III. Self-Injury as Gendered Violence
IV. Control, Body Image, and Societal Messages
Self-injury tends to be associated with young women and girls, whereas injuring others is associated with young men and boys. Both behaviors may be understood as forms of gendered violence, directed outward for men and boys and inward for women and girls. While boys learn to act through their bodies with physical violence, girls learn to act on their bodies with self-inflicted violence.
Adolescence and young adulthood are rife with both physiological transformations (for example, puberty) and social transitions (for example, changing schools, shifting orientation from family to peers) that young people often experience as distressful. However, there is evidence suggesting that the ways people respond to this distress are gendered. Specifically, girls and women are more likely to direct their distress inward, taking it out on themselves, while boys and men are more likely to direct their distress outward, taking it out on others. This can be seen in the higher rates of other-directed violence among boys and young men and higher rates of eating disorders and self-injury among young women.
Of these responses to distress, self-injury has only recently received attention from the media and scientific communities, increasing public attention and debate about the topic. First and foremost, these debates center on the definition of self-injury. Currently, most researchers view self-injury as some type of deliberate harm to one’s own body without conscious suicidal intent. However, definitions of the behavior vary greatly in terms of social acceptability, severity, and frequency. For example, some researchers include such behaviors as interfering with wound healing (that is, picking at scabs) and nail biting in their definition, while others specify much more severe and stigmatized behaviors such as self-castration and bone breaking. Additionally, some researchers focus on repetitive self-injurious behaviors, such as head banging or self-hitting, particularly among people who are differently abled. Finally, researchers even disagree about what to call the behavior. While self-injury is probably the most common term used, other terms include cutting, deliberate self-harm, self-abuse, self-injurious behavior, self-mutilation, and suicidal or parasuicidal behavior.
In addition to disagreement about how to define self-injury, there is also disagreement about who engages in self-injury and how common it is. Estimates of the prevalence of self-injury vary from less than 1 percent to 4 percent in the general population and from 15 percent to 35 percent among adolescent and college-aged samples (Briere and Gil 1998; Favazza 1996; Gratz 2003; Laye-Gindhu and Schonert-Reichl 2005; Whitlock, Powers, and Eckenrode 2006). These differences are mostly due to the fact that there are no nationally representative data on self-injury, so most samples are small or highly specific (for example, students sampled in a university class). Also, while most research has focused on self-injury among white women in the United States, there is a growing body of research on self-injury among other racial groups and in other countries, particularly among Asian women (see Bhardwaj 2001 and Marshall and Yazdani 1991 on self-harm among Asian women; Kinyanda, Hjelmeland, and Musisi 2005 on self-harm in Uganda). Additionally, there is some research suggesting that self-injury is more prevalent among gay, lesbian, and bisexual people (Adler and Adler 2005; Alexander and Clare 2004, Whitlock, Powers, and Eckenrode 2006) as well as among prison populations. One of the few consistencies across most studies is that self-injury typically begins during adolescence or young adulthood and tends to persist for an average of 10 to 15 years, though it may continue for decades (Favazza 1996; Muehlenkamp 2005). Some research indicates that self-injury may be likely in some elderly populations, due in part to higher rates of depression and isolation (Dennis et al. 2005).
For the most part, media depictions of self-injury paint it as a uniquely adolescent and female problem, as evidenced by movies such as Thirteen and Girl, Interrupted, as well as talk shows such as Oprah featuring only female guests who self-injure (Brickman 2004). Yet, because there are no nationally representative data on the prevalence of self-injury, it is unclear to what extent women really are likely to self-injure or whether it is a media myth. While a few clinical and community studies have shown that self-injury is as common among men as it is among women (Briere and Gil 1998; Gratz 2003), other studies show that self-injury is less common among men and may be carried out differently among men as well. For example, a study of 2,875 students at Cornell University and Princeton University found that 17 percent had self-injured at some point in their lives, and women were about one and a half times as likely as men to be repeat self-injurers (Whitlock, Powers, and Eckenrode 2006). Additionally, women were more than twice as likely as men to scratch or cut themselves, while men were almost three times as likely as women to punch an object. This difference in the method of injuring reflects a bigger pattern: women and girls may be more likely to act on their bodies—for example, by cutting or scratching themselves with an object—while men and boys may be more likely to act through their bodies by punching someone or something else.
Self-Injury as Gendered Violence
Whether inflicted through punching an object or punching, cutting, scratching, or burning oneself, self-injury can be seen as a form of violence toward oneself and one’s body. For instance, James Gilligan (2004, 6) defines violence as
the infliction of physical injury on a human being by a human being, whether oneself or another, especially when the injury is lethal, but also when it is life-threatening, mutilating, or disabling; and whether it is caused by deliberate, conscious intention or by careless disregard and unconcern for the safety of oneself or others.
This somewhat broad definition of violence differs from more traditional definitions because, although it is limited to physical injury, it includes the act of injuring oneself. Self-injury, according to this definition, is a form of violence, regardless of whether the self-injurer interprets it as such. Self-injury meets all of Gilligan’s qualifications: it involves the infliction of physical injury on a human being by a human being (oneself), it is mutilating and sometimes life threatening, and it is done by deliberate, conscious intention. Viewing self-injury as a form of violence allows us to compare it to the other-directed or outward forms of violence more common among men.
James Messerschmidt’s study of adolescent boys’ violence toward others in Nine Lives (2000) is a particularly useful reference. In this book, Messerschmidt considers the social settings—such as family, school, neighborhood, and even one’s own body—that influence and are influenced by violence. He also takes an explicitly gendered approach to violence, arguing that social settings also influence and are influenced by gender. In other words, one’s family, one’s school, and even the larger society (for example, the media) influence how we define masculinity and femininity and how we behave according to these definitions. From this perspective, gender is not just about one’s biological male” or female status, but instead it is something that we do in everyday social interactions, including how we walk and talk, dress, sit, and eat, and even how we do violence.
In Nine Lives, Messerschmidt argues that boys are not violent by nature, but they are more likely to become violent if they have been in social settings that define sexually and/or physically fighting back as the appropriate expression of masculinity or the best way to “be a man.” For instance, John, a young man who experienced severe sexual abuse at the hands of his father, learned that “dominating someone sexually” was “what a male just did” (37). On the other side of the coin, Sam came from a nonviolent home but was abused by peers at school because of his body size and shape (short and overweight). Lacking the physical resources to fight back, he instead made up for the masculinity threats at school by sexually assaulting the young girls he babysat. As these cases illustrate, the masculinity “lessons” do not come from just one source but can grow out of any one or more of a variety of settings—family, school, neighborhood, or even one’s own body.
Within this framework, self-injury can be seen a form of violence that stems from a variety of social sources. Furthermore, self-injury may be as gendered as other forms of violence. While lessons in masculinity taught the boys in Messerschmidt’s study to inflict violence on others, lessons in femininity lead some women (and fewer men) to inflict violence on themselves. Girls and women learn from various social settings—the media, family, school, peers—that they are inferior, and some women and girls take this out on themselves and their bodies (Brown 2003). This self-inflicted violence is manifested in the various body projects women and girls engage in, from restrictive dieting to starving oneself, and from piercing to cutting (Brumberg 1997). Whereas boys learn to act through their bodies with physical violence, girls learn to act on their bodies with self-inflicted violence.
Control, Body Image, and Societal Messages
Why are girls and women more likely to act on their bodies? Some argue that control is at the center of the picture. Like many self-injurers, some of the boys in Messerschmidt’s study had been physically, sexually, and /or emotionally abused at home or at school, resulting in a sense of helplessness and lack of control. In turn, they sought and gained a sense of control by physically and sexually assaulting others, often people whom they viewed as weaker (for example, girls and younger boys). But girls and women sometimes view themselves as weaker or inferior as well, and so instead of trying to control those who are more powerful (that is, men), they try to gain control of girls, including themselves. Lyn Mikel Brown (2003), for example, argues that fighting between girls exists in part because of girls’ struggle for power, voice, and legitimacy. The limited power to which girls have access often stems from “qualities they either have little control over, don’t earn, or openly disdain,” such as their bodies and appearance, and so they take their frustration out on each other and themselves (32).
Furthermore, when this search for control is combined with poor body image and self-esteem, it often results in self-harming practices such as extreme dieting and exercise, disordered eating, and self-injury. From a young age, women and girls are bombarded with images of unrealistically thin and beautiful women in the media. Often these images are so airbrushed and digitally altered that even the models themselves do not measure up. These images, along with other social influences, set a standard of femininity that is thin and beautiful, sexy but sweet, yet relatively passive and powerless. One of the few “appropriate” sources of power regularly advertised to girls and women is sexiness through their bodies and appearance. As a result, girls and women sometimes go to great lengths to fit the sexy media image. Because this image is virtually unattainable, their efforts become self-destructive rather than self-enhancing. Adolescent women and girls may be particularly susceptible to this, given the powerlessness they often feel amid the myriad physical, hormonal, and social changes they have to contend with. While it is difficult, if not impossible, to argue that media images and societal messages directly cause girls and women to engage in self-harming behaviors, they certainly do not help girls and women gain the sense of control and independence they may be seeking.
Although self-injury has only recently received mass media attention, it is not a new problem. People have been self-injuring in cultural and religious rituals, and likely in private as well, for centuries (see Favazza 1996). While the definitions and explanations of self-injury and the responses to it have varied greatly, the practice itself has not changed dramatically: people inflicting violence on themselves without necessarily intending to die. Like violence toward others, violence toward the self results, at least in part, from social surroundings. If boys’ and men’s violence toward others stems from settings that define fighting back and controlling others as appropriate and valued expressions of masculinity, then perhaps girls’ and women’s violence toward themselves results from social settings that define fighting back and controlling others as inappropriate. Instead, girls and women are encouraged to control themselves, to be pretty, nice, and quiet, and this results in either turning aggression down—like young girls who learn to lower their voices when fighting—or turning it toward themselves (Brown 2003). Until these messages change, girls and women will continue to find ways to take it out on themselves, with boys and men sometimes taking it out on them too.
- Adler, Patricia A., and Peter Adler, “Self-Injurers as Loners: The Social Organization of Solitary Deviance.” Deviant Behavior 26 (2005): 345–378.
- Alexander, Natasha, and Linda Clare, “You Still Feel Different: The Experience and Meaning of Women’s Self-injury in the Context of a Lesbian or Bisexual Identity.” Journal of Community and Applied Social Psychology 14 (2004): 70–84.
- Berman, Jeffrey, and Patricia Hatch Wallace, Cutting and the Pedagogy of Self-Disclosure. Amherst: University of Massachusetts Press, 2007.
- Bhardwaj, A., “Growing up Young, Asian and Female in Britain: A Report on Self-harm and Suicide.” Feminist Review 68 (2001): 52–67.
- Bordo, Susan, Unbearable Weight: Feminism, Western Culture, and the Body. Berkeley: University of California Press, 2004.
- Brickman, Barbara J., “‘Delicate’ Cutters: Gendered Self-Mutilation and Attractive Flesh in Medical Discourse.” Body and Society 10, no. 4 (2004): 87–111.
- Briere, John, and Eliana Gil, “Self-mutilation in Clinical and General Population Samples: Prevalence, Correlates, and Functions.” American Journal of Orthopsychiatry 68 (1998): 609–620.
- Brown, Lyn Mikel, Girlfighting: Betrayal and Rejection among Girls. New York: New York University Press, 2003.
- Brumberg, Joan Jacobs, The Body Project: An Intimate History of American Girls. New York: Random House, 1997.
- Dennis, Michael, Penny Wakefield, Caroline Molloy, Harry Andrews, and Trevor Friedman, “Self-harm in Older People with Depression: Comparison of Social Factors, Life Events and Symptoms.” British Journal of Psychiatry 186 (2005): 538–539.
- Favazza, Armando R., Bodies under Siege: Self-Mutilation and Body Modification in Culture and Psychiatry. Baltimore: Johns Hopkins University Press, 1996.
- Gilligan, James, “How to Think about Violence.” In Violence and Gender: An Interdisciplinary Reader, ed. P. R. Gilbert and K. K. Eby. Upper Saddle River, NJ: Prentice Hall, 2004.
- Gratz, Kim L., “Risk Factors for and Functions of Deliberate Self-Harm: An Empirical and Conceptual Review.” Clinical Psychology: Science and Practice 10, no. 2 (2003): 192–205.
- Groves, Abigail, “Blood on the Walls: Self-Mutilation in Prisons.” Australian and New Zealand Journal of Criminology 37 (2004): 49–65.
- Hodgson, Sarah, “Cutting through the Silence: A Sociological Construction of Self-Injury.” Sociological Inquiry 74, no. 2 (2004): 162–179.
- Kinyanda, Eugene, Heidi Hjelmeland, and Seggane Musisi, “Psychological Factors in Deliberate Self-harm as Seen in an Urban African Population in Uganda: A Case-control Study.” Suicide and Life-Threatening Behavior 35 (2005): 468–477.
- Laye-Gindhu, Aviva, and Kimberly A. Schonert-Reichl, “Nonsuicidal Self-harm among Community Adolescents: Understanding the ‘Whats’ and ‘Whys’ of Self-harm.” Journal of Youth and Adolescence 34 (2005): 447–457.
- Marshall, Harriette, and Anjum Yazdani, “Locating Culture in Accounting for Self-harm amongst Asian Young Women.” Journal of Community and Applied Social Psychology 9 (1999): 413–433.
- Messerschmidt, James W., Nine Lives: Adolescent Masculinities, the Body, and Violence. Boulder, CO: Westview Press, 2000.
- Milia, Diana, Self-Mutilation and Art Therapy: Violent Creation. London: Jessica Kingsley, 2000.
- Miller, Dusty, Women Who Hurt Themselves. New York: Basic Books/HarperCollins, 1994.
- Muehlenkamp, Jennifer J., “Self-Injurious Behavior as a Separate Clinical Syndrome.” American Journal of Orthopsychiatry 75, no. 2 (2005): 324–333.
- Nixon, Mary K., and Nancy L. Heath, eds., Self-Injury in Youth: The Essential Guide to Assessment and Intervention. New York: Routledge, 2009.
- S.A.F.E. Alternatives, “Self Abuse Finally Ends.” 2010. http://www.selfinjury.com/
- Strong, Marilee, A Bright Red Scream: Self-Mutilation and the Language of Pain. New York: Penguin, 1998.
- Whitlock, J. L., J. E. Eckenrode, and D. Silverman, “The Epidemiology of Self-Injurious Behavior in a College Population.” Pediatrics 117 (2006): 1939–1949.
- Whitlock, Janis L., Jane L. Powers, and John Eckenrode, “The Virtual Cutting Edge: The Internet and Adolescent Self-Injury.” Developmental Psychology 42 (2006): 407–417.