Monday, July 18, 2011

Self-Injury

I read this article for one of my classes and really, really enjoyed the point of view of this article. I thought I'd share. I hope you take the time to at least skim it. Don't I have an awesome job?!


A Look at the Increase in Body Focused Behaviors
by Wendy Lader, Ph.D.
Wherever one looks today, it is difficult to escape the increasing focus on the body. We starve it, exercise it, tattoo it, pierce it, self-mutilate and modify it through plastic surgery.
For the past 20 years, my colleagues and I at SAFE Alternatives® have focused on trying to understand and treat those that physically self-injure their bodies. We view self-injury, not as a meaningless habit, but rather a behavior that can serve a number of purposes and hold a myriad of different meanings. It can, at once, soothe, punish, numb, repulse and cleanse. It can represent an expression of anger, loneliness, invisibility, fear, self-loathing and even strength.

Throughout the years, I have often been asked whether I believed there is a relationship between self-injury and “body art.” When I first started pondering this question, I thought they were very different acts with different meanings and purposes. After all, self-injury is usually a private act inflicted by the individual, whereas body art is often a social act designed to have one fit in or impress a particular peer group. In addition, it is usually performed by someone other than the individual.

However, I came to realize that I was focusing on the differences and missing the more salient similarities. The more thought I gave to this issue the more I have come to believe that there is often only a thin line between those that self-injure and many of those that modify their bodies for the sake of beauty and or art. Is it purely coincidental that people in our society are turning to more permanent avenues of self-expression with their bodies serving as the canvas?

The younger generation seems to be finding a variety of ways to alter their bodies ranging from the mundane to the alarming and even bizarre. One pierced ear has now given way to 10 piercing, the placement of which seems to be limited only by the amount of skin one possesses. “Nose jobs” have now morphed into “body jobs”, and women (as well as an increasing number of men) can transform their bodies into the look of the day. Women are not only dying their hair or piercing their ears, but increasing or decreasing their breasts, sucking fat out and then injecting it back in and even putting implants in heretofore unimagined places in an effort to look more like JLo.

Are these modifications actually visible proclamations of one’s true identity? Many people who get tattoos, for example, think long and hard about what they want imprinted on their body to best represent to the world what is important to them. Some people have their whole life story tattooed across their arms, legs and torsos. Self-injurers often state that their scars tell their history as well, even if only to them. Do these various body alterations or designs actually represent one’s sense of self, and if so, why are people now experiencing a need to display their internal views of themselves on their bodies?

Every generation has behaviors chosen specifically to shock and if lucky appall the generation that went before; it is, after all, the task of adolescence to individuate and separate. In order to have the confidence to move forward into adulthood, teenagers must believe that they understand the ways of the world far better than their parents. Past examples of individuating behaviors include techniques such as swallowing goldfish, doing the “twist”, growing one’s hair long, fashioning it into an afro, dying it pink, wearing poodle skirts, tie die, or worse yet grunge outfits. All choices, thankfully, could be easily discarded once they had served their purpose of declaring to the older generation that their bearers are far wiser, and “hipper” than their parents ever were. Body modification can, on the other hand, be permanent, or at the very least leave permanent damage. In addition, all forms of body modification involve some degree of pain. Is this just an unfortunate by product of the process, or perhaps part of its allure? Could it be that the pain is the point, or as my clients so frequently state, “It’s easier to deal with physical rather than emotional pain?”

Overcoming physical pain or transcending one’s body is considered, in many religions to be a path towards reaching a “higher plane”, or religious rapture. Although a number of our clients are highly religious, they do not generally indicate religious rapture as an end goal for their self-injurious behavior. However, many do state that they would like to overcome their bodies, which have been considered a source of hurt, frustration and disappointment. Those that have been physically or sexually abused, for example, often believe that if they can master pain then no one will ever be able to hurt them again.

Is the increase in body modification an indication, similar to Columbine that this generation is having a more difficult time moving into adulthood, “finding themselves” as it were than past generations? Or perhaps I am just getting old.

I postulate that rather than finding one’s self through these various body alterations, people are losing themselves. Rather than getting in touch with their feelings, they are numbing. Rather than bringing them closer to their identity, they serve to alienate. Thus youth often spiral out of control as they engage in more and more of these behaviors with less and less sense of self satisfaction.

The body represents the individual to the outside world. It is how people are recognized from one another. The skin serves as the boundary between “me” and “other” (the rest of the world). It therefore makes sense that the body can represent a personal bulletin board to express to others things about oneself. Is there a fear that if one does not make their body more eye catching then no one will bother to look any further; to spice up the cover, so to speak, in hopes that someone might take an interest in reading the book? Or perhaps the natural body has become so distasteful (or boring) that one needs to find ways to embellish, disguise or disfigure it? And if so, from where does this sense of intense dissatisfaction or boredom originate?

For centuries, and in a variety of cultures, the skin has been utilized as a parchment on which to communicate any number of messages. Tattooing, piercing, branding, and scarification have been utilized to indicate tribal belonging, rank, religious affiliation, personal interests and even to frighten one’s enemies or make woman less attractive so as to protect them from being stolen (Favazza). The disenfranchised in many societies, such as bikers, gang members, prison inmates and servicemen away from home, have often chosen to “get ink”(tattoos) for perhaps similar reasons.

As a psychologist, I frequently consider and ask the question, “Why now?” So, I put forth the query, “Why are these behaviors seeping into the mainstream and fabric of our society at this point in time?” Should we just accept it as another cultural fad, or is there more meaning to the choice of this particular set of behaviors?

I believe that we are seeing an increase in body-focused behaviors for a myriad of cultural reasons, and that they are not merely a pointless fad. We live in a society that is becoming increasingly disenfranchised. Company loyalty is a thing of the past. Job changes are often accompanied by geographic moves. On top of this, divorce is on the rise as is the phenomena of “blended” families. Kids might not only move across the country with a parent, but also might need to live between two households. Whereas extended families used to live within easy distance of one another, now grandparents, cousins, aunts and uncles can be scattered and live hundreds, if not thousands, of miles from one another. We no longer have a “village” raising our children, nor do adults have the support that closer communities used to provide.

In a world in which kids have more material goods than ever, why do they feel so deprived? Is it possible that the rapid introduction of technology has served to increasingly isolate people from one another? There was a time not so long ago when neighbors sat out on their front porches and knew each other well. The streets would be filled with active kids riding bicycles, playing pick up basketball or just “hanging together” talking about their lives and sharing their dreams. They used to play cards and board games with live people. Now kids go into their homes, bury
themselves in their PC’s (Personal Computers) and chat or play online games with total faceless strangers. Even when outside amongst other people, they are so absorbed with listening to their I-pods, or cell phone conversations, that they barely notice, much less acknowledge those that pass by. In addition, our society has become more dangerous, and younger people have been indoctrinated with the “stranger danger” philosophy of safety. They are taught not to make eye contact or speak with strangers. They can no longer ride their bikes or walk to school alone. Is it a wonder that our kids often experience themselves as alienated and alone? My friends in AA often remind me, “The mind is a dangerous neighborhood to be walking around in by oneself.”

Paradoxically, kids today are shielded from very little. It is almost impossible to watch TV or view the Internet without being exposed to explicit sexual and violent scenes. In this politically correct baby boomer world, kids have been treated as mini adults. They call adults (and even sometimes their parents) by their first name, and are often encouraged to challenge rather than respect authority. Tolerance for frustration seems to be plummeting in an overindulgent society, which seems to have a difficult time setting limits on adolescent behavior or their demands. The result is often an over inflated estimation of one’s own power which can deflate quickly when presented with the realities and challenges of everyday life. The more children are allowed to act “as if” they are adults without having earned the privileges that accompany adult status, then the more empty and confused they become.

Today’s youth are being exposed to much more and at earlier ages than they ever before. Current exposure is a long way from looking at nude pictures in National Geographic; children are provided with less structure, limits and opportunity to process what they are exposed to in society. In a world that often seems out of control, the body remains ours to do with what we will. Modifying one’s body might therefore provide one with a sense of control, albeit temporary, that might seem too elusive to otherwise attain. I often hear from my self-injuring clients, “It’s my body; I can do what I want to it.” Changing one’s body is often designed to get the attention of others in an effort to decrease one’s sense of invisibility, or to gain power over one’s enemies by appearing dangerous — such as the vampire look or choosing tattoos designed to intimidate. Samoan fisherman believed that if they could survive their intricate and extensive tattooing process, then they could survive the elements.

Of course most things in life operate on a continuum. Is a butterfly tattoo on one’s shoulder, a diet to fit into a pair of size 8 jeans, or a bellybutton piercing indicative of a deeper problem, or merely normal adolescent rebelliousness and a desire to fit in with peers? The behavior is not truly the problem; rather it is the drive and intensity behind the behavior to which clinicians should attend. These body-altering behaviors can serve as a coping strategy, an effort to control the out of control, to distract from the elusive and painful emotional to the tangible and palliative physical.

I believe that many of these body modifying behaviors are an example of “smoke and mirrors,” designed to have clinicians look in one direction, in an effort to keep them from looking in another. It keeps clinicians, as well as the person engaging in the behavior, focused on the physical, rather than the emotional, or stated in another way, focused on the physical at the expense of the emotional.

Symbols and behaviors, while forms of communication, are inexact at best often leaving much open for interpretation. That is why societies have moved from pictures on cave walls to written and verbal language. In order to be heard and understood, and therefore seen one needs to learn to communicate in ways that others can understand. A baby for example will cry when in need, but in need of what? It is up to the parent to determine whether the baby is sick, hungry, cold, hot, wet, wants to be held or is in pain. Unfortunately, not all parents are “good enough” or patient enough to determine what the baby is attempting to communicate. As children age into
teenagers and young adults, their lives and feeling states become increasingly complicated. The parent’s task of helping their teenager communicate his or her experiences also becomes more complicated as teenagers push their parents away in an effort to individuate. Parenting during this tumultuous time in their child’s life becomes a task that takes considerable time, patience and skill.

The less one is able to identify, label and express thoughts and feelings, the more overwhelmed one is likely to be. The less one knows about their internal life and emotional cues, then the more vulnerable one is likely to feel. Moreover, the less one is able to communicate thoughts and feelings to others, the more likely one is to experience oneself as invisible. How can youth communicate these internal experiences to others, to feel connected and understood if they do not have the language of thoughts and feelings? What happens when those internal experiences build to uncomfortably intense, amorphous states? Perhaps, they discharge through action using their bodies, their bulletin boards to “turn up the volume” so that someone might attend and help.

In summary, I believe that the increase in addictions, like body focused behaviors, can be attributed to the increase in the fragmentation of our society, as well as our families, where individuals experience themselves as just that, individual, separate, alienated people without a sense of structure, acceptance, love and belonging. Physical actions are utilized in an attempt to either control, get noticed, or frighten, but generally fail to communicate to either themselves or others in a meaningful way, thus once again, confirming to themselves that they are alone, misunderstood and vulnerable.

In the search for one’s identity through modification of the body, one is building a “false self,” a mask that at best may make an approximation of the person underneath, but in fact serves to hide and bury the “true self”. Many of my clients recite the mantra, “If people really knew me they would not like me.” They present a face to the world that is created to defend against the fear of alienation and rejection. However, by failing to identify and accept their true selves, by never taking the risk to allow others to see them with all of their thoughts, feelings and vulnerabilities, they are creating a self-fulfilling prophesy, one that will forever alienate them from both themselves and others.

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