I Bleed Therefore I Am: Pain, Restoration and Repair in Self-Cutting

Adolescent self-harm is a national and global public health phenomenon that involves young people physically damaging or injuring their bodies. Historically, it has been understood as a coping mechanism and a form of escape from chronic levels of stress and distress in the context of unbearable states of mind. Prevalence has been hard to establish given the high levels of under-reporting, but some reports suggest that it may be as high as twenty-five per cent of young people who have self-harmed on at least one occasion (Wright, Hooke, Neupert, Nyein & Ker, 2013). Types of self-harm include self-cutting, burning, picking, bruising, medication overdoses and inserting foreign objects into the body. The focus of this article is upon the phenomenon of self-cutting and the physical and psychological wounds that are carved and stamped into the young person's body. It explores self-cutting through the theoretical constructs of attachment, adhesive identification and the twin processes of introjection and projection moving towards the purpose, function and symbolic meaning of self-cutting.

Theoretical focus: The principal thrust of this paper reasons that in states of acute dissociation self-cutting is employed by young people to repair chronic levels of splitting, emotional surges and rapid cognitive recycling (over-thinking) and depressed cognitive cycles (under-thinking). Self-cutting can be understood as an act of self-destructiveness fused with a desire to acquire control, equilibrium and relief from psychic pain. Two case scenarios, one major and one minor, ground these theoretical arguments in clinical practice. In each case, pseudonyms have been used and permission has been sought before including their clinical material.