Cutting: Understanding and Overcoming Self-Mutilation

Cutting isn’t just about cutting. It’s about burning, fainting, fingernail scratches, hospital visits, and apparent suicide attempts. It’s about what the author calls self-mutilation (though many sufferers prefer the term "self-injury" as "mutilation" implies that the goal is the scar, which isn’t always the case). These girls (and they are mostly girls) act out their anger or sadness on their own skin, inflicting pain but not attempting suicide. The author has worked with girls and boys who hurt themselves for years as a therapist, and he has written this book for both therapists and loved ones. He understands why some people choose to hurt themselves, something that is often a repulsive mystery to others. Self-mutilation, he says, is a "barrier" that keeps us from seeing someone in honest psychological pain. Self-mutilators, who are predominantly, but not exclusively, adolescent girls, have no way to express their anger or pain, whether because of socially imposed norms or because they simple haven’t learned the words. Anger is turned inward and expressed on the self. The girls feel alone, with no one to trust. Often physically or verbally abused, the girls have severe attachment disorders. The book is never too technical for the lay reader, though therapists can learn from it as well. Full of dialogue from his own practice, Levenkron really gets into the minds of these girls and boys. While he discusses treatment, however, he also argues for the recognition of self-mutilation as a psychological disorder in its own right, not merely as a symptom of disorders like borderline personality disorder or depression with anxiety. Though self-mutilation can stem from these, he argues, it can manifest itself without. Just as he argued for anorexia nervosa to be recognized as a disorder, so he argues for self-mutilation. This is an excellent book on a little-understood phenomenon.

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