A Bright Red Scream: Self-Mutilation and the Language of Pain

Explores the phenomenon of self-mutilation, tracing how feelings of rage and self-punishment are acted out by its practitioners and the process of treatment, based on interviews with dozens of patients, doctors, and researchers. 25,000 first printing. Tour.

Strong's research into "cutters" combines journalistic passion with academic integrity. Through dozens of interviews conducted for a 1993 San Francisco Focus article, she explores the reasons that lead over two million Americans to injure themselves regularly and deliberately with such items as knives, razor blades and broken glass. Although most cutters are young women who have been emotionally, sexually, or physically abused as children, Strong's research shows that this specific type of self-harm also appears in other groups. Most interviewees here claim to use cutting to distance themselves from pain and rage, or to "feel something" after years of abuse have left them emotionally numb. The powerful first-person stories, in which the cutters describe their ritualistic methods and somewhat addictive cravings for seeing their own blood, highlight the problem and ultimately lead to understanding and sympathy for those who suffer from the disorder. (A foreword from University of Missouri-Columbia psychiatrist Armondo Favazza, author of Bodies Under Siege, discusses past difficulties in bringing the disorder to the public's attention.) In addition to presenting a psychological focus, Strong also investigates possible neurological and chemical changes that both abuse and cutting can cause. A brief foray into comparison with the American tattooing trend and scarification in other cultures proves to be the book's only weak point, drawing on hypotheses rather than concrete fact. The author recovers quickly, however, when she explores the comprehensive programs and treatments available to cutters. Riveting and dynamically written, this book is an important addition to psychological literature. Agent, Sandra Dijkstra. Author tour.
Copyright 1998 Reed Business Information, Inc.

A compassionate and informed discussion of self-mutilation, the ``addiction of the '90s, practiced by two million or more Americans. Self-mutilation has surfaced as a fad of pubescent girls, who use razor blades to carve their forearms with, for instance, names of their boyfriends. It's called cutting and is what Dr. Armando Favazza, in the preface, refers to as ``superficial/moderate'' self-mutilation. In other cultures or at other times, cutting, flagellation or similar forms of self- mortification have been regarded as physically healing, spiritually uplifting, or tribally bonding. Today Americans are horrified at the idea of painful blood-letting, associating it immediately with suicide. But the cutters described here are neither faddish or suicidal. They are using their razors, knives, broken glassor cigarette lightersto live. Like anorexia and bulimia (also efforts to gain control), some forms of self-mutilation serve as controls for unbearable rage and emotional pain that would otherwise lead to a psychotic break. Many cutters have suffered sexual or physical abuse as children, and the trauma they carry with them as adults is similar to post-traumatic stress disorder, says Strong. Among the symptoms is dissociation, where mind and body separate, leaving ``numbness and emptiness.'' For some, the only way to reunite the two is by hurting themselvesthe pain returns them to awareness. It may also release ``natural opiates,'' like endorphins, that minimize the emotional and physical pain; that may be one reaction that contributes to the addictive nature of the experience. Strong (a journalist who has written previously on child victims of war trauma) examines the theories of physiology, psychology, sociology, and neuroscience in relation to the need to self-mutilate; enriching her research are interviews with more than 50 cutters, some found on the Internet site where self- mutilators can talk to one another. The final two chapters discuss treatment alternatives. Humane, empathetic, and informed exploration of a frightening complex of behavior; it will be valuable to professionals, families, friends, and most of all to the cutters themselves. (Author tour) -- Copyright ©1998, Kirkus Associates, LP. All rights reserved.

Pulitzer Prize^-winning journalist Strong expands on a previous groundbreaking article on "cutters" or self-mutilators, who are mostly women with histories of abuse or dissociation who injure themselves to deal with feelings of anxiety or numbness. Through interviews with psychiatrists, researchers, and those who self injure, Strong thoughtfully presents current cultural, cognitive, psychoanalytic, and pharmacological perspectives on the causes of cutting, its diagnosis, and treatment. She manages to explicate self-injury as a symptom and a disorder in itself--a morbid form of self-help--well and movingly. The frustration over the current limitations of science and, in particular, of the standard diagnostic tools in treating and explaining the baffling disorder is palpable. An impressive complement to Mary Pipher's best-selling explication of the woes of adolescent girls, Reviving Ophelia (1994), and Daphne Scholinski and Jane Meredith Adams' case study, The Last Time I Wore a Dress. Jennie Ver Steeg