Naming self-harm can be a tricky business, and the recent debates about including ‘non-suicidal self-injury’ in the latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (American Psychiatric Association, 2013) is just one example of this. My research, with people who have self-harmed, and General Practitioners, suggests that the type of practices self-harm is understood to involve, and the meanings they have, can vary widely. While for some people, ‘self-harm’ is taken to mean skin-cutting; for others it might refer to overdoses; misusing drugs and alcohol, attempting suicide, risk-taking, or maintaining an abusive relationship.
Surveys that collect data about rates of self-harm provide
important information; but they do not tell us the whole story about how
someone understands self-harm, what kind of practices self-harm involves, how
self-harm affects and contributes to their day-to-day life. Even a particular
type of self-harm, say, self-cutting, can be used and experienced in many
different ways (Chandler, 2012; Chandler, 2013).
In a paper that was published recently (online first) in the
BMJ journal Medical Humanities, I
explore narratives about living with bodies scarred or marked by self-cutting.
The paper uses Arthur Frank’s typology of illness narratives (Frank, 1995): restitution, chaos, and
quest, to demonstrate the different ways in which people talked about the
impact of scarring on their lives.
- Restitution: For some participants, a focus of their story was to emphasise removal of scars, and attempts to ‘fix’ the problem of the scarred body.
- Chaos: More rarely, people spoke of their scarred bodies as chaotic, indicating feeling out of control of their body and the scars.
- Quest: A more optimistic account was given by others, who talked about the role of scars in ‘telling a story’ – to themselves and to others. Importantly, the story was one of hope, and of overcoming difficulties.
If rates of self-harm are increasing, there are likely to be
more people living with scarred bodies in future. It is important to
acknowledge that these scars may have very different meanings, and be
experienced in different ways. Indeed, a common theme across the research I
have done with people who have self-harmed highlights the pain caused by other
people’s assumptions about what self-harm, or self-harm scars, might mean.
Read the published article online at: http://mh.bmj.com/content/early/2014/05/08/medhum-2013-010488.long. This article has been made open-access.
Contact Amy by email.
Further reading:
Contact Amy by email.
Further reading:
American Psychiatric Association (2013), Diagnostic and statistical manual of mental disorders: DSM-5,
Arlington, VA, American Psychiatric Association.
Chandler, A. (2012), 'Self-injury as embodied emotion-work: Managing rationality, emotions and bodies', Sociology, 46, 3, 442-457.
Chandler, A. (2013), 'Inviting pain? Pain, dualism and embodiment in narratives of self-injury', Sociology of Health & Illness, 35, 5, 716-730.
Frank, A. (1995), The Wounded Storyteller; Body, Illness, and Ethics Chicago, University of Chicago Press.
Chandler, A. (2012), 'Self-injury as embodied emotion-work: Managing rationality, emotions and bodies', Sociology, 46, 3, 442-457.
Chandler, A. (2013), 'Inviting pain? Pain, dualism and embodiment in narratives of self-injury', Sociology of Health & Illness, 35, 5, 716-730.
Frank, A. (1995), The Wounded Storyteller; Body, Illness, and Ethics Chicago, University of Chicago Press.
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