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Self-control, Selfishness and Mutilation: How ‘Medical’ is Self-Injury Anyway?

Published online by Cambridge University Press:  17 May 2012

Sarah Chaney
Sarah Chaney
Affiliation:
Sarah J. Chaney, PhD student, The Wellcome Trust Centre for the History of Medicine at UCL, 183 Euston Road, London NW1 2BE, UK. Email: s.chaney@ucl.ac.uk
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Self-inflicted injury, or ‘self-harm’, has been a topic of much debate in recent years. The media in the Western world has tended to portray the issue as an increasing ‘trend’, relating it to various contemporary concerns, including the so-called ‘celebrity culture’ and urban decline. The past decade in the UK has seen the publication of various clinical guidelines, a National Inquiry into Self-Harm in young people, and almost continual media speculation. In the last two decades of the nineteenth century, speculation also occurred around ‘self-mutilation’, an area newly defined by alienists (asylum psychiatrists). This topic has received little historical attention; yet, had ‘self-harm’ been on the agenda in the 1970s and '80s, nineteenth-century self-mutilation would no doubt have been presented as part of a discourse on professionalisation, in which the creation of a new psychiatric category was presented as part of the ‘medicalisation’ of psychiatry, through observation and classification within asylums. More recently, a changing historiography has led to histories of self-harm being located within a schema for ‘making up’ people, such as attention to the development of a patient profile for the apparently new behaviour of ‘delicate self cutting’ in the mid-twentieth century. This article builds on this concept to explore broader social issues around the creation of the concept of ‘self-mutilation’, which help to explain the occurrence of an impetus for ‘making up people’ in a particular period or culture. In particular, the impetus is related here to changing ideas of what constituted the ‘self’ and the relation of the individual to society in the late nineteenth century.

Keywords

Self-MutilationSelf-HarmSelf-InjuryNeurosesDegeneration Theory
Type
Articles
Information
Medical History , Volume 55 , Issue 3 , July 2011 , pp. 375 - 382
Copyright
Copyright © The Author(s) 2011. Published by Cambridge University Press

References

1 Barbara J. Brickman, ‘“Delicate” Cutters: Gendered Self-Mutilation and Attractive Flesh in Medical Discourse’, Body & Society, 10, 4 (2004), 87–111; C. Millard, ‘Self-Mutilation and a Psychiatric Syndrome: Emergence, Exclusions & Contexts (1967–1976)’ (unpublished PhD thesis: University of York, 2007); Ian Hacking, ‘Kinds of People: Moving Targets’, Proceedings of the British Academy, 151 (2007), 285–318.

2 F.W. Warrington, ‘The “Strange Confession” in Staffordshire’, The Lancet, 119, 3046 (1882), 81–2: 81.

3 Editorial, ‘The Case of the Farmer Brooks’, The Lancet, 119, 3046 (1882), 73. Other newspapers repeated this quote verbatim, for example: F.W. Warrington and ‘A Correspondent’, ‘The Strange Confession in Staffordshire’, The Times, London, 13 January 1882, 10, col. F-10.

4 See, in particular: Eric Sinclair, ‘Case of Persistent Self-Mutilation’, Journal of Mental Science, 32, 137 (1886), 44–50; James Adam, ‘Cases of Self-Mutilation by the Insane’, Journal of Mental Science, 29, 126 (1883), 213–19.

5 Armando R. Favazza, Bodies Under Siege: Self-Mutilation and Body Modification in Culture and Psychiatry (Baltimore, MD: Johns Hopkins University Press, 1996). On anorexia nervosa, see Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease, (Cambridge, MA: Harvard University Press, 1988); Walter Vandereycken and Ron van Deth, From Fasting Saints to Anorexic Girls: The History of Self-Starvation (London: Athlone, 1994).

6 For a clear formulation of this, see P. Maury Deas, ‘The Uses and Limitations of Mechanical Restraint as a Means of Treatment of the Insane’, Journal of Mental Science, 42 (1896), 102–13: 102.

7 James Adam, ‘Self Mutilation’ in Daniel Hack Tuke (ed.), A Dictionary of Psychological Medicine (London: J. & A. Churchill, 1892), 1151; G. Fielding Blandford, Insanity and its Treatment (Edinburgh: Oliver and Boyd, 1884), 195.

8 For example Sarah Dewey, Bethlem Patient Casebook (Female), 1886, CB/129–195; Francis Ambridge, Bethlem Patient Casebook (Male), 1893, CB/145–77.

9 Interestingly, it has been suggested that the behaviours should be re-connected in DSM-V. D.J. Stein, J.E. Grant, M.E. Frankling, N. Keuthen, C. Lochner, H.S. Singer, and D.W. Woods, ‘Trichotillomania (Hair Pulling Disorder), Skin Picking Disorder, and Stereotypic Movement Disorder: Toward DSM-V’, Depression and Anxiety, 27 (2010), 611–26.

10 H. Hallopeau and Ernest Besnier, ‘Alopecie par grattage (trichomanie ou trichotillomanie)’, Annales de dermatologie et de syphiligraphie, 10 (1889), 440–1; Ernest Besnier, L. Brocq and L. Jacquet, La pratique dermatologique: traité de dermatologie appliqué (Paris: Masson, 1900), 313–4.

11 Bethlem Patient Casebook (Female), 1895, CB/152–14.

12 Erasmus Wilson, Lectures on Dermatology: Delivered in the Royal College of Surgeons of England in 1874–1875 (London: J. & A. Churchill, 1875); J.B. Footner, ‘Remarks on a Case of So-called Hysteria’, The Lancet, 122, 3130 (1883), 325; T. Colcott Fox, ‘Case of Feigned Skin Disease’, The Lancet, 120, 3096 (1882), 1109.

13 Bethlem Patient Casebook (Male), 1893, CB/145–77.

14 See, for example, George Savage, ‘Hypochondriasis and Insanity’ in Tuke, op. cit. (note 7), 610–8; Henry Rayner, ‘Melancholia and Hypochondriasis’ in T. Clifford Albutt et al., A System of Medicine (London: Macmillan, 1899), 361–81.

15 On ‘morbid introspection’, see above and Henry Maudsley, The Pathology of Mind, (London: Macmillan, 1879); see also, Michael J. Clark, ‘Morbid Introspection’, Unsoundness of Mind, and British Psychological Medicine (London: Routledge, 1988).

16 Letter, Ambridge to Dr Smith, 9 January 1896, CB/145-77

17 Andrew Wynter, The Borderlands of Insanity (London: Renshaw, 1877); George Savage, ‘An Address on the Borderlands of Insanity’, British Medical Journal, 1, 2357 (1906), 489–92.

18 See cases reported in James Adam, op. cit. (note 7); Adam, op. cit. (note 4); William J. Brown, ‘Notes of a Case of Monomania with Self-Mutilation and a Suicidal Tendency’, Journal of Mental Science, 23, 102 (1877), 242–8.

19 Roger Smith, Inhibition: History and Meaning in the Sciences of Mind and Brain (London: Free Association Books, 1992).

20 William James, The Principles of Psychology (New York: Dover Publications, 1950), 375–9.

21 On the particular association of the beard with masculinity, 1850–90, see Christopher Oldstone-Moore, ‘The Beard Movement in Victorian Britain’, Victorian Studies, 48, 1 (2005), 7–34.

22 On the latter, see Judith R. Walkowitz, City of Dreadful Delight: Narratives of Sexual Danger in Late-Victorian London (London: Virago, 1992)

23 Warrington and ‘Correspondent’, op. cit. (note 3); ‘The Extraordinary Confession in Staffordshire’, Daily News, 9 January 1882

24 Adam op. cit. (note 7), 1151; Blandford, op. cit. (note 7) 194–5.

25 Blandford, ibid.

26 George Savage, ‘Heredity and Neurosis’, BRAIN, 20, 1-2 (1897), 1-21; George Savage, ‘The Lumleian Lectures on the Increase of Insanity’, The Lancet, 169, 4362 (1907), 933–6; Maudsley, op. cit. (note 15).

27 James C. Howden, ‘Notes of a Case: Mania followed by Hyperaesthesia and Osteomalacia. Singular Family Tendency to Excessive Constipation and Self-Mutilation’, Journal of Mental Science, 28, 121 (1882), 49–53.

28 This is laid out particularly clearly by George Savage, ‘Hypochondriasis and Insanity’ in Tuke, op. cit. (note 7), 610–8.

29 Charles Darwin, The Descent of Man and Selection in Relation to Sex (New York: D. Appleton and Company, 1897)

30 Besnier, Brocq and Jacquet, op. cit. (note 10),314

31 Warrington, op. cit. (note 2); Warrington and ‘Correspondent’, op. cit. (note 3); F.W. Warrington, ‘The Case of Isaac Brooks’, Journal of Mental Science, 28 (1882), 69–74.

32 Warrington, ibid., 73.