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Introduction

Kimberly is a college student who wrote this introduction as a part of a compilation of personal accounts of women who are depressed and self-injure.

It is well-known that depression is a widespread problem in many countries. It is also becoming more apparent that self-injury is a problem throughout the world. This is not only a problem among women. Many men are depressed, and many men self-injure. This book focuses on the lives of depressed women 40 years of age or younger who self-injure. Men are not excluded as an attempt to invalidate or downplay their situation but merely to draw attention to a certain form of depression. The experiences of men and women in depression are different based on inherent personality differences, social position, and biology. This book will focus on women and the specific status they hold based upon these differences.

Depression is defined as "a state of deep and pervasive dejection and hopelessness, accompanied by apathy and a feeling of personal worthlessness "Depression is characterized by erratic eating and sleeping patterns, lethargy, feelings of guilt and self-hate, sadness, loss of interest in things one used to enjoy, physical aches and pains, difficulty focusing on tasks, and low self-esteem." (Nolen-Hoeksema, 3)

Depression is described by Joan Riviere as:

...the situation in which all one's loved ones within are dead and destroyed, all goodness is dispersed, lost, in fragments, wasted and scattered to the winds; nothing is left within but utter desolation. Love brings sorrow and sorrow brings guilt, the intolerable tension mounts, there is no escape, one is dead. Besides there would be no one to feed one, and no one whom one could feed and no food in the world. And more, there would still be magic power in the underlying persecutors who can never be exterminated-the ghosts. Death would instantly ensue - and one would choose to die by one's own hand before such a position could be realized.

This is a very powerful and true account of what depression feels like. It is not known if Riviere harmed herself or not but this definition should be very helpful to anyone who is searching for a firmer grasp on the global despair associated with depression.

Self-mutilating behavior, self-mutilation, self-injury (SI), self-injurious behavior, cutting, masochism, self-destructive behavior... the list of terminology goes on and on. All of these terms attempt to put a label on the behavior through which a person harms himself or herself on purpose. Most often this is accomplished through cutting, burning, hitting parts of his or her body against walls, forcing objects into apertures of the body, pulling hair out, or more extremely through removing organs such as the eyes or genitals. Part of the reason there are so many different ways to describe this behavior is because it is such an uncomfortable topic of conversation. It is mostly heard in whispers - "she's cutting herself again, why would anyone do that to herself?" - or in textbooks. The topic is very taboo. The behavior is hard to understand.

Self-injury is however becoming what is termed as "the anorexia of the '90s." There are an estimated 2 million people who self-injure in America. More and more sufferers (the word sufferers does not correctly describe them - they are survivors and are so much more than just sufferers of this illness, yet for lack of a better word this one will have to suffice) are sharing their stories and seeking help. It is very difficult for them, though, because the reaction of the general public is varied and generally not supportive. Most people simply cannot comprehend how a mind would choose to destroy one's own body. The act does not seem to have any benefits to the sufferer. It is not as if blood or pain can make problems from the past go away. So why do people do this? For those who do not understand, it is very easy to simply dismiss one who self-injures as crazy.

Self-injury is not an attempt to kill oneself. Self-injury is a way to cope with emotional stress. It enables those who practice it to actually function in society better than they could without it. It is very much related to feelings of self-hate. There are many different hypotheses as to what exactly this behavior accomplishes. Usually, it is some combination of any number of the following:

The person may gain a feeling of control through injuring herself. She felt out of control of her emotions and hurt herself in order to take control of her body and mind.
She may feel calm and relaxed after harming herself. Anxiety and stress overwhelmed her and she hurt herself in order to be able to sleep or relax.
She may feel less tense and angry after she cuts.
She may find that physical pain is a lesser pain than emotional pain or painful memories, so she may elect to injure herself in order to escape the emotional pain.
Her pain may be transformed into a visible form, making certain that no one can deny she is hurting any longer.
The sufferer may gain a feeling of power or validation, like "look at what I can withstand," which transfers to feelings of worth and strength.
Pain may be the only thing she can feel, so she may harm herself in order to escape feelings of numbness and begin to feel more alive.
The pain may result in the feeling that she has successfully purged her guilt.
She may feel she deserves to be punished, and harming herself is a legitimate way of punishing herself.
The pain may in actuality bring with it some joy and pleasure.
She may feel satisfaction if someone abuses her (emotionally or physically), and she harms herself as a way to "get back" at him or her. Or she may feel that she "wins" because she has the last word.
Hurting herself may feel like a more acceptable way to express her anger than by harming those with whom she is truly angry (if not herself).

Self-injury easily turns from an isolated incident into an addiction. It can be likened to alcoholism and drug abuse in many respects. At first, some simple scraping of the skin that does not even draw blood may provide relief, but soon blood is needed. The cuts get deeper. It is similar to a junkie needing more and more of a drug to get the same high. The injury becomes more and more frequent. It becomes very dangerous when cuts get close to major arteries or organs. Sometimes sufferers need the relief so badly that when they cannot get it they do not know when to stop, and they accidentally kill themselves. Accidentally is the correct word. The methods for suicide are usually much different than those for self-injury.

It is a common misconception that self-injurious behavior occurs only among adolescent girls who are just following the trends. This is not true. There is also a stereotype that a person must be psychotic in order to hurt him or herself, but that is also not true. Some sufferers do experience psychotic episodes while some do not. There are 50-year-old men who self-injure as well as 14-year-old girls. Another frequent misconception is that those who self-injure have been abused as children. This assumption is false. It is just as likely for a person who self-injures to come from a stable home having never suffered any physical abuse as opposed to an abusive home. The selections in this anthology will prove just how varied the backgrounds, ages, and degrees of self-injury of these women are.

It is common (not singular) for one who self-injures to be female, intelligent, and a late adolescent. It is not known if females are more likely to self-injure or simply if males are less likely to come forward about it. Those who self-injure are bright and intellectually- minded for the most part. They have a high degree of intelligence, even if their depression keeps them from focusing at school or work. There are a great number of women with eating disorders that self-injure (or vice versa). Some see eating disorders as a form of self-injury in many respects.

There are many homosexuals and bisexuals who self-injure. This may be because their sexuality is termed "deviant," blatantly wrong, and evil by many people and religious groups. Such labels do not exactly promote self-love. Many feel that they are a "problem" to be "fixed" and try to deny their sexuality all their lives. They are persecuted, and may become depressed and turn to self-injury in an effort to deal with negative thoughts and stereotypes about their lifestyles.

Bibliography

Gleitman, Henry. Psychology. New York: W. W. Norton & Company, 1986.

Leites, Nathan. Depression and Masochism: An Account of Mechanisms. New York: W. W. Norton & Company, 1979.

Nolen-Hoeksmea, Susan. Sex Differences in Depression. Stanford, California: Stanford University Press, 1990.

Rosen, Barent W., and Walsh, Paul M. Self Mutilation: Theory, Research, and Treatment. New York: The Guilford Press, 1988.

Rubin, Sylvia. The Unkindest Cut San Francisco Chronicle. 11 October 1998.

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