Becoming a Self-Injurer
In this chapter we begin our exploration of the details of self-injury. As we noted in chapter 1, some of the chapters are tied to historical periods, with earlier times preceding later ones. This chapter examines people’s entry into self-injurious behavior in the earlier years of our study. We begin by looking at some of the types of factors that led people to self-injure, then we move to a consideration of the pathways that they followed into the behavior, and then we look at some of the typical patterns of progression that most people followed.
In discussing some of the reasons why people become self-injurers, we noted in chapter 2 that the psycho-medical literature has suggested a profile of selfinjurers as coming from backgrounds of severe trauma such as physical or sexual abuse and possibly chemical imbalance or mental illness. It is clear from the way people presented themselves that some portion of self-injurers had psychological problems ranging at the more extreme end from clinical or diagnosed conditions (depression, bipolar, anxiety disorders) to milder states of general malaise (they felt sad or bad). Aside from the occasional individual curious about how it felt to self-injure (often drawn into it because of a close friend who engaged in it), most people who cut, burned, or otherwise injured themselves did it because they were in some sort of emotional distress.
Some self-injurers fit the clinical profile and suffered from serious mental illness. Many of these sought the help of psychiatric professionals, checking into hospitals and inpatient treatment centers. For example, Marnie, a 51-year-old former bank teller, told us that she suffered from dissociative identity disorder (DID, multiple personality syndrome) and had struggled throughout her life to deal with the “alters” who sometimes took over her body. She had huge gaps in her life that she could not remember, dating all the way back to high school, and she sometimes communicated with her