Patricia Adler regularly studies what many shy away from: deviance, drug use, and labor in a rapidly globalizing world. She is Professor of Sociology at the University of Colorado, Boulder, as well an author, and the winner of the 2010 George Herbert Mead Award for Lifetime Achievement from the Society for the Study of Symbolic Interaction. Her work has been published by Cornell University Press, The Sociological Quarterly, and New York University Press. Her most recent book, which she co-wrote with her partner Peter Adler, is called The Tender Cut: Inside The Hidden World of Self-Injury. The Tender Cut examines physical acts of self-destruction and self-injury, like cutting and burning, as well as the history behind self-injury, and how it has changed within the current cultural context. It’s an honor to have spoken with her and to have her on our site. Persephone Magazine, please welcome Patricia Adler.
Persephone Magazine: You are the author of the recently released book, The Tender Cut: Inside The Hidden World of Self-Injury. What prompted you to tackle self-injury and how did you get starting researching this topic?
Patricia Adler: The germ of an idea for this study began in the spring of 1982 in Tulsa, Oklahoma. Shortly into his first teaching job, Peter met with a student in his office who came to tell him about an odd practice of hers: she intentionally cut herself. Intrigued and sympathetic, he listened to her story, looked at the small cuts on her legs that she took great pains to hide, and asked questions, with curiosity, about her motivations and sensations from it.
Over subsequent years we both caught further glimpses of similar behavior. As interested and “cool” professors who taught courses on deviance, popular culture, drugs, and sport, we often found ourselves the adults to whom college students turned as sounding boards. Our next encounters with cutting were rare at first, but took on greater frequency during the late 1980s and early 1990s. By the mid ’90s, we knew or had heard about enough people who cut themselves intentionally that we felt surrounded by it. Yet during the occasional times when we discussed this with friends or colleagues, we found it fundamentally unknown. Then, in the spring of 1996, a young high school-aged friend of ours, the daughter of close friends, confided to Peter about her cutting. She had never mentioned it to her parents, but she needed someone to talk to about it. Peter was her college advisor (one of his side avocations), and they had a close relationship. This very detailed, intimate conversation caught our attention. We felt the behavior was calling us to study it.
PM: Why is it necessary to have an open dialogue on self-injury and the role that it plays in many people’s lives?
PA: Many people who came forward to do interviews with us recounted years of horrible treatment in emergency rooms and psychiatric hospitals, with doctors and counselors, and in interacting with parents, friends, and other concerned adults. For years, the psycho-medical community has dominated the discourse about self-injury, controlling its definition, diagnosis, demographics, effects, and treatment. They viewed it as a mental disorder mostly practiced, like eating disorders, by teenage, white, girls coming from affluent backgrounds. It has alternately been stigmatized as either a sin (bad, evil, aka the Middle Ages and even still now) or a sickness (an addiction, a disease, a mental disorder). But many of the people who do it now regard it simply as a voluntary choice, as a coping mechanism that helps them deal with the emotional distress engendered by their life circumstances. It is also a way of expressing affiliation with an alternative set of norms and values, often in youth subcultures (Goth, heavy metal, Emo), or a way of rebelling from traditional family controls, or the lack of control found in a hopeless and helpless life. So there are many reasons why people self-injure in addition to the traditional ones of physical and sexual abuse, and of bad environments.
PM: The book spans across ten years of research and draws on over 150 interviews. In what ways did self-harm change in context over this period of time? What would you say was the common thread in between many of the people you spoke with?
PA: Although there are myriad reasons why people self-injure, and there is an increasingly diverse population of people who engage in the behavior, there is one thing that ties them together. They are people who feel emotional distress. Self-injuring seems to release endorphins in the brain (just like exercising) and makes people who feel sad, angry, or otherwise bad feel better. It doesn’t really do anything for people, however, who are feeling fine. We interviewed one young man who had taken a knife away from his girlfriend in an attempt to help her stop cutting, and one day he decided to try it himself to see what it was all about. But he didn’t have her emotional pain and he found that it just hurt, and didn’t do a thing for him.
How has self-injury changed in context over this period of time? We propose that three significant historical periods can be discerned that affect the population, prevalence, meaning, and practice of self-injury. Self-injury has clearly existed for a long time, although throughout most of history there has been little public awareness of the phenomenon. During this first era, practitioners acted mostly alone and in a social vacuum. Early mentions of self-injury from the time of Herodotus in the 5th Century, B.C. through the Middle Ages depict self-injurers as religious fanatics, outcasts, and the severely disturbed or mentally ill.
Somewhere in the mid-1990s, public knowledge of self-injury began to rise and a second era dawned, with depictions of it appearing in books, films, television shows, magazines, newspapers, and other media. Several celebrities came out in public and admitted their self-injury, and discussions of it flourished in many high schools. This burgeoning awareness, although limited in scope, spread fairly rapidly through segments of the population that were most likely to come into contact with self-injurers: adolescents, young adults, educators, doctors, and psychologists. It affected the way self-injurers thought about themselves and were regarded by others, but they still mainly kept to themselves, operating as loner deviants.
We argue that a third period began around 2001-2002, when websites began to appear on the Internet focused on self-injury (self-mutilation, self-harm) complete with public chat rooms where people could interact with fellow and former self-injurers, those who wished to discourage the practice, and random other visitors. Internet self-injury sites and groups have enabled the development of cyber-subcultures and cyber-relationships where communities of self-injurers flourish and grow. At the same time, during this phase the practice of self-injury became widespread among a broader range of people: prisoners, especially juvenile delinquents; homeless street youth and others who suffer and lack control over themselves; boys and men; people of color; those from lower socioeconomic statuses; members of alternative youth subcultures; youth suffering typical adolescent stress, and a growing group of older hard-core users who begin the practice to seek relief but settle into a lifetime pattern of chronic self-injury. The behavior of individuals engaging in this practice during these three periods was defined and shaped in different ways.
PM: What do you think are the most common misconceptions about those who self harm or what the act of self-injury means?
PA: A lot of people have still never heard of self-injury, but there is a significantly growing segment of the population that now has. Most people we encounter, in fact, even seem to know someone who self-injures. But they don’t really understand it. They don’t get how or why cutting or burning yourself can make you feel better. Many continue to think of it as a suicidal act. That is the most common misconception.
The second most common misconception is that it indicates that the person doing it is mentally ill. Self-injurers have been told by members of the psycho-medical community that they are (to varying degrees) mentally disordered, suffering from such syndromes as borderline personality disorder (BPD: inappropriate anger and impulsive self-harming behavior), antisocial personality disorder (the tendency to be aggressive, to have reckless disregard for personal safety), histrionic personality disorder (a pervasive pattern of excessive emotionality and attention-seeking behavior often enacted through physical appearance), post-traumatic stress disorder (sometimes due to rape or war), various dissociative disorders (including multiple personality disorder), eating disorders, and a range of other conditions such as kleptomania, Addison’s disease, depersonalization, substance abuse, alcohol dependence, and assorted depressive disorders.
It is because of these two common misconceptions that many self-injurers are put onto drug therapy, especially adolescents.
PM: Self harm is something that historically has been around for years and is present in many societies, whether classified for religious purposes like flagellation by Catholic or Shi’ism circles or mourning practices like New Guinean peoples who often cut off a finger when a loved one dies. Where do you see connections in this seemingly universal occurrence? What then becomes the line between culturally sanctioned self-injury and its pathological counterpart?
PA: There are many things that people have done to their bodies over the years that are injurious including MÃ¼nchausen Syndrome (the somatic disorder in which people feign physical or mental illness in order to draw sympathy to themselves, or to gain admittance to hospitals or clinics), Klingor Syndrome (where people with delusions [often religious], sexual conflict associated with guilt, past suicide attempts or other self-destructive behavior and depression, severe childhood deprivation, and major premorbid personality disorder, are the group at risk for genital self-amputation), religious self-flagellation, body modification (tattooing, piercing, scarifying), and more. Although these may have some outward appearance of commonality, self-injury is the deliberate, non-suicidal destruction of one’s own body tissue, practiced by people to deal with anxiety or emotional pain.
PM: In The Tender Cut, you state that self-harm has become more of a cultural phenomenon when it has been considered a part of psychological conditions in the past. What caused this change? How do you see it fitting in with our culture now?
PA: Self-injury has become a contemporary mode of self-expression, often a way to articulate angst on the outside that people are feeling on the inside. Practitioners, either alone or through the community of cyber subcultures, have created and shared multiple explanations and social connotations for their acts, defining them as self-empowering. Through their own acts, self-injurers achieve the ethic and aesthetic of self-mastery and self-transcendence through which they experience and present themselves as exhibiting superior self-control.
PM: Do you see any links in between the rise of the Internet and the way self injury has become more of a highlighted subject?
PA: The rise of the Internet has given people community in ways that they did not have before. It’s made people aware that they are not crazy and that they are not alone. It’s offered practical suggestions for stopping and it’s also given people the license to continue. It’s helped people who felt alone find friends in whom they could confide about their innermost problems. It’s given people an outlet for talking about their feelings and their inner pain in ways that people in the “real” world are not interested in hearing and usually cannot tolerate. It’s provided a community of people who understand and accept them. It’s provided contact with people who do not want to stop and who feel that it’s an acceptable coping mechanism. So I’d say that the Internet both facilitates continuing to self-injure as well as supporting people who want to quit self-injuring, and sometimes a little of both.
PM: How have people responded to The Tender Cut?
PA: I’d have to say that I’ve been astounded by people’s response to The Tender Cut! Most of our previous research has been well received within the academic community, but not gotten much attention beyond that. Only 10 weeks from its publication, this book has received widespread attention in the print, online, radio, and television media across three continents, is slated for translation, and is already in its third printing.
PM: What great work can we look forward from you in the future?
PA: We will continue to write in the areas of deviance, work and leisure, and the sociology of drugs.