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In graduate school, a classmate of mine wrote her thesis about body modification. As I listened to her present her research to a standing-room-only crowd, I remember wondering why so many people were interested in this seemingly remote subject; how would this material be relevant as I ventured out into clinical practice? Almost fifteen years later, I approached Alessandra Lemma's Under the Skin: A Psychoanalytic Study of Body Modification with some of the same skepticism. Now, having finished the book, I am a skeptic no longer.
Body modification is the deliberate altering of the body for nonmedical reasons. This groundbreaking book is an in-depth psychoanalytic exploration of what motivates a person to modify his or her body. Lemma contends that modifications of the body's surface are born out of deep unconscious meaning. Lemma looks “under the skin” to the individual's internal life and to relationships with internalized objects to make sense of compulsive and extreme forms of body modification.
There is nothing new about our current-day body modification practices. Tattooing has been around since the Stone Age, and the first recorded plastic surgery technique was performed in India in 1000 B.C. to reattach an amputated nose (p. 132). Cross-cultural studies show a universal tendency to alter, distort, and disfigure the human body (p. 15). Despite these long-standing and universal tendencies, there has been a worldwide increase in body modification practices over the last twenty years. Cosmetic surgery has increased by 465 percent since 1997 (p. 134). In In the Flesh: The Cultural Politics of Body Modification (2003), Victoria Pitts details how in the late 1980s body piercing and tattooing took off as a countercultural movement. Subculture groups with diverse interests began to identify themselves as “marked persons” or body modifiers: “What they shared is that they all positioned the body as a site of exploration as well as a space needing to be reclaimed from cultur