Flesh Made Word: Cutting Back to the Mother

This paper explores the severe self-mutilating behavior of a 21-year-old female patient. In a theoretical framework that emphasizes the role of language in human development as explicated by Lacan (see Muller, 1996), this young woman's cutting may be seen as an attack on language itself. The patient, Ms. A, could not bear to put her distress into words. Instead, through her repetitive mutilation of her neck, she made her flesh perversely substitute for words. Instead of a name appearing where a thing was—the process of symbolization—a thing (her wound) replaced a name. Her assault on symbolization occurred in the service of attempting an impossible reunion, a kind of wordless oneness, with the original thing, that is, the mother. My formulation derives from Lacan's (1963-1964) reinterpretation of Freud's death drive, which locates that drive in a symbolic rather than biological context. This approach allows for a conceptualization of what other authors have noted about self-cutters: their inarticulateness and their impoverished use of symbolization (Doctors, 1981; Kaplan, 1991). In my work with Ms. A it became clear to me that she did not have a deficit in her capacity for symbolization; indeed, she had superior verbal intelligence and was a gifted writer, articulate in poems and stories. How, then, could I understand her speechlessness and the insistent, self-destructive acting out in our work? I believe that her capacity for symbolization was intact but intolerable to her. Because language interfered with a deeply held unconscious fantasy of unification with the maternal body, she was