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Favazza, who is a professor of psychiatry at the University of Missouri, Columbia, defines self-mutilation as "the direct, deliberate destruction or alteration of one's own body tissue without conscious suicidal intent."(7) He is referring to moderate self-mutilation, which differs from "coarse" psychotic infliction of major traumas and amputations, as well as from involuntary acts, Dike the head banging of autistic or developmentally disabled individuals. The acts young women like Jill perpetrate on their bodies usually include cutting, burning, plucking of hairs from the head or body, bone breaking, head banging, needle poking, skin scratching, and others.

The "Psych Lit" abstracts of professional journals from 1991 through 1997 list well over 200 articles dealing with the topic of self-mutilation alone. The scientific journals describe and analyze the phenomena of self-injury from the full range of disciplinary approaches--from the neurophysiology of pain and brain states, to the family dynamics, social context, and religious orientation of victims. Psychoanalytical theory is still pervasive and will be discussed shortly. The population of self-mutilators also ranges from teenage girls to male prisoners and even animals in captivity.

Given the enormous diversity of approaches and the variety of self-mutilators (the largest single group seems to consist of young women in their teens and twenties, though self-mutilation has al:so been recorded among black slaves in the nineteenth century and among soldiers who seek to avoid combat or extreme exertion), it would clearly be foolish to reduce self-injury to one or two causes. On the neurophysiological level, the injury seems to produce natural endogenous opiates known as beta-endorphins that lead to temporary states of euphoria after the infliction of the injury.(8) At an entirely different level of analysis, self-mutilation has been linked with post-traumatic stress syndrome, particularly following sexual abuse or rape, imprisonment, or war experiences.(9) Of course none of these experiences is universally recognized as definitive causes of self-mutilation. Jill had suffered none of them, but she was a victim nonetheless of extremely high stress levels.

The question I wish to pursue here is not which theory is right, or what is the "true" cause of self-mutilation. Far more interesting, I believe, is the phenomenological question: What is it like--from the subjective point of view--to cause oneself cuts, burns, and bruises? It is clear that those who commit such acts experience them in a different way from that which the empathetically "healthy" bystander imagines. Self-mutilators seem to experience the trauma in a positive manner, and the subjective terrain of their experience is never identical with the causes attributed to the actions by scientists. In other words, the voices of the agents, their personal narrative, reveals something important about self-injury, and despite the variety of causes and the diversity of the practitioners, their voices ring in a strikingly consistent manner. These cases of self-mutilation may actually share an important feature with religious self-mutilation.

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