Cutting the Pain Away

I was friends with kids like these in middle school. They carried razor blades around in their pockets, carved their ex-boyfriend's initials into their arms, stubbed out cigarettes on their hands, and wore angry red wounds on their knuckles, wrists, calves and thighs. In her new book, A Bright Red Scream; Self-Mutilation and the Language of Pain, Marilee Strong tries to explain what is to most, inexplicable.

Her book comes at a time when the phenomenon of self-mutilation is beginning to be noticed. On Tuesday night, October 27, there was a special segment documenting two years in the life of a self-mutilator on Dateline NBC. During the segment, they repeatedly referred to the phenomenon as "the anorexia of the '90s." In 1997, self-mutilation was also the topic of a cover story in The New York Times Magazine.

Strong's own book stems from an article of the same name which she wrote in 1993. She shows all the marks of a good journalist; she clearly knows her topic, and writes about it with ease. She manages to capture the pain and anguish that self-mutilators feel before they cut themselves, and the release and calm that they feel afterwards.

The women in her book, and she points out that most self-mutilators are women, use everything from irons to scissors to inflict pain upon themselves. Many have highly ritualized cuttings, in which they set out the instruments of their own torture as carefully as a surgeon setting out her tools. The images in the book are unnervingly graphic, and Strong spares the reader as little as the victims spare themselves. In one chilling episode, a woman "sliced one [arm] open from wrist to elbow down to the muscle and burned herself so badly she required a skin graft."

Strong intersperses these kinds of nauseating descriptions with psychological analysis. This style is reminiscent of Reviving Ophelia: Saving the Selves of Adolescent Girls by Mary Pipher. Even though she allows the reader access to the most intimate details of the people she profiles, the scenes are so repetitively horrific that one loses perspective on the problem. Inured to the scenes of physical trauma, the reader has the sensation of watching a car crash, repulsed, but unable to look away.

Cutting becomes addictive to self-injurers. As an emotional high, it doesn't get much better, and Strong compares it to the effects of heroin use. Strong cites studies in which self-injurers show high levels of opiate-like chemicals in their brains. Strong also compares the trauma that many self-injurers experience to the trauma of war veterans, who have high rates of opiate addiction.

Strong argues that most self-mutilating behavior is a reaction to sexual or physical abuse, during childhood or adolescence. People, young women especially, who are violated in this manner feel out of control of their own emotions and bodies. Harming themselves is a way to respond to the clamor of emotions inside. After cutting, as Strong puts it, "they have moved from a place of passive helplessness to active control."

This is part of the reason why so many of the people in Strong's book find it so hard to stop. Some have been cutting all their lives, now in their '40s or '50s, they are finally seeking help. Although self-abuse is not a new phenomenon, Strong reports that it is growing. In cities like San Francisco, there is a sub-culture of piercing and sado-masochism. "The growing social acceptance of at least some of the so-called body arts has blurred the line between self-expression and pathology," Strong says.

Strong also argues that kids are increasingly vulnerable and lost in today's world. They must grow up, "without the kind of family and institutional support that existed in the past...". This is the same excuse which has been used to account for everything from punk rock to eating disorders, and here Strong puts it to use again. But Strong differentiates between the piercing and tattooing culture which is becoming more prevalent and the kind of pathological body mutilation that her subjects suffer from. She says that the former is becoming more popular but stops short of saying that it is popularizing the latter.

What Strong's book doesn't explain is why kids who haven't been sexually or physically abused during their childhood resort to cutting. On Dateline NBC, the subject had suffered her parents' painful divorce in early childhood, which, with the birth of a physically and mentally disabled younger brother, was enough to produce self-injury later in life.

Strong reports that 50 to 90 percent of "chronic self-injurers" reported being sexually abused as children. The Dateline NBC report stuck with a modest 50 percent. Strong fails to address the other 10 to 50 percent of self-mutilators.

So many of the people Strong interviews have had such incredibly traumatic childhood, that their stories become distended from reality for the reader. A typical testimony begins, "Cherie doesn't remember when the abuse began." While Strong does a good job explaining why people having gone through this kind of trauma in childhood would turn to self-mutilation affects those who have experienced more subtle traumas in their childhood, traumas that can be more easily overlooked by parents and caretakers.

While the Dateline NBC report, in typical TV fashion, wants us to fear, "it could happen in my family too!" Strong inures us to the dangers of self-injury by relegating it only to the victims of the most severe childhood abuse.

Nasty divorces are increasingly commonplace, and there is no doubt that their affect on children is profound. So why do some of those children go on to carve themselves up while others do not? Strong hardly mentions cases like these. She does link self-mutilation to eating disorders, however, which clearly occur among people with loving and intact families.

If self-mutilation is the "addiction of the '90s" as Strong claims, then chances are it will be showing up in even the most secure of households. Until someone figures out why, people will continue to cut the pain away.