a million years would have thought I would EVER be a cutter. I had been depressed, even suicidal, during the past year, but cutting had never occurred to me. It just seemed to make sense at the moment. I was scared by what I had done and didn't think I'd do it again. But when I finally stopped crying, cleaned it off, and went to bed, I realized that it made me feel better, if only a little. At that moment, I didn't care too much about anything." - Mia, age 16.

An interesting observation was made in the group by Wenzday:

"the thing that struck me most about all of us, is that we seemed to be driven to injure ourselves, without having any concrete reason why. you talk about 'little voices saying, cut yourself', or cutting/stabbing yourself with stuff and then sorta 'waking up' after the fact."

It appears that picking up a sharp object and damaging the skin is a natural reaction to overpowering emotions in some people. A dissociated state is often entered and the memory of the event becomes hazy. The one feeling that appears to remain, however, is the realisation that the frustration preceeding the act of SI has subsided: "I liked that it calmed me down and I was intrigued by it, so I did it again the next day and it's gone on from there." - Lindsey, age 17. There appears to be an innate self-destructive force that is awakened in self injurers. I propose that one of the main reasons why SI is a taboo subject is that 'normal' people fear that they too could be driven to such an extreme.

This research paper has been made possible thanks to the SIsters from the discussion board support group. Due to the secretive and shameful nature of SI, the Internet provides a safe place to be open in discussing this behaviour. One woman, Maddmom, explains the value of the Internet as follows:

• "As some of you know, I live in a small town…Because of this, it is impossible for me to talk to anyone about my true feelings. I must, at all times, look like the perfect wife, mom and partner…Look up "Grin and bear it" in the dictionary and you will find my picture. The Internet is a safe place for me to say how I really feel, and what I'm thinking. I am able to express these things because I am able to know who might tell my secret, and watch out for those people.

• "I also like the internet because the people I know here are pretty much all fakes (like me), and we all just smile at each other and say "I'm fine, thank you, how are you?" whereas people on the internet are more real with me. It's like all the fears just melt away. Then, there is the fact that I can get some outside feedback It's sometimes nice and refreshing to hear that …there are sisters out there who RESPECT me and my beliefs, and even agree with me."

  Anne, age 18, agrees with these ideas:

• "hmmm... the Internet is supposed to be a safe haven and all, because we're all anonymous, which i think is why a lot of us are here.. i tell people on this board things that even most of my closest friends…don't know.. like i trust you guys with some things that are like in the deepest crevices of my very being, even though i've never met most of you…the people on here, and in other SI groups like this i'm sure, are so supportive because they understand so much more of what i'm going through than a lot of people irl [in real life] can.."

Internet allows people who self injure to connect and relate to others who self injure. SI can spring from and be intensified by isolation and this bond of understanding is invaluable. The Secret Shame website, one of the most informative pages on the Internet, emphasises this need for connection and community spirit with its heading in large letters: "Self-Injury: You are NOT the only one." There is also an acknowledgement of the role SI plays as a coping mechanism: "This site is meant to help you understand that you are doing nothing shameful -- you are maintaining psychological integrity with the only tool you have right now. It's a crude and ultimately self- destructive tool, but it works; you get relief from the overwhelming pain/fear/anxiety in your life."

The Internet also provides an arena for self injurers to relate their personal stories and advice about dealing with SI. This page is a particularly good homepage. Such a dependence on the Internet does have its drawbacks however; for example when the computer is disconnected the self injurers support group is lost. Naomi's story relates such an occasion -

Naomi, a member of the discussion board support group, has written a strikingly honest first person account of her personal experiences battling against her SI urges to cut herself. Naomi is in her early twenties and is married with two young children. As a self injurer, I found I could empathise with many of her feelings and as a research student, I feel that Naomi does a great job of conveying her mindset. The quotations in the following paragraphs are extracts from her writing and offer a profound insight into the mind of a self injurer:

"The most popular and most effective use to those who SI is cutting into the skin…The reason that cutting is the most popular use, in my belief, it is to see the blood .. to me it is a form of crying and a way to let out the emotions that are caught inside of myself."

Blood is such a primal substance and to see yourself bleed can be life affirming, especially if the self injurer is experiencing feelings of numbness and dissociation. For this blood flow to be self inflicted is an act of power and control, when the rest of the self injurer's life may feel out of control. Naomi also describes the cathartic release of frustrated feelings when she sees herself bleed, which is a common experience among self injurers. This is sometimes a substitute for tears, as several self injurers in the support group have mentioned their inability to cry. Whilst tears dry and disappear, blood stains and then the cut becomes a scar, which is seen as a validation for some self injurers.

SI becomes more than merely the cutting of skin; it takes on its own existence and can become all consuming:

"I want cutting to be my true friend… I want this friend because I have no grasp on anything else in life. I have no control over anything else in my life, and mainly no control over myself."

Self injurers also sometimes refer to their razor or knife as their friend. To the outside observer this is difficult to understand, yet SI is often a deep secret and the only comfort in times of extreme emotion. Naomi comments:

"I smile an almost evil grin when I cut, I am going against societies beliefs, who I should be, and who they want to make me into. I smile because of them, they can't take this from me they can't stop me from doing this unless they chain me to a bed…and if they did that they can't stop my mind from imagining it."

You can hear her smiling in the language and tone of this extract. SI is something that belongs wholly to the self injurer; nobody can cross her boundaries and take this away from her. She has control and this is gratifying.

Naomi relates her worst SI experience in her writing, which occurred after an argument with her husband. It was also during a period in which she had no Internet access:

"I no longer had my support group from my SI board because it was taking two weeks to install the phone line and it was only through internet access that I could talk to them. So I felt I lost my friends for a while…I wasn't actually thinking of those things when I decided to cut, but they were on my mind they were sitting inside me."

This offers an indication of the dependency on and attachment to online friends/SIsters. This dependency could be viewed as unhealthy, yet an Internet support network is infinitely better than no support group at all. The availability of members online and the features such as chatrooms add to the benefits of online support as friends can meet up and talk in real time.

Scars are a major aspect of SI. They may fade in time yet they remain to remind the self injurer of her darkest times:

"I do regret the scars and try to hide them. I only regret the scars and hide them from people for what they would say if they saw them. They would say it was for attention, they would say I was sick. And that I am a pretty fucked up person and no I don't want those words. They would also pity me and thank God that they are not like me…"

Scars are seen as something to be ashamed of, yet self help strategies encourage scars to be viewed in a positive way, like battle scars that prove the self injurer has won because she has survived. Why should society determine that scars are ugly and something to be ashamed of? Who is to say that scars are not beautiful? Yet in American culture, self inflicted scars are horrific reminders of the pain which self injurers face and yet society ignores.

'Fallenstar', age 19, shared her personal opinion about scars with me during an instant messenger conversation:

• ragdoll (10:30:48 PM): what are your thoughts about scars? do you ever like your scars?

• Fallenstar (10:31:27 PM): yeah i like my scars, i have one faint little one from when i was 13 or so, i dont want it to go away

• ragdoll (10:32:22 PM): why don't you want it to go away? though I do agree with you on this

• A telephone call interrupted the conversation at this point.

• Fallenstar (10:38:18 PM): oh umm cause it reminds me of stuff i spose, i always forget things, also it tells where ive been and whats happened i guess, like i have different scars from different hard times in my life

• ragdoll (10:39:32 PM): yeah I totally know what you mean. But why do you want to remember the hard times?

• Fallenstar (10:40:37 PM): well if i remeber the hard times, times that arnt so bad i will kinda remember how hard the other times were and appriciate the good times i spose

• ragdoll (10:41:16 PM): do you think that works?

• ragdoll (10:41:45 PM): cos i'm not too sure why i want to remember really either

• Fallenstar (10:41:53 PM): well it did at the begining of the year and while i was in south africa

• Fallenstar (10:42:18 PM): i think our scars are a part of us, and if we lose them we lose a whole part of ourselves

• ragdoll (10:42:50 PM): sometimes I think it's so I will remember how upset I was and that those feelings must have been valid and important for me to have cut - yeah, i agree there - so you'd never get your scars removed if you had the chance?

• Fallenstar (10:43:30 PM): nope, not unless they caused a problem for me, mine are easy to hide [they are on her wrist] so they wont and id never get rid of them

• ragdoll (10:43:49 PM): but are you ashamed of them at all?

• Fallenstar (10:46:32 PM): not so much ashamed more scared of what people will think and how they will react to them. there is alot of shame behind it though, i mean im ashamed that i do this but im not the sort of person that is that affected by shame, dont think i think enough of myself to be at the moment

• ragdoll (10:47:05 PM): do you worry that people will think you're suicidal?

• Fallenstar (10:48:30 PM): yes, bf [boyfriend] did at first, asked me if i wanted to die, had to explain im not going anywhere

• Fallenstar (10:48:46 PM): that the kind of reaction im afraid of

  Fallenstar has similar fears to Naomi, worrying that her scars will cause people to judge her and that they will automatically assume a suicidal intent. I was particularly struck by the idea that: "i think our scars are a part of us, and if we lose them we lose a whole part of ourselves." Cuts and blood are the physical manifestation of emotional pain on the body. Scars are the lasting reminder of this. Scar fading treatments can be bought, yet it seems that to erase the scars would be to take away a history of survival. "Pink ribbon scars that never forget.*10" "Scars are souvenirs you never lose.*11 " Scars are not graffiti on a wall, they are a living reminder never to fall back into the dark times. Modern American culture is not willing to face the scarred ones because it is scared. Perhaps to act out emotional tension and pain physically on the body is too primal for the technological world of today. Yet it is this technology that has given us SIsters a voice, which one day will be heard, just as anorexia and bulimia were demystified. Until then we will wear long sleeves in summer, refuse to go swimming and blame our non-existent cat.

  
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  Footnotes

  *1 xv Preface A Bright Red Scream [back]

  *2 p250-260 Bodies Under Siege [back]

  *3 Diagnostic and Statistical Manual, fourth edition as published by the American Psychiatric Association and used to classify pathological behaviour. [back]

  *4 The personal pronoun 'she' is used for consistency. It is generally thought that women self injure more than men, who typically are more overt in expressing their negative feelings do. Yet a significant proportion of self injurers are men and generally they SI more severely. It seems that fewer men seek help for this behaviour, leading to them being under represented in research. In my personal life I know three males that have self injured, yet there are no regular male self injurers who post on the Internet support group I frequent. [back]

  *5 Similarly, the term 'cut' is used for consistency and clarity. Other SI behaviours include burning (with a flame or chemicals), hitting scratching, biting, hair pulling, inserting foreign objects under the skin and opening up old injuries. [back]

  *6 p180-181 A Bright Red Scream [back]

  *7 In order to protect the privacy of all the members of this group, myself included, I will not cite the address or name of this website. However, on my honour, the material quoted within this paper is extracted from material posted on the Internet and is all genuine. [back]

  *8 'SIsters' is a term I coined on the support group message board. It combines the shorthand for self injury - S.I. - with the word 'sister', which embodies the community spirit and bond between the women who post there. [back]

  *9 p25. Cutting [back]

  *10 from Today a song by The Smashing Pumpkins from the album Siamese Dream. [back]

  *11 from Name a song by The Goo Goo Dolls, bonus track on UK version of Dizzy Up The Girl [back]

  
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