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Already an experienced clinician, Sharon Farber chose to return to school to get her Ph.D. in clinical social work. This ambitious first
book is the product of her prior clinical experience and more recent doctoral thesis research. The book, divided into four parts, provides a survey of the almost infinite number of ways human beings can harm their bodies; the psychic determinants of this behavior; what these behaviors communicate; and, lastly, how we as clinicians can be useful to patients who perform these acts.
Part One, “The Borderland of Self Harm,” comprises three chapters, each with multiple subsections. Here, Farber describes the many varieties of body manipulations she has encountered. Her sources vary from popular magazines and television to academic works in history, anthropology, psychiatry, and psychoanalysis. The breadth of her survey is informative and impressive. As clinicians, we have all had experience with some of these behaviors. However, few of us have been exposed to them as extensively as we are in these first 107 pages.
Part Two, “Neglect, Violence, and Traumatic Attachments,” is a valiant attempt to recount what is known about the etiology of self-harm behaviors from a variety of perspectives. The author invokes attachment, object relations, instinct, family systems, and ego, self, and evolutionary psychological theories, as well as the newer neuroscientific findings, to further an understanding of the determinants of self-harm. Throughout, she presents material to support one of the important themes of this book: that as destructive as these behaviors are, they are also creative attempts at self-preservation.
Part Three, “The Body Speaks,” attempts to explicate the various functions and meanings that self-harm behaviors can be designed to serve and express. Again, Farber reaches to some nontraditional sources to investigate this topic. Her research, described in the appendix, has helped to substantiate the notion that self-harm behaviors ser