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In this timely and focused study of body modification, the psychoanalyst and psychologist Alessandra Lemma looks very specifically at what drives some
individuals to pierce, tattoo, use cosmetic surgery or otherwise modify their bodies, and at the unconscious conflicts and internalized relationships at work in fuelling these often uncompromising bodily communications.
Early on, Lemma draws a distinction between those who ‘decorate’ their bodies with one or two tattoos, for example, during adolescence, and those for whom their acts are ones of compulsion, who might visit the tattoo parlour once a month, and go on to devote ‘hours to the self-care rituals that tattoos require in the short term’. In a later chapter on cosmetic surgery, ‘The botoxing of experience’, she addresses the increasing use of surgical operations for bodily enhancement, linking a cultural preoccupation to a more primitive drive to reinvent the self. This, she argues, can function both as an attack on the given body—‘what you have given me is not good enough, I need to give myself something beautiful’—or a bringing into reality of a longed for merger with an idealized mother who has been attacked as hated, and where the hatred and implicit attack are so well disguised by the surgery.
There is much here that brings to mind patients who, unable to bear and reflect on their experience of trauma and pain, or their fear of separation and loss, turn to the body or skin as a means of communication. Such patients often reveal long-held, compulsive fantasies and actual plans for cosmetic surgery, in an unconscious attempt to manage unbearable anxiety and contain their feelings of rejection and loss.
Lemma indicates that this book has been in gestation for a long time, and one of its considerable strengths is that she is able to draw on work and observations of a very wide range of patients and individuals—from adolescents and young offenders to adults, whether in prisons, patients in private psychoanalytic