Further Thoughts on “Self-Cutting”: The Intersubjective Context of Self-Experience and the Vulnerability to Self-Loss

It was a privilege to participate in a symposium with a group that so thoroughly honors the variety, complexity, and richness of psychological life. Our colleagues from Austen Riggs are standard bearers in the on-going struggle to understand the intricacies of subjective experience. Twenty years ago, I studied the symptom of “delicate self-cutting” at a psychoanalytically oriented psychiatric hospital that specialized in long-term treatment. Studying these papers and preparing this discussion has given me a welcome opportunity to revisit this compelling symptom and to review my understanding of it.

Each of these therapists lived through impossibly difficult times with their patients and demonstrated incredible courage, fortitude, and professional devotion. I wholeheartedly admire them, their work, and their thoughts about their work. This is a provocative, evocative, haunting symptom. Whether or not one embraces a view of the symptom that includes its communicative value, it is clear that self-cutting, which functions in different ways to relieve patients, never fails to disturb others.

Central to these cases is how vulnerability is understood, experienced, and managed. I believe that self experience is co-determined by the felt responsiveness of others, though full awareness of this is universally resisted, for it is frightening to recognize how vulnerable our experience is to the human surround (Stolorow & Atwood, 1992). Despite the best intentions, we can still