A History of Self-Harm in Britain by Chris Millard

Author:Chris Millard
Language: eng
Format: mobi, pdf
ISBN: 9781137529619
Publisher: Palgrave Macmillan
Published: 2015-08-01T21:00:00+00:00

Except where otherwise noted, this work is licensed under a Creative Commons Attribution 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/

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5

Self-Harm as Self-Cutting: Inpatients and Internal Tension

At the start of the 1970s, the number of people recorded as ‘self-poisoning as communication’ is still rising. Typical is a 1972 report from Dunfermline that claims acute ‘poisoning has reached epidemic proportions ... [t]he number of poisoned patients increases year by year and there is no evidence that the trend is altering’.1 In the same year, a bleak study issues from Sheffield, entitled ‘Self-Poisoning with Drugs: A Worsening Situation’. This study claims that the rate of self-poisoning in Sheffield has doubled in the last decade and now accounts for almost one in ten medical admissions and one in five emergencies. Studies from Edinburgh, Oxford and Cardiff are cited as nationwide support for these truly alarming statistics.2 By the late 1970s however, it is reported from the Edinburgh RPTC that rates of self-poisoning are falling for men and levelling off for women. Keith Hawton and colleagues in Oxford report five years later that overall ‘the recent epidemic of deliberate self-poisoning may have reached a peak’ around 1973.3 Work on this phenomenon of self-poisoning, parasuicide or overdosing continues throughout the decade; clinicians marvel at the seemingly endless increase, and then wonder at the abrupt levelling-off. There are three major research centres for these studies: in Edinburgh, at the MRC Unit and Ward 3 of the Royal Infirmary of Edinburgh; in Bristol, at the Accident Emergency Department of the Bristol Royal Infirmary; and in Oxford at the John Radcliffe (General) Hospital. These endeavours are increasingly led by Norman Kreitman (Edinburgh), Hugh Gethin Morgan (Bristol) and Keith Hawton (Oxford).

Another form of self-harm emerges in the 1960s and 1970s in British psychiatry. Self-injury, self-mutilation or self-laceration are labels identifying people who damage themselves principally by cutting the skin on their forearms and/or wrists. This kind of self-harming behaviour is today the archetype broadly presumed to be indicated by the terms ‘self-damage’ or ‘self-harm’. The rise in the prominence of this behaviour coincides with a decline in self-evidence for self-poisoning as communication, a cry for help. Overdosing comes to be seen (especially by those who focus predominantly on self-cutting) as an earnest attempt to end life, rather than a cry for help. This chapter brings into focus a clinical concern that, in a certain sense, displaces overdosing. This is not to comment upon the relative prevalence of these behaviours (a topic fraught with difficulty, especially around self-cutting), but to mark a transformation in what it meant by ‘self-harm’: from communicative overdosing to self-cutting performed for quite different reasons.

Like self-poisoning, self-cutting or self-mutilation does not have a common-sense, self-evident existence. It is a concept made and refined over a period of time, one which gradually becomes coherent and even obvious. What starts as a range of disruptive behaviours (including window-smashing, shouting obscenities, or swallowing ‘bizarre’ objects such as dominoes) is refined through increasing focus on self-cutting and the exclusion or relegation of other behaviours to secondary significance.

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