A Bright Red Scream: Self-Mutilation and the Language of Pain

by Marilee Strong

"I highly recommend [A Bright Red Scream], because it’s beautifully written and . . . so candid.” —Amy Adams, star of HBO's Sharp Objects in Entertainment WeeklySelf-mutilation is a behavior so shocking that it is almost never discussed. Yet estimates are that upwards of eight million Americans are chronic self-injurers. They are people who use knives, razor blades, or broken glass to cut themselves. Their numbers include the actor Johnny Depp, Girl Interrupted author Susanna Kaysen, and the late Princess Diana. Mistakenly viewed as suicide attempts or senseless masochism—even by many health professionals—"cutting" is actually a complex means of coping with emotional pain. Marilee Strong explores this hidden epidemic through case studies, startling new research from psychologists, trauma experts, and neuroscientists, and the heartbreaking insights of cutters themselves--who range from troubled teenagers to middle-age professionals to grandparents. Strong explains what factors lead to self-mutilation, why cutting helps people manage overwhelming fear and anxiety, and how cutters can heal both their internal and external wounds and break the self-destructive cycle. A Bright Red Scream is a groundbreaking, essential resource for victims of self-mutilation, their families, teachers, doctors, and therapists.

Genres: Psychology, Nonfiction, Mental Health, Mental Illness, Self Help, Science, Medical

271 pages, Kindle Edition

First published March 27, 1998

About the author

Marilee Strong is an award-winning journalist who specializes in reporting on crime and psychological and social issues. She is the author of two previous books: "A Bright Red Scream," on the aftereffects of childhood abuse and trauma, and "Erased," which presented an original criminal and psychological profile of a particular kind of intimate-partner homicide. She has also written widely on topics such as child abduction, women in prison, gang violence, hate groups, and psychological treatment for sex offenders. She is a graduate of Columbia University's Graduate School of Journalism, where she awarded a Pulitzer Fellowship, the school's highest honor. She is the recipient of more than a dozen writing and reporting honors, including a National Headliner Award and the Society of Professional Journalists Excellence Award. She has been a guest on NBC's "Dateline," Fox News' "On the Record with Greta Van Susteren," the BBC, and numerous other TV and radio shows around the US, and has been appeared in several film and television documentaries on the subjects of her work.

Reviews

[Kirsten · Rating 3 out of 5]

This is an interesting but ultimately flawed look at the phenomenon of self-mutilation as it relates to mental illness. Self-mutilation can take many forms, but the most common seem to be self-inflicted cutting and burning. It's not undertaken with an intent to commit suicide; instead, many people who cut or otherwise injure themselves believe it is one of the things that prevents them from committing suicide.

There aren't that many books for the layperson on this issue, despite increased exposure in the media. This book, by a journalist, pretty much falls under the "good start" category. My biggest problem with it is that at the outset, Strong mentions that the majority of people who self-injure are women who have been sexually abused, but that a sizable minority don't fit that category. She then proceeds to completely ignore self-injury in people who have NOT been sexually abused for the rest of the book. Almost all of the theories she discusses involve PTSD and dissociative disorder brought on by sexual trauma, and she seems to have disregarded any case history that did not fit this paradigm. This ended up frustrating me a lot, and also made me wonder what other inconvenient theories and case histories she'd disregarded in favor of a tidier narrative.

[Cari · Rating 2 out of 5]

A good start with a lot of insight into the chronically misunderstood behavior of self-injury. Unfortunately, Marilee Strong focuses almost completely on the percentage who cut because of severe childhood trauma and abuse, effectively ignoring the significant percentage (between 40% and 50%, depending on the study) who experienced no neglect, no physical or sexual abuse, or any other similar circumstances at any point in their lives. For me, this detracted heavily from the book, as it was so one-sided. I guess I feel the author either opted for the "sensational" stories or simply took the easy way out. It's much harder to pinpoint why someone who had suffered no neglect or abuse in their childhood would start cutting themselves in their adolescence or even adulthood, and frankly, that's what I was looking for in a study on self-harm.

Despite that, I would have rated the book a bit higher, except some (though by no means "all" or even "a lot") of the information contained is outdated. Not the author's fault - the information was all current when A Bright Red Scream was first written. But research into self-harm and associated illnesses has been on the fast track the last few years. A lot of cutting edge studies have been done, and the passage of a decade has added a lot of new information. Especially when Strong discusses borderline personality disorder (one diagnostic criteria of which is self-injury), the gains made over the last ten years have left that section lacking. She treats it with despair, "borderlines can't be fixed," and yet new research and treatment methods have proven otherwise in recent years. Perhaps a version with an updated introduction to bring the reader up to speed with years' worth of work and research gains would be beneficial.

Beyond all that, this book contains a quote that I thought beautiful and devastating: "For most people, tears, not blood, are the language of the body."

[Judi · Rating 4 out of 5]

This is an incredible book. I am a cutter so of course that was my pull. Its full of a lot of "psycho-babble" and normally I skim read when this kind of text arises, but this time I just put the book down for a while and came back and Im glad I did. This book covers all parasuicidal behaviors: cutting, burning, head banging, pulling out ones own hair, etc. It discusses at great length the psychology of it, the reasons why and what the person gets out of it; all of which is gathered through data collecting from these individuals. In between all this there are stories about real "cutters" and short but very poignant interviews. It was wonderful to see and hear myself and how I feel in writing. It made me feel connected to something, even though I would like to find that connection in healthier ways. I would like to say that this book may make parasuicidals act out; it did for me. I fantasized about it while reading and I can honestly say that if not for my DBT group I might have.

[Jennifer Day · Rating 5 out of 5]

A friend made me read this at the time in my life where I still found the most relief in making myself bleed and creating new scars. A Bright Red Scream is a wonderful book that really did help me. It sheds a lot of light on the reasoning of cutters themselves and also on the underlying issues that can cause this behavior to manifest itself. I recommend it to both current and former cutters as I think it has the possibility to help you understand yourself. There is a lot of good information in this book as well as some personal stories. It's another book that I truly hope will bring this awful and dangerous behavior out of the hidden places of long sleeves, pants and little "accidents" and that will make people realize this is a REAL problem, not something to make fun of or something that people only do to get attention.

[mariana ૮₍˶ᵔ ᵕ ᵔ˶₎ა (perrito lector)]

una mirada muy empática, informativa y necesaria al tema del self-harm, sus causas y las posibles vías de recuperación : -) me hubiera gustado que la autora hubiera ahondado aunque sea un poquito más sobre algunas otras formas o manifestaciones del self-harm fuera de cortarse ya que creo que necesitan más representación y también creo que ayudaría a validar las experiencias de las personas que las practicamos. en general, me pareció q el libro es una exploración muy sensible y responsable del tema y se lo recomiendo a cualquier persona interesada en aprender un poco más del tema

[Kamalia Ramlan · Rating 4 out of 5]

Kalau kau kenal sesiapa yang mencederakan dirinya sendiri, bukanlah bermakna mereka mahu menamatkan nyawa semata-mata. Kesakitan akibat mencederakan diri sendiri sebenarnya sebagai satu cara memberitahu yang mereka masih wujud. Penderaan fizikal, seksual, mental dan emosi yang ekstrim menjadikan mereka membenci diri mereka sendiri.

Sebuah naskhah yang membuka mata aku tentang 'self-mutilation'. Membaca kisah mangsa-mangsa yang terpaksa hidup dalam keadaan 'kesakitan' yang ekstrim benar-benar tak terbayangkan.

[Shy · Rating 5 out of 5]

This book was TRIGGERING.
this is the first book i've ever read on self harm that actually tells how it feels to cut.
The personal stories were so close to my own experiences it was crazy. the rituals and intrusive thoughts. All of it was real. By reading this I have learned so much more about myself and others who deal with self harm.
They go into deeper detail as to what could have caused one to want to harm themselves and I think that is the most helpful thing in this book. The breakdown and explanation of what self harm is and what may be augmenting the urges is here.
Fully recommend for anyone dealing with self harm personally or knows a loved one dealing with it. Very informative and true.

[Sumayyah · Rating 3 out of 5]

I had so many problems with this book that I don't know where to begin. I simply hope that, in the future, there is more inclusion of people of color and people who are well into adulthood and still struggling with cutting/self-injuring.

[Vanessa · Rating 5 out of 5]

As someone who has struggled with self-harm since the age of 11 (I'm just turned 25 three weeks ago), I found this book very intriguing. While there are some definite flaws, at least based on my own personal experiences, I would still recommend it to people trying to get into the mindset of someone who self-harms. While it can be frustrating that it doesn't accurately describe everything, you're never going to find a book that does that 100%. Self-harm begins and is done for such personal reasons that not one person will be able to write a book that another can relate to completely. The treatment center I was at recommended this book to my parents as a way to open the lines of communication. It is definitely worth reading and very insightful for what it is.

[Jay Shahwan]

This difficult book came to me out of necessity, as my life has been upended by a loved one who chose to self-injure. It's a phenomenon that's quite common, I've come to understand, and I needed to learn how to reach out to someone whose pain was so imbedded that the only possible solution was to cut. The author's interviews were both horrible and enlightening. Not for the faint of heart.

[Allen Turley · Rating 3 out of 5]

I read this book because i wanted to try to wrap my head and heart around cutting. It was completely beyond my comprehension as to why someone would self-mutilate.It definitely helped. I am not as near afraid of helping people with this struggle. This is a secular book that offers no hope. Jesus is the one who truly offers love and healing.

[mimi · Rating 5 out of 5]

Such a delicate writing for such a delicate subject.
Best book about self-harm you can find.

↠ 5 stars

[Derodidymus · Rating 3 out of 5]

Self-injury represented a sacrifice of one part of the body for the sake of the whole.

the book reads quite easy and it is both informative and concise, making it a useful experience. i think it was more valuable at its time of publication especially because it brought attention to a subject many viewed as shameful, crazy. however as it is mentioned in its introduction, the interest in this behavior has increased since then and some of the data and opinions might be outdated and even in contradiction with current scientific beliefs which makes it a decent book but not the ultimate book.

i do appreciate its purpose and i found it to be well-organized (the 'interviews' with different people who self-mutilate were heart-breaking and truly important for the book's authenticity) but also somehow repetitive.
a lot of discussion on abuse, dissociation, BPD, trauma.

Why, then, was the specific behavior of self-mutilation chosen by these adolescents? The answer is breathtaking in its simplicity. Through the act of self-mutilation, Walsh and Rosen conclude in their book, cutters have „acted out all the familiar roles from childhood: the abandoned child, the physically damaged patient, the abused victim, the (dissociated) witness to violence and self-destructiveness, and finally, the aggressive attacker.”

[The Rainbow Zee · Rating 5 out of 5]

In my life, I have self-harmed.

I've had this book for a long while. I would read bits of it, but when you're in the midst of crisis, sometimes just reading about it can trigger episodes. But since it's been a long time since I've SH, I was able to finish it.

This book is a vital resource for anyone who self-harms, treats those with SH, guidance counselors, friends and family. It's important to note that those who self harm aren't typically suicidal (at least not in the beginning). And while people usually associate SH w/ teen girls, anyone can be a victim of SH.

My only concern about this book was a section on piercing and tattooing. While I think there is a line that can be crossed, I felt the author erred on the side of caution. I have a tattoo and one piercing. I love them, plan on getting more, and don't feel like it is the same as when I would self-harm. Maybe it's connected to issues, but I'm proud of them, I think they are beautifu.

In any case, I highly recommend this book.

[Elisse · Rating 3 out of 5]

Looking to learn about the issue of cutting amongst adolescents for the work I do, I looked to this book. It takes a very psychoanalytic approach to the problem, describing cutters issues in terms of family dynamics and interpersonal experience. I just wonder to what extent this issue, like many other mental health issues, has a biological component. I didn't finish the book because it felt like I was going far down a path that I wasn't sure was the current model used by mental health practitioners.

[darrienmichael · Rating 4 out of 5]

I read this book a while back but I remember it being interesting and full of true facts and stimulating interpretation. If you are a cutter, or if you know a cutter, this book will help you to understand the emotionally painful and taboo subject. Psychology students should also read this book.

[James Crawford · Rating 4 out of 5]

book by Marilee Strong, 1998

Marilee Strong is a journalist. She obviously did very, very extensive research for this book and the hard effort she made is very obvious and helps the book considerably.

This is not, of course, a happy book. It's filled with personal stories of people who have been through extremely intense physical and/or emotional pain and who have found the need to practice SIV, or Self Inflicted Violence, which is most often associated with cutting but can also include hiding and other forms of self-abuse.

(In the section below I will separate my own thoughts by ( ) so you won't confuse what the author knows with what I think is true.)

The author notes that about 2 million Americans each year commit some act of self-injury. That is 30 times the rate of suicide attempts and 140 times the rate of successful suicide attempts.

One of the quotes that I found most interesting from a cutter is this:

"I hate myself. It's almost an insult for people to refer to it as a self-esteem problem. I'm talking active, passionate hatred." ( People who practice any form of SIV are not people who are at ease with themselves or with the others around them. They often feel trapped; inadequate, alone in constant emotional upheaval and pain. They very likely see no ending at all to their situation. Imagine living every hour of every day hating yourself, hating the situation you are in, and knowing that you are trapped in that situation.)

Self-injurers are also not people who are stupid. "Self-injurers are often bright, talented, creative achievers-perfectionists who push themselves beyond all human bounds, people pleasers who cover their pain with a happy face." (This is somewhat similar to the Japanese practice of having "two faces." One face is that which you present to those around you; the other face, usually hidden, is your "real" face, how you really feel about things, not necessarily how society expects you to feel.)

Even someone as famous, rich and beautiful as Princess Diana was a cutter. In an interview she said "You have so much pain inside yourself that you try and hurt yourself on the outside because you want help."

Not only can these self-injurer hate himself or herself, but their can be a terrible amount of darkness within them. In describing one particular cutter the author says: "She could never cut deep enough-down to the impenetrable blackness, the pitiless void- to release all the rage and emptiness inside her." .

(One way to picture this is to think of a bog. A bog is a pond, the surface of which is covered by a dense growth of plants. To all appearances it appears as solid ground, but if you step on it you could end up going through the plants and into the water below. Now imagine that this pond is a pond filled with painful memories, emotional hurt, rejection, any form of personal darkness you can think of. The plant surface represents the very slender margin for a self-injurer between dealing with everyday things and falling through the plants into the darkness below.)

(For most people, the pond is small and the plant growth on top is pretty much equal to a solid forest floor, but for self-injurers that margin is very narrow. They might even be afraid to express emotion, terrified that they might fall into that pond and loss mental and emotional control of themselves.)

She writes on another page: "They most commonly described themselves as feeling empty inside, unable to express emotions in words, afraid of getting close to anyone and wanting to desperately stop their emotional pain." (In other words, the self-injurer, at some level, really wants help but their fear of getting close to someone and trusting them can be the very thing that prevents them from getting the help they need.)

So why does a person injure themselves on purpose? The cutting (or other form of injury) might give the person a temporary relief from their anxiety, their stress, their "dark thoughts." (It can also be used to regain self-control if the person feels that he or she is about to "lose it" in front of others. It can also be a form of punishment against oneself for real or perceived things the person has done in their life.)

The author says that, behind the symptoms of traumatic stress in self-injurers "...is a range of painful childhood experiences, including emotional deprivation, physical neglect, emotional abuse, physical abuse, sexual abuse and childhood loss."

Notice that physical and sexual abuse are not the only things that can lead to cutting. Emotional deprivation, living growing up without any kind of emotional nurturing in the home, can lead to later problems. (Also, I think that some things not listed above could also be causes such as poor peer relations, constant rejections on overtures of friendship and/or dating and similar childhood/teenage problems might also contribute to the "traumatic stress" that can lead to SIV.)

Another interesting factor that might contribute to cutting is "real or perceived" loss or abandonment. "Self-injurers are acutely sensitive to abandonment. Because they never properly attached to and then separated from their early caretakers, they live in a perpetual state of separation anxiety so unbearable it feels annihilating."

The younger the age at which trauma happens in a life influences how long- term the problems of SIV can become. One very interesting section is this:

"She feels different, defective, out of control. She can neither soothe herself nor trust others to comfort her. There may be large parts of her history she cannot remember." (I doubt anyone can recall virtually anything they ever did, but a person such as this might find recalling childhood experiences to be almost impossible. They might be able to remember perhaps one or two things, but the vast majority of their childhood simply isn't there. Thinking about it conjures up virtually nothing. It's as if the person has an internal VCR that is taping everything that happens to them then is automatically erasing most of that tape.)

The author notes that self-injurers can be, basically, overly sensitive to "perceived threats." Something that, to an objective observer might not seem threatening at all, can be perceived as very threatening by a self-injurer and can trigger an episode of cutting, etc.

The author notes that many women have somewhat negative feelings about their bodies (no doubt, in my opinion, to television ads, programs and magazines that set up an almost impossible physical ideal for women to attain), "...the level of shame and disgust self-injurers feel is in another dimension entirely. We're talking hate, malevolence..." (To a much lesser extent some men have the same type of feelings, but I don't think there feelings about their bodies are tied as closely to their inner core being as are the feelings of women about their bodies).

Another term used in the book is dissociation. The book doesn't offer a simple explanation, and finding one is not easy, but from the internet the simplest explanation I found was that it ranges in severity from the very common experience of temporarily daydreaming to a much more extreme reaction to some trauma where the person basically "buries" the memory as deeply as possible.

Just because the person doesn't consciously recall the incident, though, doesn't mean it won't affect the person, because such buried memories can still have an effect on the person's body and their reactions to things happening around them.

The reason I pointed this out is that the author notes that people having dissociation might respond to closeness of someone with "...panic, rage, and anxiety, and may use self-destructive behavior to create distance and a sense of protection."(I tend to call things like this having overly-effective defense mechanisms.)

The book also goes into various forms of treatment for self-injurers and has a list of resources people can turn to in trying to deal with self-injurers.

This, then, is a really good book to help a person understand SIV. It isn't filled with meaningless psycho-babble. It does have a lot of personal experiences in it, and it presents possible causes of SIV and offers a variety of possible treatments for it.

(All comments about the introduction are mine alone.)

Now, normally I would make a remark about the introduction first, if I even wrote any comments about it at all. In this case, though, I am saving that part for last. The introduction to the book, on the other hand, was written by a woman who is a doctor and had written her own book on the topic. The introduction, by the way, is, in my opinion, the weakest part of the entire book and should really have been left out.

The writer of the introduction brings up a major Christian religious issue- the crucifixion of Jesus, and in a way ties it into the topic. This is a totally inappropriate comparison. There is a massive difference between cutting to try and deal with emotional pain and allowing oneself to be cut by others for a spiritual purpose. There is virtually no relationship at all between the two.

The second major turn-off for me as far as the introduction goes was the writer's joining of trans-sexualism with psychosis, acute alcoholic and drug intoxications. Gender Identify Disorder (which is the proper term) is not a psychosis. It is not a form of intoxication. It is something totally different and by lumping that with the things she does it seems that the writer is broadcasting her own innate prejudice against those with Gender Identity Disorder.

Then she tends to brag about a book she wrote which again is a turn-off for me. The purpose of this book is to try to help people who are involved with Self-Inflicted Violence, not try to brag about something you've written.

Fortunately, the introduction is short and the types of unacceptable reasons in the introduction are not seen anywhere else in the book.

[Jacqueline Taylor · Rating 4 out of 5]

The only negative thing that I have to say about this book is that there are times that it is repetitive. This is something that is difficult for me to push through. I find it annoying. I end up saying "I know, I know. You said that!" in my head while I'm reading. Luckily, the whole book wasn't like this or I wouldn't have made it through.

Something to keep in mind while reading this book is that it was published almost 10 years ago, meaning that the research it is talking about is no longer the most recent. However, after having done some of my own research, I haven't found that there is much new research on the topic. What has been done is falling in line with what has been discussed. Mostly, there have been new theories and treatment approaches since this was published. But not even much in that department. Unfortunately, the world of medical research is sluggish because years have to pass before the long term effects can be considered.

I liked the straight forward, matter of fact manner in which the material is discussed. Yet, there is compassion for those who engage in self harm. The book considers pathological self harm in context of humanity's long history of body modification (self harm?) and religious beliefs. There is so many things that we humans engage in that could be put under the category of self harm: tattoos, cosmetic surgery, piercings, rites of passage and risk taking activities (sky diving). When do behaviors of self harm become pathological?

It briefly touches upon the symbolism of self harm and blood. This theme comes out more when you are reading the interviews with the people engaging in self harm. Their ways of describing their self harm runs along parallel lines to each other and often wades into the symbolism without directly discussing it.

The book is written by a journalist rather then a medical professional. This really didn't give the book that much different of a feel to it. But it did change the interview style. Rather then being ridge and highly structured, the interviews are fluid and self directed. This gives them more of a story telling feel. It can be hard to see the human behind the symptoms when reading a medical record. But these interviews never stray from the human heart. They are raw.

A caution about reading this book: there is a lot of difficult material that is openly discussed. At the center of the discussion of self harm, there is the powerful theme of childhood abuse. This book does not delve into graphic details, but it does not shy away from the topic either. There is no avoiding discussion of a child being raped when five, by her father, while her mother ignored the situation. These kinds of stories are common in the histories of those who engage in self harm.

The other difficult material in this book is the injuries themselves. There is no shying away from these either. Frank accounts of self harm are provided with the various stories being discussed; serving as examples to the points being discussed. There is no graphic description of these wounds, but there is a cataloging of them and an accounting for their meaning. This can only be done with a matter of fact approach.

The book discusses the stigma that comes with engagement in self harm. There are many assumptions made when someone is labeled a "cutter," but most of these are wrong. While we don't know much about the complex process leading to self harm; it is clear that there is as much suffering (if not more) then in every other mental illness. If one approaches the book with a truly open mind, they will be hard pressed to walk away with anything but compassion for these individuals. They have suffered more as children then most of us will suffer for the entire duration of our lives.

I enjoyed this book enough that once I was finished, I turned back to the first page. There are very few books that I reread and there are even fewer that I begin again before ever putting down. This is a very human book and I recommend it to anyone who desires to better understand the consequences of child abuse or why some people write their pain on their bodies.

[Alice Wardle · Rating 4 out of 5]

Marilee Strong presents a fascinating account into the lives of those who self-mutilate (now more commonly called self-harm) in 'A Bright Red Scream: Self Mutilation and the Language of Pain'. It is quite shocking to hear the experiences and opinions of self-harm from people who actually do it - that they see it as something that helps them is vastly different to onlooker's opinions of it being self-destructive. Stopping people from harming themselves does not make the tension or emotional pain go away, but the tension has to be relieved in other ways, often in the form of substance abuse or even suicide attempts.

The stories within the book do differ a little bit, but all the patients almost exclusively were sexually or physically abused during childhood. It would have been interesting to hear about the experiences of people with a very different story; however, it does mention that almost half of the people who self-harm in a referenced study were sexually assaulted in childhood, thus they were the focused group of this book.

The title of the book - A Bright Red Scream - perfectly resonates its contents. The stories are very shocking, and Strong does not shy away from the details. For that reason, it is very well-written, and provides the impetus for discussions about self-harm and what we can do (and should be doing) to alleviate child abuse (which is the origins of the issues for a lot of people who self-harm). It is also quite shocking to see people who self-harm (which sounds softer than self-mutilate) be referred to as "cutters" - I am not sure how that would be viewed nowadays.

[Catalina Cortez · Rating 3 out of 5]

This was an informative book about self-harm and self-mutilation behavior. However, one of my main concerns with this book is its lack of a clearly defined target audience. The author tries to include everything for psychologists, people who self-harm, those seeking a better understanding of the subject, people with eating disorders, and more. It lead to a lack of depth in addressing specific concerns.
Additionally, the author seems to focus primarily on one particular reason for self-cutting. Although the introduction acknowledges this limitation, I'm curious about the decision to include a chapter on the cultural aspects of self-harm while neglecting to explore other potential motivations.
It's worth noting that this book was written in the 1980s, which means that some of the resources and information may be outdated, and many of the referenced resources may no longer be relevant or accessible.
For persons who self-harm i think nothing is going to be groundbreaking and maybe could be very triggering specially for the multiple stories of people that not always have a happy ending.

[Laurie · Rating 5 out of 5]

I had my eye on this book for many years now and im glad i finally picked it up. Ive struggled with cutting for 20 years now off and on. Thie book help me understand myself better but also broke me. I'm 31 right now and ive always said i never wanted children. Never had the desire nor wanted the responsibility of having one. I fear that i will end up neglecting the child and turn out just like my mom. My question is why on earth do people have kids when they are so messed up? It seems like an on going cycle of abuse. I dont get it. Overall i loved this book, i recommend this to everyone dealing with self harm and their families.

[Cheyenne · Rating 5 out of 5]

Not a book to find a "cure" to self-harm but a collection of perspectives from various people at different stages of life who manage their relationships with their bodies and minds. Definitely should be in a good mental space before reading. Could be a good book for family and friends who want to understand self-mutilation more.

As a person who has dealt with and currently deals with self-mutilation tendencies this book gave me some comfort knowing that other people viewed self-mutilation the same way I did.

[Nebamun · Rating 4 out of 5]

I'm good with this, I didn't really finish it, but I kinda had enough? It's not like it's not good or anything, when I was an adolescent I kinda had ideas about what this book could be, even if I couldn't find it, and now that I did finally read it, it does answer some questions, but it's not as necessary as I used to feel, it's definitely son of his days, so perhaps there's far more recent content that would find a better explanation? Or that would kick differently, it's definitely good for an informative one tho

[Will · Rating 3 out of 5]

An interesting look at self-mutilation, though reads as being a bit dated. It parallels self-harm to cultural practices of scarification, tattooing, etc. It also looks at the role of self-harm in the relief of suffering, by creating an external wound that shows the pain, and then with time heals. However the book focusses too much on the role of childhood suffering, whereas more recent studies show that only a certain percentage of those who self-harm do so as a role of childhood abuse.

[Marija · Rating 3 out of 5]

This review comes a little late because this book is one that needed some time for digesting. I was recommended this book after reading Hidden Valley Road because of how both books give an in-depth look on mental illness. However, I found this book to be much more graphic and disturbing. I do feel like I have walked away with a better understanding of why people cut, but I have heard that the research in this is already out of date.

[Lavin · Rating 2 out of 5]

Tw: described self harm, eating disorders, abuse and sexual assault (including of children), incest, fire trauma

Claims ~50% of those who self harm have trauma. Does not talk about people who self harm who have trauma. Focuses predominantly on girls and women who have sexual trauma.

Fave quote: “You don’t feel like you’re hurting yourself when you’re cutting. You feel like this is the only way to take care of yourself.”

[Chris Nagel · Rating 3 out of 5]

The butler did it.

Definitely dated. At the time, this was a big deal, and there are still not very many books that give much detail about the way and why of cutting. Strong is sympathetic to her subjects. I wish she had been sympathetic enough to consider how the SAFE program was affecting them after all, because I believe that it is now considered a terrible idea to have people with PTSD go through group therapy, especially confrontational therapy.

[Emma · Rating 3 out of 5]

This felt somehow very voyeuristic in its over-reliance on case studies. I felt like this could have been grounded more with some therapeutic discussions/outcomes, but the book never really went there. So if felt like an 'expose' of SH rather than anything relating to treatment. That said, it was written by a journalist not a practitioner so....

[Charlotte Basnett · Rating 4 out of 5]

Very interesting and will stick in my head for a while but I agree it is flawed arguments, sexual abuse in what most mutilation is chalked up to when that’s not 100% factual. Also there are many stories of real life people who I don’t really care for I prefer more of the science or the psychology behind the people who self mutilate

[Zahraa Raafat · Rating 3 out of 5]

such an eyeopener. it might not be the most scientific as it's written by a journalist and not a psychiatrist, but it's definitely a nice introduction to a heavy topic. being based on personal narratives, it was at points distracting, but I Thoroughly learned From the book. It defiantly changed the way I Saw the topic of self-harm.