ejs
© 2005 The
Edwardsville Journal of Sociology
Carving an Image of Society: A Sociological Approach
to Self-mutilation
Kelly L. Faust
“It is society which,
fashioning us in its image, fills us with religious,
political, and moral beliefs that control our actions.”
٭ Durkheim in
Suicide, trans. 1951 p.212
Introduction
Self-mutilation
is the act of intentionally inflicting harm on oneself. One of the most
important things to note about self-mutilation is that it is not an attempt at
suicide. In fact, a common theme in much of the research on self-mutilation is
that self-mutilation is the opposite of suicide (Favazza,
1996; Strong, 1998; Hodgson, 2004). Favazza (1996:
225), author of one of the most comprehensive works on self-mutilation, Bodies Under Siege, offers the following definition of
self-mutilation: “the direct, deliberate destruction or alteration of one’s own
body tissue without conscious suicidal intent.”
Self-mutilation
has long been of interest to psychologists. Research exists on the detection,
diagnosis, possible causes, and treatment of self-mutilation, though it is
limited. Self-mutilation is often studied as a psychological phenomenon. As a
result, the existing research is conducted with the individual as the primary
focus. Psychological factors need to be examined; however, no one has attempted
to explain what role society plays in the detection, diagnosis, cause, and treatment
of self-mutilation. In this paper, I examine existing theories on
self-mutilation, and combine Durkheim’s theory on suicide (another
psychological phenomenon) with available information on self-mutilation. This
is done as an attempt to determine what part, if any, society plays in the
occurrence of self-mutilation. I begin by looking at the existing research on
self-mutilation to develop a model. I then review Durkheim’s theory on
suicide.
A Model of Self-Mutilation
Self-mutilation
includes many behaviors such as nail biting, piercing, burning, cutting,
hitting, or punching. The actions involved in nail biting and piercing are
self-explanatory. Burning includes burning oneself with cigarettes, lighters,
and matches. People who engage in these behaviors are commonly referred to as
“burners”. Cutting refers to slicing or scratching the skin to the point of
bleeding. People who engage in cutting behaviors are commonly referred to as
“cutters”. Cutters utilize a variety of tools, often razor blades, pieces of
glass or plastic, needles, and even their own fingernails. Though the labels
are common, those who participate in self-mutilation may not identify
themselves with the label. Hitting or punching entails physically striking
oneself either with one’s hand or a blunt object. Another common behavior among
self-mutilators is carving. In this action the individual may use any of the
tools for cutting to carve words or pictures into their skin (Favazza, 1996).
Classifications of Self-mutilation
Favazza (1996) classified
self-mutilation into two categories: culturally sanctioned self-mutilation and
deviant-pathological self-mutilation. The first category, culturally sanctioned
self-mutilation, refers to rituals and practices. In certain cultures, body piercing
is an example of culturally sanctioned self-mutilation, as are rituals thought
to rid the body of demons or satisfy angry gods. Deviant-pathological
self-mutilation, the second category, has three sub-categories: major
self-mutilation, stereotypic self-mutilation, and moderate/superficial
self-mutilation (Favazza, 1996). Major
self-mutilation refers to, what are most often, single
occurrences or infrequent events typical of persons suffering from
schizophrenia. In these cases, the individual is often in the midst of a
hallucination in which they believe that their actions (burning, cutting,
hitting, and even amputation) are demanded of them. An example of such behavior
would be a person with schizophrenia hearing voices telling them to cut off
their finger as punishment for their own actions or possibly even society’s
actions. Stereotypic self-mutilation is most common among those persons with
severe mental impairments and Autism. This type of self-mutilation presents
itself in actions such as repetitive head banging and is also referred to as
self-injurious behavior (SIB) (Favazza, 1996).
Superficial/moderate
self-mutilation is the most common type of self-mutilation. This type
encompasses the remaining, previously mentioned, behaviors of nail biting,
burning, and cutting. Favazza (1996) further
classifies superficial/moderate self-mutilation into three variations:
compulsive, episodic, and repetitive. Compulsive self-mutilation is the
variation that includes behaviors of nail biting and hair pulling. These
behaviors occur repeatedly throughout the course of one’s day. Episodic and
repetitive self-mutilation include the same type of
behaviors, such as burning, cutting, and carving but with different
frequencies. The episodic self-mutilator does so occasionally as the response
to stressful, overwhelming situations or emotions. People who engage in
episodic self-mutilation typically do not identify themselves as “cutters” or
“burners” (Favazza, 1996). Repetitive self-mutilators
mutilate for the same reasons as episodic self-mutilators; however, they are
more likely to identify themselves as “cutters” or “burners” and are
overcome by their preoccupation with these behaviors.
Empirical Research on Self-mutilation
In a study
by Ross and Heath (2002), four hundred and forty high school students from two
different high schools were surveyed. The research shows that 13.9 percent of
the students surveyed report engaging in self-mutilating behaviors, the most
common type of which was cutting. An overwhelming majority, 77 percent, was
Caucasian. Ross and Heath (2002) also found that 59 percent of those who
participate in self-mutilating behavior have parents who are married, while
only 36 percent come from homes where the parents are divorced or separated.
Yet another finding is that “girls are significantly more likely to
self-mutilate as compared to boys” (Ross and Heath 2002:10).
These
findings support some of those discussed by Favazza
(1996). He cites work by Graff and Mallin (1967; in Favazza, 1996: 164) when stating that the typical
self-mutilator is “an attractive, intelligent, unmarried young woman.” Favazza (1996) also clearly states that self-mutilation is
not an attempt at suicide and is often referred to as the opposite of suicide.
Reasons for this assertion are that self-mutilators often do not want to die;
but rather, they want to live. This is the only way they know to deal with
feelings that could otherwise lead to suicide (Favazza,
1996).
Psychological Research on Self-mutilation
The
Diagnostic Statistical Manual (DSM-IV, 2000) addresses self-mutilation as a
diagnostic criterion for Borderline Personality Disorder or Impulse-Control
Disorder Not Otherwise Specified (NOS). The DSM (2000: 292) defines Borderline
Personality Disorder as: “A pervasive pattern of instability of interpersonal
relationships, self-image, and affects, and marked impulsivity beginning by
early adulthood and present in a variety of contexts.” The diagnosis of
Impulse-Control Disorder NOS is applied when the individual’s behavior does not
fit one of the specific Impulse-Control Disorders. This includes behaviors such
as persistent picking at one’s skin.
A common
theme in the existing psychological research on self-mutilation is that this
behavior is correlated with abuse (White Kress, 2003; McLane,
1996). Much of this literature asserts that adolescents engage in this behavior
as a way of dealing with the trauma of abuse. Not every person with a history
of abuse self-mutilates. A large percentage of those who self-mutilate,
however, do have histories of abuse (White Kress, 2003). As a result, the
behavior of self-mutilating may serve to unite those who have similar histories
with abuse. McLane (1996) points out that there are a
multitude of other self-destructive behaviors such as smoking, eating
disorders, and unhealthy relationships, which serve a unifying purpose for
those who engage in them.
Even within
a psychological context, it is possible to find social aspects of
self-mutilation. Applying social factors to psychological phenomena is not an
effort to discount the psychological research that already exists. Rather, the
intent is to gain a more complete understanding and explanation of a
behavior.
Durkheim’s Theory and Classifications of Suicide
If
self-mutilation is often referred to as the opposite of suicide (Favazza, 1996; Strong, 1998; Hodgson, 2004), why compare it
to suicide? By proposing a sociological theory on suicide, Durkheim (1897)
paved the way for more open thought on the implications of sociology as a
discipline. Durkheim’s approach seems to form a precursor to psychological
aspects of suicide, rather than eliminating psychological aspects altogether.
Social forces are viewed as general causes of suicidal behavior that are then
internalized and individualized, resulting in the act of suicide. Durkheim’s
theory on suicide is chosen not because it details an action similar in some
ways to self-mutilation. Instead, it was chosen because it is the only
extensive theory of its kind.
In his
discussion of suicide, Durkheim (1897) distinguishes between psychopathic
states and normal psychological states. Within the psychopathic state, he
identifies four types of suicide: maniacal suicide, melancholy suicide,
obsessive suicide, and impulsive or automatic suicide. Maniacal suicide is most
common among those suffering from hallucinations, usually schizophrenia.
Mechanical suicide corresponds with Favazza’s (1996)
classification of major self-mutilation. Melancholy suicide is characterized by
extreme depression, created or imaginary, and often unrelated to a person’s
circumstances. Obsessive suicide usually lacks authentic motive. A person may
be fixated with the idea of suicide, and thus for them, committing suicide
becomes an instinctive drive. Impulsive or automatic suicide also frequently
lacks motive, and is characterized by an irresistible impulse to commit
suicide. Obsessive and impulsive, or automatic, suicide
correspond to Favazza’s (1996) classification
of stereotypic self-mutilation. Within normal psychological states, Durkheim
(1897) classifies suicide into three types: egoistic suicide, altruistic
suicide, and anomic suicide.
Egoistic Suicide/Egoistic Self-Mutilation
Egoistic
suicide occurs when an individual’s ties to society and morality are too lax.
Egoism is commonly defined as self-centeredness, thus people in this state are
concerned with themselves over anything else. The first consideration in
egoistic suicide is religion. Durkheim spent a great deal of time focusing on
the study of religion and its purposes. Morality was also an important term for
Durkheim. Morals are a set of rules or codes that people adhere to in any given
society (Spaulding and Simpson, 1951). Durkheim believed that religion is a
creation used to assist the reinforcement of these morals. High levels of
collectiveness characterize certain religions. Durkheim (1897) proposes that
these religions experience fewer suicides than others, which encourage free
thought. If individuals do not subscribe to the higher beliefs of a religion,
they are left to make sense of the world on their own. When individuals cannot
make sense of the world in which they live, they may simply loose the desire to
live (Spaulding and Simpson, 1951).
Religion is
not the only way individuals can be tied to society. Durkheim (1897) also cited
family, education, beliefs, and politics as forces that influence egoistic
suicide. Families, if large and close-knit, can also provide the necessary ties
to society through their own traditions and common beliefs. Politics can be
another source for common beliefs that serve to connect individuals to the
society in which they live. Beliefs or philosophies such as existentialism can lead
to depression, which in turn, may cause suicide. Existentialism is the belief
that “man is born into a state of nothingness, out of
which he/she creates meaning” (Furman and Bender, 2003:126). Again, we see that
the individual is left to create meaning on his or her own. Education,
according to Durkheim, may increase the occurrence of egoistic suicide. Lax
ties to society cause extreme individualism and individualism leads to a desire
to learn. Often, in the course of learning, common beliefs and traditions of a
given society are called into question (Spaulding and Simpson, 1951). Once
again, the individual is left to make sense of the world on his or her own.
After
examining the research on self-mutilation, it is evident that the typical
self-mutilator often falls into the egoistic category. Many self-mutilators
report that they harm themselves as a way of coping with feelings of
loneliness, anxiety, anger, or depression (Ross and Heath, 2002). Egoistic
self-mutilation is done to serve the individual’s needs. Individuals
self-mutilating to alleviate the feelings of loneliness, anxiety, anger, or
depression would be one example of this. Using self-mutilation as an attention
seeking behavior such as cutting or burning after a breakup or argument is
another example of egoistic self-mutilation. There is no literature, however,
that addresses the frequency of instances of self-mutilation used for this
purpose.
In further
support of an egoistic approach to self-mutilation, there is some evidence that
instances of self-mutilation are increasing (Ross and Heath, 2002). At the same
time, the breakdown of morals and an increasing emphasis on individuality is
noticed. Information on the religiosity of adolescents, who make up the
majority of self-mutilators, is needed to fully assess this logic. The average
family size, however, has decreased in recent years. According to Durkheim,
family traditions cannot be established as easily in smaller families. At this
point, little data exists regarding self-mutilators’ religiosity or family
size. Future research is necessary to fully integrate the sociological
model.
Altruistic Suicide/Altruistic Self-mutilation
Altruistic
suicide is often seen as the opposite of egoistic suicide. When an individual
commits egoistic suicide, they do so because his or her ties to society are
lacking. On the other hand, an individual who commits altruistic suicide does
so because his or her ties to society, or a particular group in society, are
too strong. Altruism means for the good of the group. In this case, the
individual is placing the group’s agenda above his or her own. In Suicide,
Durkheim (1897) identifies three types of altruistic suicide: obligatory,
optional, and acute.
Obligatory
altruistic suicide occurs when common beliefs in a society require individuals
to kill themselves. This type is more commonly associated with cults or
primitive religions (Spaulding and Simpson, 1951). A person usually commits
obligatory altruistic suicide when they believe they will be punished, religiously
or otherwise, for failing to do so. In the case of optional altruistic suicide,
the society or group does not force the idea of suicide. They merely recommend
it. To the society or group in question, suicide is seen as honorable. Acute
altruistic suicide occurs when one is motivated by beliefs of what he or she
will gain after death. Suicide bombers are an example of this in that they
believe, through their religion, they will be rewarded
in the after-life.
The idea of
altruistic self-mutilation explains primitive self-mutilation or what Favazza (1996) refers to as culturally sanctioned
self-mutilation. This is somewhat different from the typical types of
self-mutilation discussed so far. In these instances, self-mutilators either
allow themselves to be disfigured, or disfigure themselves in an attempt to
please society, gods, or other immortal beings. For example, female genital
mutilation is considered altruistic self-mutilation, as well as acts required
of an individual before entering into the ancient healing art of shamanism. The
belief is that one must endure intense physical and mental pain in order to
then be able to heal others (Favazza, 1996).
Anomic Suicide/Anomic Self-mutilation
Anomie is a
term used by Durkheim to refer to a state of normlessness
or conflicting norms; this is where anomic suicide gets its name. In the
instances of egoistic or altruistic suicide, the individual’s relationship to
society is the cause. With anomic suicide, it is an individual’s interaction
with society that is the cause. Every human has basic needs such as food and
water. In modern society, however, “the more one has, the more one wants, since
satisfactions received only stimulate instead of filling needs” (Spaulding and
Simpson, 1951:248).” Thus, individuals set unattainable goals and produce for
themselves a constant state of discontent and possibly even depression. States
of anomie can be brought on by changes in society. Economic changes, such as
depression or inflation, cause individuals to re-examine their needs and adjust
accordingly (Spaulding and Simpson). This change can lead to an internal
struggle regarding what one can afford versus what one desires. Occupational
change, another type of economic change, affects the individual in the same
ways and, therefore, can also cause anomie. Becoming un-employed is a prime
example of such anomie.
Furthermore,
when an individual commits murder before committing suicide, the situation is
classified as anomic suicide. Often, the anger associated with this combination
of actions is a result of the individual’s inability to internalize societal
norms or reconcile the conflicting norms that individuals is are faced
with.
Anomic
self-mutilation is caused by the individual’s inability to deal with stress or
frustration caused by changes in society or in the individual’s social groups.
Because self-mutilation is more common among adolescents, the social groups in
question are often school-aged peers. Any type of teasing, bullying, or general
lack of acceptance also creates a state of anomie. In these cases, the
unattainable goal is often popularity or acceptance. Self-mutilators then
participate in mutilating behaviors as a way of coping with this anomie.
Conclusion
Having now
examined both the research on self-mutilation, as well as Durkheim’s
sociological theory of suicide, I can begin to identify the new model’s
successes and failures. The existing classifications of self-mutilation seem to
fit within a Durkheimian approach. There are,
however, a few shortcomings. These shortcomings are a direct result of the lack
of empirical research on self-mutilation. In order to completely integrate a
sociological approach to self-mutilation, more information on individuals who
engage in this behavior is needed. It is necessary to know their religious
affiliation, as well as their degree of religiosity. Additionally, more
information regarding family size and peer group structure is needed.
In Suicide,
Durkheim (1897) writes that instances of suicide are more common among men. He
argues that women need less from society and, therefore, are less likely to
experience any of the identified types of suicide. This argument seems to
contradict the existing research on self-mutilation, which says that females
are more likely to self-mutilate. This discrepancy actually serves to support
the integration of a sociological model of self-mutilation. If one accepts the
notion of self-mutilation as being opposite to suicide, then it would make
sense that more males commit suicide while more females engage in
self-mutilation. Further empirical research is needed to form a continuum of
the sociological approaches to suicide and self-mutilation. A sociological
approach to self-mutilation opens the door for a psychosocial understanding of
many phenomena affecting society today such as eating disorders, depression,
and even low self-esteem.
“What is carved in
human flesh is an image of society”
٭ Mary Douglas
in A Bright Red Scream
(Strong 1998:xviii)
References
American Psychiatric Association (2000). Quick Reference to the Diagnostic Criteria From DSM-IV-TR. Washington, DC:
American Psychiatric Association.
Durkheim, Emile (1897). Suicide translated by Spaulding and
Simpson, 1951.
Favazza, Armando (1996). Bodies Under Siege: Self-mutilation and Body Modification in Culture and Psychiatry, 2nd
Edition.
Hodgson, Sarah (2004). “Cutting Through the Silence: A Sociological Construction of Self-injury.” Social Inquiry 74:162-
79.
McLane, Janice (1996). “The Voice
on the Skin: Self-mutilation and Merleau-Ponty’s
Theory of Language.”
Hypatia
11:107-118.
Ross, Shana and Nancy Heath (2002). “A Study of the Frequency of Self-mutilation in a Community Sample of Adolescents.”
Journal of Youth & Adolescence
31:67-77.
Strong, Marilee (1998). A Bright Red
Scream.
White
Development 81:490-496.
Kelly Faust is a graduate student in the Department of Sociology and Criminal Justice Studies at SIUE. Her email address is: kcreature@yahoo.com