Self-Injury: Symbolic Sacrifice/Self-Assertion Renders Clinicians Helpless

Abstract

Keywords:Potter's paper starts by situating self-injury in a broader discourse of body modifications. In this discourse the body is being used as a text, a tool to communicate meaning. The meaning that is communicated might be difficult or impossible to articulate otherwise (by using words, for example).The meaning of the communication is embedded in a context of social, cultural, religious, political, and other norms. Potter explores possible interpretations of the meaning of self-injury in women with BPD, including an interpretation of self-injury as symbolic sacrifice. She suggests that a cultural understanding/nonunderstanding of the meaning of a particular instance of self-injury is an important determinant of whether such self-injury is considered pathological/nonpathological. She then shifts the focus to the present-day culture in which women's bodies are commodified and objectified, and feminism, iconic communication, moral conflict, oppression, psychiatrist/psychologist roles, social norms Potter's paper considers self-injury in women diagnosed with borderline personality disorder (BPD) to be a form of body modification where the body is used to communicate meaning. She touches on symbolism as a possible explanatory theory for this sort of self-injury. She also refers to the culture of body commodification as underlying self-injury. She then argues that clinicians have a duty to give uptake to the patient's own interpretations about the meaning of the self-injury. Giving uptake is a virtuous approach for ethical interactions with people diagnosed with BPD who self-injure, and it aims to preserve the communicator's integrity, along with other benefits. Potter offers five maxims for giving uptake properly. However, I shall argue that giving uptake can be very difficult for clinicians, and that an appreciation of this difficulty depends on an expansion and linkage of some of the theories that she touched on. Self-injury is revisited experimentally as a double-edged sword of symbolic sacrifice and iconic-symbolic self-assertion. This revisiting aims to illustrate how clinicians might be caught in a double bind, where giving uptake properly might be very difficult if not more or less doomed to fail.

Self‐Injury, Gender, and Loneliness Among College Students

“…White, Trepal-Wollenzier, and Nolan (2002) highlighted the importance of examining one's own biases and opinions regarding self-injury when working with clients who self-harm and avoiding power struggles that can arise when clinicians impose sanctions on SIB too quickly in the course of treatment. Research suggests that it is not uncommon for mental health professionals to react with fear and revulsion to SIBs (White et al, 2002) and feel as though their clients are punishing and manipulating them (Kruger, 2003). Given the possibly negative reactions therapists might have toward their clients, mental health professionals should seek consultation to help them understand the mechanisms that perpetuate their clients' reliance on such self-destructive behaviors.…”