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Self Mutilation - A Love Letter
관리자(cjlee7600@hanmail.net) http://www.freudphil.com
2010년 08월 26일 00:27 1519

By John Gasperoni, Ph.D.

The impetus for this article, or what I would mark as its beginning in time, which is also a notion to keep in mind throughout the article, comes from a piece published in the New York Times Magazine entitled “The Thin Red Line.”[2] The article circulated through the clinic where I work, and sparked much debate about what would be the clinical picture of someone who intentionally and painfully physically harm him or herself, why and how these activities would lead to the relief of anxiety, whether these were truly “female perversions,” as the author in the article contends, and what must be the biological components of these kinds of behaviors, since they couldn’t have a solely psychological origin. The article itself is a finely crafted piece of writing, weaving together the clinical and treatment material with references to indigenous or tribal practices, the modern primitive movement, the mainstream notions of perversion, and the posssible biological basis of the pleasure for those who engage in such practices, while holding to the assumption that this behavior is a contemporary form of adolescent self-loathing. It seemed to me that a Lacanian reading would provide a more comprehensive way of making sense of all of the material. What I would like to do in this presentation is to follow the trail of marks left behind that go to make up the thin red line that marks the difference between hysteria and perversion.

A Scar is Born
What results from the traumatic breaking of the skin? Simply, a scar is formed, leaving a trace of the rupture as a memento on the skin, a deformation of the surface of the body. As Freud has said, “The ego is first and foremost a bodily ego; it is not merely a surface entity, but is itself a projection of a surface [the editor’s footnote continues:] ... It may thus be regarded as a mental projection of the surface of the body, besides, as we have seen above, representing the superficies of the mental apparatus.”[3] In the mirror phase, the infant quilts together the reflected image of its body, the name bequeathed to it, and the confirmation given to this by its parents, instituting this Imaginary identification as founded on the promise of an anticipated omnipotence and omniscience. In that the body of the infant is marked by the signifiers of the Other, it is not the body of physiology or biology with which the infant identifies in the mirror phase, but the social or symbolic body. This is a body marked by the signifier, cut into pieces by the words with which the maternal other has labelled it. As Lacan states, “This form is even tangibly revealed at the organic level, in the lines of ‘fragilization’ that define the anatomy of phantasy, as exhibited in the schizoid and spasmodic symptoms of hysteria.”[4] The organism of the infant, in being marked, or scarred, by the signifiers of the Other is transformed into the body, or the nascent form of the ego, with which the infant identifies as this is confirmed by the gaze of the Other. The mirror phase is an instant of seeing, the institution of a cycle of logical time. The mirror phase also provides the infant with its first solution to the problem of the Real, in that it provides the way for the infant to rise above its motor incapacity and the experience of the corps morcele to perceive itself as whole, a méconnaissance to be sure, but even in error and lies the truth speaks.

A scar is a mark that breaks or disrupts the Imaginary continuity and perfection of the perceptual Gestalt of the body. What is a mark? In his course on linguistics[5], Saussure tells the story of how, one day, he and his girlfriend were walking in the park along the river and he was overcome with emotion and proposed to her. She accepted his proposal, and he immortalized her assent by taking out his pocket knife and cutting a notch in the tree they were standing under. He placed a monument on the skin of the tree to mark the instant when, in his mind, their marriage began. Every year, they would return on their anniversary to this spot, and after they had counted together the notches already marking the time of their life together, he would take out his knife and again cut another notch in the tree. These notches were a commemoration of a moment of inauguration, marking a break between what once was and could never be returned to versus what would come to be in a future not yet realized but promised. These notches in this tree marked a radical discontinuity or break for Saussure, a punctuation mark separating what he had relinquished from what he hoped to gain. For Saussure, these marks he had cut into the skin of this tree were signifiers. A signifier signifies nothing outside of its power of signification. A signifier brings about the presence of signification it its pure state, by its opening up the void of what the Other means. A signifier is a monument to a spoken word of promise, marking both the instant when the speaking created the reality to be of what had been said as well as the death of what was caused by the speaking. Although it is a moment that has lived and died, this moment lives on through the signifier, which acts as a monument to what has passed. The signifier acts like a tombstone, marking the absent presence of the unique existence that is no more so that it will not be lost to memory, marking the place of return, marking the place one goes to mourn what was once enjoyed but is now lost forever.

A (Wr{R}ight[ite]) of Passage
For members of indigenous cultures, this is the Symbolic function of those sacred rites of passage that act as the boundary or limit between the roles available to one in the culture, usually marking the point of entry into the “adult” world of that culture. In such rites, the individual undergoes a time of preparation in which all normal or expected social functions are relinquished. The rite itself involves a recognized, structured, and socially sanctioned trial with deprivation, physical hardship, and excruciating pain inflicted either by one who has already endured this rite and is acting as a guide or shepherd, or by oneself. This leads to a non-normal state of consciousness in an encounter with the Real that opens the individual to a unique experience from which insight or new knowledge is gained, changing one’s place in the world. As a result of this initiation, the individual then bears the mark of her or his ordeal on the flesh of her or his body, either in the form of a codified tatoo, as in many of the South Sea island cultures or as scars as in many indigenous North American cultures. For most of us “whites,” our first introduction to this was through the movie “A Man Called Horse.”[6] In this film, an English nobleman is captured by an Indian tribe and used as a draft animal. He struggles to be treated as a man but is always rebuffed by the tribal warriors with the gesture of their drawing two fingers across their chests, signifying the scars they have received by undergoing the ritual of the sun. In this ritual, the young brave, wishing to become a warrior, is hoisted off of the ground by the hooks inserted through his chest muscles and left hung suspended until he has the mystic visions that give him sacred knowledge. Until he submits to this ordeal, the protagonist of this film is not seen by the warriors of the tribe, is not considered as being their worthy of recognition.

Here we have a very graphic illustration of what, from an psychoanalytic perspective, we would call an Oedipal transition, or a well conducted treatment. The individual, wishing to be set free from one set of Imaginary identifications while taking on a new Symbolic identity, undergoes a socially sanctioned and structured ritual ordeal so as to encounter the Real. The encounter with the Real is an encounter with one’s limits, with one's castration. As such, it is traumatic, as is any encounter with the Real. Within the sacred space of ritual, the encounter with the Real is not a chance encounter or an accident. It is a meeting sought out, a confrontation and challenge, a necessary encounter to effect the transition from one Symbolic place in one’s community to another, to effect a change in name. In the encounter with the Real, a mark is left behind on the surface of body, raising up on the flesh a signifier marking the place where the encounter occurred, the place where something was relinquished and lost forever, the place where a mark of difference was gained. In the passage through the ordeal, a signifier is raised up which acts as a seal, an imprimatur of legitimacy. This signifier, Janus-like in function, both seals the tomb of what was lost and seals the pact between this individual and the cultural roles and obligations he will come to inhabit. But, in that what this will come to mean for this individual is still unknowable, these are signifiers without yet a signified. They act as master signifiers in the individual’s discourse, launching them on the trajectory of their destiny.

Modern Primitives?
The situation is not quite so clear with those individuals who make up the “modern primitive” or new tribalism movement. Here, the extreme body arts aim at creating a decorative mark that places one outside of the “normal” limits of culture. Rituals, when used, are more for spectacle and entertainment, for the generation of an Imaginary specialness for the participants rather than for the sacrilizing of the intersubjective space. The signifiers etched on the flesh act as a mark of difference, but it is a marking of difference from the culture, of the creation of a separate order through a negation of the cultural Symbolic rather than a mark of submission to that Symbolic order. In that the focus is on being seen as different, as not being a member of the dominant culture, it becomes an issue of Imaginary identification rather than Symbolic identity, a mark of a refusal of castration. Many of those in the modern primitive movement interviewed for these pieces reported histories of victimization, either through being the recipient of physical and sexual abuse or through parental substance abuse and neglect. For some, home was a place where the constant parental demands for performance and perfection only escalated to new heights with each success. It becomes a question of whose body this body belongs to?, bringing to mind Freud’s young grandson[7] who attempted to master his trauma by a change of voice, going from passive to active as a way to gain mastery and control over what was overwhelming and uncontrollable for him. It is a way of saying, “If you hurt me, this body is yours and I am yours. If I hurt me, its my body.” It becomes an issue of who is the one recognized as having the authority to so engrave the mark of ownership on this flesh called “my body.” This can be seen as creating a mark of difference from one’s family, effecting for oneself the act of being severed from the maternal other and those Imaginary identifications that the father was unable to effect. It is using pain to mark a limit and then go beyond that limit, denying the existence of a limit or an authority who could so pose such a limit.

As a reflexive, self-inflicted incurring of pain beyond a limit, as with delicate self-cutting, the practitioners of extreme body arts are attempting through the pain experienced to make the Other exist. Unlike those engaged in sacred ritual where the pain has a point or purpose, here the pain is meaningless; it is a Real pain that undermines any Symbolic fiction that might unite a community.[8] In that the action is all in one’s own hands, one is calling forth the unbarred Other, summoning up the Other beyond castration so as to demonstrate that in the encounter with the Real one is equally not castrated. This is very much like the hysteric’s quest for a master, not so that the hysteric might submit to such a master but to prove that this master is no master of the hysteric, to prove that the master desires and is lacking and is therefore not a master. Seen in this light, the extreme body arts are an attempt, through the encounter with the Real, to stamp or certify this flesh as my body, to write over the signifiers of the Other with my own, creating an Imaginary body outside of the demand of the Other. It is a making of the body into a palimpsest where the earlier writings still show through this new text. In that these are also staged, or held as a performance, it raises the question of for whom this spectacle is held and whether the point of the spectacle is to capture the look of horror and disgust or fascination on the faces of the onlookers, so that the aim would be to captivate the gaze of the onlookers as a substitute for the gaze of recognition from the Other.

Piercing is an example of a body modification that attempts to circumvent the usual exchange of gifts between the infant and its caretaker. For the infant, it is fed and made full by the gift of food given in response to its cries. And as Josine Lefort[9] has demonstrated in her case studies, it is an accomplishment of monumental proportions when the infant links its mouth and the food it is given with its anus and the feces that come out, linking the one hole with the other and making of its body a torus as it learns to give the gift of the fecal column on the demand of the maternal other. A piercing can be the creation of a supplemental torus with the stuff of the body, creating a site where the exchange of gifts occurs outside of the realm of the demand of the Other, thereby attempting to institute the subject as the unbarred Other. A piercing could also be a way to inscribe the site of the piercing into the dynamics of exchange, hooking a new body part into the circuit of exchange, thereby inscripting a “new” erogenous zone.

From the perspective of an hysterical structure, the infant has erected an ego based on an Imaginary identification with the parent of the other sex. At the time of Oedipus, the subject, in order to bridge or suture the gap between the culture of their family and the Symbolic of the particular culture within which his or her family resides, must bear the mark of a signifier denoting his or her sex which does not fit with the sex of the body of the parenthe or she identified with in the Imaginary. One would then have to consider the practices engaged in by those involved in extreme body arts as an attempt to demonstrate the wrongness of the signifier bequeathed to them at the time of Oedipus. For those who are biologically female, this would be a demonstration of the adage “take it like a man” — that is, only a true or real man can bear the unbearable. For those who are biologically male, the Symbolic recognition by the father is both insufficient and incorrect. This would then be acting out the request to the father to be recognized both in name and in body, a magical submission to the supposed mutilation that has occurred to those who are biologically female.

For most people, to speak of hysteria is to enter the realm of psychopathology. For Lacanians, it is to enter the realm of the barred subject after Oedipus, who has been hystericized by having to bear the mark of a signifier of sexual difference before it can be attached to any signified. In looking to DSM-IV[10], there are two places I would want to focus your attention. The first of these is the definition of what constitutes self-mutilation, and second is the description of this behavior as a symptomatic behavior. According to DSM-IV, self-mutilation is the direct, deliberate destruction or alteration of one’s own body tissue without conscious suicidal intent.[11] This is to distinguish it, first, from so-called involuntary acts, such as head banging, which might be observed in those considered “retarded,” otherwise referred to as the developmentally disabled, or “autistic.” For a Lacanian, an autistic is one who, during the mirror phase, could not identify with other beings of its own kind since this identification was not adequately confirmed by the maternal other. Then there are those “coarse” self-mutilations, such as eye enucleations or self-castrations, performed by those considered psychotic. In these enactments, the psychotic is detaching that piece of her or his body that she or he has taken to represent the Imaginary phallus, that object that would satisfy the desire of the maternal other or what Lacan has written as the -j, and return it to the Other.

As a symptom — and here DSM-IV focuses on such behaviors as cutting, burning, trichotillomania, bone breaking, head banging, infibulation, and dermabrasion — the activity of self-mutilation is only mentioned in two places. First, in the section on sexual paraphilias, it is listed as one of the potential activities engaged in by sexual sadists and sexual masochists.[12] But the DSM-IV takes pains to note that these individuals, unless the behavior gets out of control leading to serious injury or unless they are unable to engage in these behaviors with a consenting partner, rarely come into treatment. We would say that if their jouissance can be assured with a counterpart, then they don’t suffer, such that the question of their existence never becomes an issue that drives them to treatment. The other place that DSM-IV talks about self-mutilation is in its discussion of borderline personality disorder, looking at self-mutilation as being on the continuum of various self-destructive and suicidal acting out behaviors that these individuals engage in.[13] There are two points I would want to focus on out of this. First is the interpersonal and emotional instability of those who are labelled with this diagnosis. From a Lacanian perspective, in the relationship with the counterpart, who is usually a well-paid therapist, the “borderline” individual alternates between seeing the counterpart as either the unbarred Other, with the concomitant love, worship, and glorification that results, or as barred and castrated, with the rage and disgust that follows from having one’s méconnaissance so rudely punctured. This is the hysteric’s dialectic, which brings to mind Dora, with her glorification of Frau K and her haughty and disgusted dismissal of her father, Herr K., and Freud.[14] Second, acting out is a message addressed to the Other, but it is a message that the subject does not enunciate in speech. The subject is either lacking the signifiers with which to present this message to the interlocutor so that it might be returned in inverted form or is unwilling to hear the enunciation of his own desire because he wishes to remain ignorant of it. It is a message for which the subject goes lacking, so that it is acted out. In either case, the Other is again implicated.

The Story of Jill M.
Jill M. is a sixteen year old caucasian girl who is five feet ten inches tall with long blond hair, green eyes, and an underbite that makes her appear as if she is half-smiling. She is the middle child three, having two brothers. Her father, Jim, is a lieutenant in the local police department; her mother, Nancy, a housewife. It is an intact, supportive family. Her older brother, who is one year her senior, was born with health problems that cost him one kidney. As a consequence of this, he required intensive treatment with many hospital visits for three or four years, with the family never knowing from one day to the next what his condition would be. Nancy, whose childhood was marked by alcoholism, felt a general sense of impending catastrophe while the children were young. She would not drive on expressways, and would take approaching storms as tornadoes, huddling with the children in the basement. This has left Jill, who grew up with a terrified mother, a chronically ill sibling and a father who kept a certain distance from the emotional upheavals in the household, with a sense of isolation and impending peril, as well as a fear of storms. As she grew up, Jill developed an unusual tolerance for pain. Triumphing over physical pain was something Jill could excel at, distinguishing herself from her physically weak older brother while at the same time reassuring her mother that she would always be strong. There is a mix of toughness and a hypervigilant desire to please that has formed the engine of Jill’s social persona, which mixes an easy affection with an opacity that seals off her real thoughts.

Jill's difficulties began two years ago, when she was fourteen and just entering high school. Near her family's home, there is a park where many of her peers would "hang out." When Jill would go to this park, the adolescent boys would make lewd and lascivious comments to her that would embarrass and disgust her to the point where she couldn't respond. The older girls at school assumed she was a “slut” and would give her “dirty looks” at school. Blaming herself for having provoked these reactions, Jill began to feel ashamed and isolated. Her unease spiraled into panic when a boy she trusted began spreading lies about her, claiming that the two of them have done “all this sexual stuff,” which left her feeling “blown away,” “dirty,” and as if she were “absolutely nothing.” She found herself in the bathroom of the family home, crying uncontrollably and feeling “completely crazy,” overwhelmed with anxiety and unable to concentrate, because she couldn’t find a way to let her emotions out in words. She spotted a wallpaper knife her mother had been using and began to cut her leg. It got her excited to see the blood, as if the blood was carrying out her other pain as well. She had discovered that cutting herself could temporarily ease her emotional distress. Eventually, her friends got wind of her behavior and told her parents, who were frightened and mystified. They took Jill to Children’s Memorial Hospital, where she was treated for depression and put on Prozac, which she took for a few months until she felt better. By the summer, she was cutting again in secret and also burning, mostly her upper thighs, where her mother, who by now was anxiously monitoring Jill’s behavior, wouldn’t see the cuts if she emerged from the family bathroom in a towel. Last summer, Jill wore boxers over her bathing suit even to swim. By January, her state was so precarious that one bad night would have the power to devastate her.

On that Saturday night in January, despite Jill’s anxious resolutions, things at the party she had gone to ultimately went awry. Instead of leaving with her best friend to stay at her house, Jill stayed later at the party and ended up drunk in the basement with a large group of boys, who began to razz and tease her. Realizing she was in a situation she would punish herself for later, Jill went upstairs and tried in vain to get a friend to leave the party with her. She had nowhere to stay and no way to get home without calling her parents, so she ended up at the home of her friend’s brother, who was in his twenties and lived near the party in an apartment he shared with his friends. This proved to be another mistake, as the next morning these boys also made lewd and disgusting sexual suggestions to her. But by now, a cycle of shame and self-blame was already in motion. On finally arriving at the two-story brick house where she lives with her parents and brothers (one older, one younger), Jill learned that she was being grounded for not having called home the night before. Her bedroom, right off the kitchen, is a small, makeshift room with accordion doors that do not seal off the noise from the rest of the house. She felt disgusted with herself and that she was “the dirtiest thing ever” for her behavior at the party, which left her so depressed that all she did was sleep on Sunday. That Sunday, no-one was happy with Jill: her parents, the friend whose house she hadn’t slept at and, in her fearful imagination, countless older girls who by now had heard of her sloppy conduct at the party and were waiting to pounce. Monday morning, too afraid to go to school, Jill went into the bathroom and began to cut on herself with a knife. Scaring herself, she went to talk with her mother, who became angry with Jill, framed Jill's hurting herself as an attack against her parents, and took the knife away. Jill went outside and continued to cut on herself with a broken shard of a glass candle holder and, when this didn't bring the relief she was seeking, began to dig at and pull off her skin using a pair of fingernail clippers. That night, convinced that her mother was so angry that she no longer cared what happened to her, Jill took approximately thirty aspirin, leading to her spending the night vomiting with ringing in her ears and unable to concentrate or focus. She slept through Tuesday before telling her parents what she had done to herself. They rushed her to the hospital, where Jill spent three days in the intensive care unit with arrythmia while IV's flushed out her system.

After her medical discharge, Jill entered residential treatment, being transferred to the SAFE (self-abuse finally ends) Alternatives Program in February. For insurance reasons (the family insurance carrier defined Jill's problem as "self-inflicted"), she could only stay as a resident of this program for ten days, completing the program on an out-patient basis. The week after her discharge, she began easing her way back into school. The thought of facing her peers en masse filled her with anxiety. There was also a second danger for Jill: her irrepressible impulse to please, which could make her vulnerable to unwanted sexual attention. She steers clear of romance out of an apprehension she attributes to the friend who lied about her.

By mid-March, having finished the SAFE program two weeks earlier, Jill returned twice each week to see her therapist. The openness Jill showed towards her parents at SAFE had vanished behind a sheen of wary cheerfulness. Jill seems to be making a staggered kind of progress. Since leaving the program, she claims she has had no impulses to hurt herself. Her mother, admittedly a worrier by nature, is less sure, and says she has resorted to sneaking into Jill’s room in the wee hours with a penlight, lifting the covers while her daughter sleeps to check for new cuts or burns. So far, she’s pleased to say, there’s been nothing to report.

Comments on the Expert’s Opinions
Within the population of self-mutilators, at least two-thirds report some form of sexual abuse, which leads to these individuals being plagued by episodes of dissociation, which are described as feeling dead or numb in one’s body, as being over there watching oneself, separate from one’s body. The genesis of dissociation is described by one of the experts in this way: “When you are abused, the natural thing to do is to take yourself out of your body. Your body becomes the bad part of you that’s being punished, and you, the intact, positive part, are far away. But what begins as a crucial self-protective device can become an inadvertent response to any kind of stress or fear.“

How would this be spoken of from a Lacanian perspective? In a dissociative response, the individual experiences herself solely in the Imaginary, seeing the reflection in the mirror as being the real or true “me” with all of the life, or covered with the lamella[15], like the others of my kind. In the scenario of abuse, the Symbolic pact has been ruptured by the intrusion of the Real, by the unmediated horror of the unbarred Other’s jouissance, of being the object used to satisfy the desire of the Other. What is left is the uncanny counterpart, over there, the whole, complete and ideal one, the one with something extra. It is the child that is being beaten that Freud has spoken about, the one that father loves that I hate, the one I wish I could become so that father would love me.[16] What is experienced in trauma is the eruption of the Real and one’s impotence and insufficiency in the face of this Real, precipitating the dissolution to the corps morcelé, or the body in bits and pieces prior to the assumption of the Gestalt of the body as a whole in the mirror stage. The individual hopes to magically transform this scenario through an emotional reaction whose aim is to create an Imaginary display of potency that will be taken as a Symbolic performative that can heal the wound and return control over and power in the situation where the Real erupted. The question that this leads to is how the self-mutilating behavior ruptures this capture in the dissociative state. To be captured in the Imaginary is to be frozen in time, to be in a place out of time where the perfection of the image has a statue-like immortality. The function of the Oedipal transform is to mark the subject with a signifier of their sex, and this marking both severs the symbiotic tie linking subject to the maternal other while presenting the subject with a mystery to solve, — namely, the question "what does this signifier signify to me about myself?" If adequate, the Oedipal transform hystericizes the subject with this master signifier, and instantiates a cycle of logical time. It is through the attempt to speak in the Symbolic the Real of the trauma of loss incurred by the Oedipal transform that moves the subject into the time for understanding. The self-mutilating behavior would then be an attempt at a Symbolic repetition at the level of the Imaginary of the Real of castration that ruptures the Imaginary captivation of dissociation by its remarking the beginning of time.

A majority of experts in this field express confusion as to why the body would collude with the avoidance of pleasure in the masochistic acting out, while at the same time being fascinated by the auto-erotic and masturbatory quality of the experience that links physical pain with sexual satisfaction. What is missed is the distinction between a behavior aimed at the pleasure-pain continuum and one whose intent is the production of jouissance. There are two aspects of the production of jouissance. The first of these is to become the object that would satisfy the desire of the maternal other. To become the Imaginary phallus of the mother, or the -j, is to become that object one presupposes the mother to be lacking to be whole, to make the two into one, thereby returning to a state of symbiotic fusion with the maternal other and immersing the two made one into a sea of jouissance. This is also the path of the hysteric’s jouissance, to efface oneself as a subject so as to become the object-cause of desire of the Other. Here, the object-cause of desire functions as a signifier that has as its signified the Imaginary phallus, or the objet a above the bar with the -j below the bar as marked by the unbarred Other.[17] The second aspect has to do with becoming the instrument that would be used to produce jouissance for the Other, becoming that object the Other requires to produce jouissance while being closed to this jouissance oneself. This would be the path of the pervert’s jouissance. In either case, there is the eradication of subjectivity and the demand for the subject to bear his or her lack, a weight lifted from the subject who is either object of satisfaction for the Other or an instrument for production of the Other’s jouissance, who is sacrificed to and for the pleasure of the Other. The closer one comes to the position of an object, to an abjection of subjectivity, the greater the production of jouissance for the subject. The distinction between these two practices is the destination to which each path takes its practitioner. For the hysteric, there is a jouissance produced, a gratification or satisfaction that results, but it never fully or accurately answers to what was asked for in the demand and so always lacks. For the pervert, the punctuation of any gratification is avoided in the effort to effect the shift from an objectal position to an instrumental one, becoming a fetish for the Other. Both lead to the addiction to abolish oneself in the Other’s pleasure.

One of the markers of self-mutilation is that, according to many in the field, the onset is always in adolescence. This is explained in the following way. The child who grows up in a traumatic environment suffers two consequences. Trauma can cause lasting neurological changes if it occurs while the central nervous system is still developing. The expert cited by Egan[18] states: “The shock absorbers of the brain are shot. If everything is running smoothly, if it crawls along just fine - as it does in nobody’s life - you’re fine. But the moment you get hurt, jealous, upset, fall in love, fall out of love, your reaction becomes much stronger.” Secondly, such children learn that they can depend on no-one, that they must be completely self-sufficient, that no-one can help them, or that they don’t deserve the help. They are ill equipped to deal with independence and terrified to express emotions like sadness or rage for fear of driving everyone away, being more easily overwhelmed by these feelings and turning them on themselves. “They go through childhood developing poor capacities to deal with states of internal disruption. I can’t think of a single thing that involves more internal upheaval than the adolescent years. The changes that come with their menstrual cycle or with sexual arousal engender panic in the young self-injurer.”[19]

What occurs at adolescence? With the upheaval of the Real of sexual maturation, the time for understanding approaches the moment to conclude when the subject will be able to enunciate the signifier of their sex and have a knowledge of what it signifies. The signifier is always empty, always projects its signification ahead of itself it in time since its meaning, or what it signifies, is always retroactively fixed. The approach of the moment to conclude is to come to know what one might be in the dialectic of desire, for the desire of the Other. This bequeaths a retroactive meaning to the statement enunciated by the subject by the punctuation of the intrusion of the Real. The subject will endeavor to signify this, finding a way to speak so that she might hear herself telling herself what it signifies for her by having this message returned to her in an inverted form. Here, we stand with Freud and Breuer[20] and those hysterics who, with their movement into adolescence, were now able to give a sexual meaning to the pre-sexual sexual shocks, or the contact with the jouissance of the Other, they had received in childhood, and came to know what they were for the Other, which disgusted and horrified them.

The problem facing adolescents, according to the next expert quoted, is that prior to the rise of the industrial west, many cultures had adolescent initiation rites. “We’ve done away with the rites of passage, but the pattern can still exist. And the younger teenagers who are seeking to become adults, the ones who can’t make it the ordinary way, somehow tap into that.”[21] This leads to a presentation of the practitioners of new tribalism or extreme body arts, who, the article goes on to state, share many of the same urges of the self-mutilators to revisit the sites of trauma and abuse on their bodies and alter them in some manner that feels symbolically curative. But the many resonances between motive and procedure that exist between self-injurers and body modifiers can obscure a crucial difference: control. Getting an occasional brand or cut design in the course of a functional life is not the same as slashing at one’s flesh - or fighting the urge to do so - on a daily basis. One is a shared act of pride; the other a secretive act steeped in shame. And many body modifiers are motivated not by the process at all but by the simple desire to belong to a group that is visibly outside of the mainstream. So it has to do with control, or the illusion of control. The article quotes a body artist who, after having designs carved in her flesh with a razor, takes an impression of the blood design on Bounty paper towels, having a portfolio of hundreds: “You know that you’re going to endure some pain, you’re going to shed your blood...That act, once it happens and you come out victorious, makes you go through a transformation. We have so little control over what goes on around us...It comes down to you and your body.”[22] Here, we’re back with Freud’s grandson, asking the question, “do I act or am I acted upon?” If I act, if I initiate the activity, if it is something from within the subject that accepts the risk, then I am in control, even if I cannot know what my speech might mean until I interpret the response I receive. To act is to take oneself as a subject, with the illusion of potency that is spoken of as being in control. If I am acted upon, if I am the recipient of actions intended by an other, then I am not in control, but have passively submitted and surrendered in the struggle for recognition. To be passive is to deny myself as a subject who might desire, to bring death to desire and become an object for the Other, to become a helpless thing in the hands of the maternal other. The change in voice from passive to active, from being the one spoken to the one doing the speaking, is to accept the risk of what one might hear oneself saying in speaking, of coming to a knowledge one didn’t want to have.

How does abuse contribute to self-mutilation? The dictionary defines abuse as to use wrongly or improperly or to misuse, to hurt or injure by maltreatment or ill-use, to assail with contemptuous, coarse, or insulting words or to revile, and in obsolete usage, to deceive or trick.[23] Within the mainstream, abuse is always taken as an extraordinary occurrence or circumstance, something beyond the normal, expected range of life-events. The list of events that DSM-IV considers to be beyond the normal range is detailed in the description given of those stressors that would provoke or evoke PTSD.[24] From a Lacanian perspective, to abuse someone is to violate the Symbolic pact as expressed in the social link, to tear apart the Symbolic bonds that constitute this community by the refusal or failure to recognize the social fabric constituted by the Symbolic, and thereby to refuse this other as having a place within the links so constituted, to refuse to recognize this other as a subject. In its disregard for the Symbolic, the abuse lets lose the Real, rending the Imaginary Gestalts with which one has identified and returning one to the corps morcelé. To be the victim of abuse is to be completely at the mercy, or lack thereof, of the Other. But is this not the situation of the infant who is forced to learn its mother's tongue in order to survive in the human community? The infant, at first, can only cry out to express its needs. The maternal other comes and offers the infant string upon string of signifiers in the attempt to decode the infant's cry. But the signifier bequeathed to the infant never really hits the mark in being an expression of what the infant was crying for. As it is given from the maternal other, the infant assumes that this signifier is saying something more true about him or her thanhe or she themselves can know, taking whatever state he or she was in that caused them to cry as the signified of this signifier given by the Other. In learning to speak our mother's tongue, in coming to use the signifiers handed to us by the Other, have we not all suffered the abuse of maltreatment, of being tricked or deceived with cruel words, of not having our needs adequately met? Haven't we all, at an unconscious level, been subjected to the abusive tyranny and violence of the Other?

How a Lacanian Might Read the Case of Jill M.
To read a case is to know when the story began, to be able to mark the beginning of time when this destiny was first given its nascent form. It is to be able to mark the point where the subject took up the signifiers given to her or him and began to be played by the dialectics of desire within her or his family complex. This means that Jill is the symptom of her family, a symptom that has taken several generations to develop into the form of expression that it has today. As far as I can discern from the comments made, this is a concept not followed to its logical conclusion by any of the experts or treaters quoted in this article, caught as they are in the myth of the autonomous ego. When did Jill’s story begin? It began in the childhood home of her mother Nancy, “a home marked by alcoholism,” as it is described in the article. While not specifying what went on in Nancy’s childhood home, we are told that Nancy has been diagnosed with obsessive compulsive disorder and that she felt an impending sense of doom while raising her children, which she spoke of in the article as her seeing any coming storm as a tornado. For Nancy to be an obsessive is to say that, in her psychic economy, the father, while not foreclosed in the Symbolic, has defaulted in some way and is in debt, is unable to bear his own impotence and rage in submission to the law, and has passed this debt on to Nancy. From a Lacanian perspective, substance abuse can be read as a contemporary masculine form of hysterical protest, as a way of avoiding the Real of castration so as to keep desire unsatisfiable. The conclusion here is that, for Nancy, the Real has never been adequately or sufficiently held in check; it rumbles in the distance with ominous foreboding, leaving one with a feeling of dread, with a feeling of hopelessness and powerlessness as the raging storm rips up and rends apart the fabric of one’s life. Could Nancy's fear of tornadoes be a metaphoric displacement for a drunken, angry father yelling and raging through a home while a small, terrified child hides in a corner cowering in the face of the loud, incomprehensible words being bellowed and screamed? When it came time for Nancy to deal with the serious illness of her first born son, Jill’s older brother, the constant dread of not knowing when the Real would devastate her world acted as a repetition for Nancy, precipitating a reawakening of her awareness of her insufficiency in the face of the Real. Although Jill’s father is a policeman, Jim was unable to adequately represent the Symbolic law in his own home. What allows me to say this? Jim is described as always having kept a certain distance from the emotional upheavals in the household, in his own words having “a ton of denial.” We can imagine that in the face of Nancy's fears and obsessions, Jim was unable to speak or to act in the family in such a way so as to reassure his wife, to give her an effective word of comfort, to assist her in using the Symbolic to suture over the intrusion of the Real. Since no one could provide Nancy with the words she needed to hear, she went elsewhere to address her lack, placing this as an unspoken demand made to Jill. Jim has been unable to effect the Symbolic cut that would sever the dyad formed by Nancy and Jill. Jill has been left to the task of becoming that Imaginary phallus that would provide Nancy what she lacks, an image of strength and self-sufficiency, an ability to deal with all of it on her own, and a high tolerance for physical pain and discomfort, unlike her older brother. At the level of the Imaginary, Jill has made an hysterical identification with the figure of the man Nancy has always desired her father to have been and that Jill's father was unable to embody.

Jill's father was as inadequate to the task of the Symbolic father as was Nancy's, but in a different way. We can see this in Jill's attempt, when she was fourteen and just entering high school, to deal with the unwanted sexual attention she received from the boys in the park and the way in which the other girls, from Jill's perspective, took the remarks as actually saying something true about her, confirmed for Jill by the way she saw the other girls looking at her, or what we would call the gaze of the Other. Jill turns to a counterpart, another boy, and speaks to him, trying to enunciate her truth so that this message might be returned to her. The repetition of her pre-sexual sexual shock comes for Jill when the boy she trusted violates the implicit Symbolic pact and lies about her in a way that leaves her no way to respond. His lies make of Jill an object to be used by the Other in a way that she cannot refute, confirming for Jill that the others see her only as another object of their demand, obliterating her as a subject as she had willingly obliterated herself in the face of her mother's demand. If she is a thing for the Other, if she is a thing for her counterparts, then she shall be a thing for herself, and finds relief in cutting and burning herself. She has a secret, a secret knowledge that makes her special, a secret knowledge that, while marking her as different from all the others around her, provides her with a forbidden jouissance that speaks to a refusal of castration. The site of her aggression is her inner thighs, high enough up on her legs so that when wrapped in only a towel or when wearing men’s boxer shorts the cuts will go unnoticed by her mother. Are not these cuts a magical, self-inflicted re-visitation of the castration that she presupposes has happened to her body when she was marked with the signifier of her sex? Are not these cuts an effort to create a signifier on her flesh that marks the absence of the phallus? When she is betrayed by her counterparts to her mother, she is taken to the hospital the first time and given Prozac, which reminds me of the opening line to the old Jefferson Airplane song “White Rabbit.”[25] This intervention, while making her feel better, takes away the jouissance of her secret suffering, but creates a scenario in which her mother gets to resume her own obsessive worry and ruminations.

Consciously, neurotics always tell themselves that they recognize the situation that causes them to suffer and that they can avoid or prevent themselves from going there once again, only to lead themselves exactly and directly to the place where they suffer the most, where they obtain the most jouissance. This is clearly demonstrated by Jill’s engagement with the persons and events of the party, which leave her disgusted with herself, “like the dirtiest thing ever,” and depressed. The feelings of disgust are the hysteric’s sign of the encounter with sexuality, and depression the mood that results when the signifier falls too heavily on one’s flesh. The day after the party, Jill could not admit her distress or speak it to anyone, trapped in her failure to have pleased everyone else and enraged with herself for her impotence to be that object of Imaginary phallic perfection for the others. If she cannot be the Imaginary image of perfection to please her counterparts, maybe she could be that which would please her mother. And so Jill begins to cut on her flesh with a knife, terrifying herself with the ferocity of her attack on herself to the point where she turns to her mother for help. But Jill experiences her mother as being so angry at her that she no longer cares to tend to her injured child, an experience for Jill of being rejected by her mother when she attempts to fulfill Nancy's other demand, which is to be that which causes her mother to ruminate and worry as did Jill's older brother. Jill, in being borne down by the weight of the signifier, continues down the logical path of the fading of the subject in the attempt to become that thing which would satisfy the demand of the Other, leading her to attempt to "thing-ify" herself completely by killing herself. Jill acts out the message she has received from her mother behind the bar of negation with which Nancy has enunciated it, taking it on as a command to kill herself so as to become that dead thing that would satisfy the demand. The method Jill chooses in her effort to kill herself — taking an overdose of pills — also speaks to her identification with her mother. The aspirin Jill takes are pills that do something, but not what she anticipates, since they make her suffer in a way that is not under her control. Jill must speak her suffering, first to her parents, and it is this act on her part that ushers her into treatment.

What is the structural form of Jill's psyche, and of that of self-mutilators in general? More specifically, is self-mutilation is a symptom of the hysteric or of the pervert? This is a question that can never be answered with certainty until a well-conducted treatment is brought to its conclusion. The constellation of statements that would constitute a separate answer for the hysteric and for the pervert both indicate an essential failure on the part of the father, the issue being one of a difference in emphasis of how and where the father has faltered in fulfilling his mandate in the Real, the Symbolic, and the Imaginary. Disgust is the hysteric’s sign of the encounter with sexuality, and this is present in Jill's reaction to boys, how she avoids emotional involvement or "romance," how she develops a "distaste" for any boy who shows an interest in her, and how she became anxious seeing all these boys looking at her at the high school hockey game. She does not know what the other might want of her, but by the way she sees herself being seen she knows it has to do with the other's desire and how she might play a part in satisfying that desire. In that the Other’s desire is taken by Jill as a demand, this act removes it as a source of anxiety or angst for her while creating something to fear. What she announces as her desire is to make everyone happy, to be guaranteed in fulfilling their desire that she be who they take her to be from the way she appears to them. Since she cannot even satisfy some of the people some of the time, her pleasing is doomed to fail, and this leads her to suffer. The hysteric does not suffer well in silence; there should be someone there to receive her lament that none are equal to the task of recognizing her in the fullness of her being. While Jill finds relief from her suffering in carving a signifier to represent her castration on her flesh, there is no confirming gaze to certify this. Her friends find out, and they tell her parents, who bring her to treatment for the first time. This treatment does not provide her the words to signify with, but only pills to take, pills inadequate to the task of plugging up the paternal lacks. She resumes the cutting and burning, but seductively plays with the veil of a towel in front of her family, marking a limit with the edge of the towel that she wishes someone would look beyond to recognize the failure of the Symbolic to bequeath her the proper signifier of her sex. The cutting and burning would then be an attempt to open a hole or void in the Imaginary so that what the Other signified by marking her with the signifier of this sex might emerge. It would be a mark of her failure to submit to the Symbolic, of her failure to have separated from her mother.

The second treatment provides her with counterparts to identify with and words to speak. The questions left unanswered, though, are "Are these the right signifiers?" and " Have these been acknowledged as having been spoken by the right interlocutor?" If the answer to both of these questions is yes, then we could accept Jill's statement that her need for this behavior has dissolved, making of Jill an hysteric. But, from what I can tell, the more important issue has not been addressed — that is, how Jill's behavior recreates the scenario of her mother Nancy's suffering, producing jouissance for her mother. The mother of the pervert to be and that child who will have a perverse structure are in a complicitous relationship. While holding the father with regard in the public eye, the mother communicates her disparagement of the father as not being a fit representative of the Symbolic law to her child. It is telling the child that the mother stands outside of the law in that she does not have to fully obey the Oedipal injunction against re-incorporating her product, such that neither has to submit to castration and loss. In pleasing Nancy's unspoken demand by becoming that over which Nancy will ruminate and worry, Jill makes herself be that instrument that will produce Nancy's jouissance. Jill, through the signifiers of the cuts and burns on her flesh, is demonstrating the impotence of the Symbolic to sever her from her entrapment in the dyadic relationship with her mother. In this way, as long as Nancy does not take Jill’s word that she has quit cutting herself, as long as Nancy continues to awaken in the night and secretively check Jill’s body while she sleeps, as long as Jim remains unable to prevent or stop Nancy’s nightly checking of Jill’s body, as long as Jim is unable to set a limit on the jouissance that Nancy’s derives from her use of Jill, and as long as Jill continues to be afraid of and avoid the other sex, then Nancy and Jill continue to orbit around Nancy’s refusal of the Symbolic as being able to provide her the means to speak her encounter with the Real, leaving Jill to mark this on her flesh. Unfortunately, this issue will only be resolved the day that Jill responds to having perceived that her mother is no longer obsessively worrying about her. Once the hysteric who acts out in this way receives the look of recognition and the signifiers with which to speak her experience so as to have her message returned to her, her behavior is no longer needed to speak for her, to be her cry to the Other. In that the pervert already has certainty about what the Other wants of her, the behavior is necessary in that, in the circuit of the drive, the goal is always missed while her aim remains true.

The Final Cut
The taken for granted position is that self-mutilation is a new form of adolescent self-loathing. Can we accept this? Before I offer an answer, there are several other considerations and questions that must be looked at, which will lead to some ideas of why these behaviors are becoming more prevalent and more violent. This will involve a brief etymological excursus following the lines left behind in the wake of self-loathing. This excursus will lead us to the issue of Imaginary capture and how the subject is liberated from this capture, which will involve exploring what constitutes a "father" and how does the father function in the Real, the Symbolic and the Imaginary. Given this understanding of the function of the father in the institution of the subject, especially in the father's symbolic mandate, I will conclude by looking at the impossible task of being the bearer of the law while in submission to that law in a culture without limits.

The American Heritage Unabridged Dictionary, like all other dictionaries, demonstrates the closed self-referentiality of the signifier. To loathe is to dislike greatly or to abhor. To abhor is to have a feeling of repugnance. To abhor, in its archaic usage, meant to be strongly opposed. Repugnance, in addition to its usual usage as to have extreme dislike or aversion, also has a use in formal logic. In logic, repugnance means the relationship of contradictory terms or inconsistency. In the logic of the barred subject, where might we find repugnance? Turning to Lacan's graph of desire,[26] specifically in the lower region where Lacan has placed the Schema L the calculus of repugnance emerges. Here, the barred subject has as its reference point the ego ideal, written by Lacan as I(O), on the other side of the graph. For the barred subject, its line of sight is deformed through its passage through the ego ideal and the ego. And it is the ego, or the intermediary formed between the image in the mirror and the validation or confirmation by the Other which acts as the taken for granted vehicle of the barred subject, that is trapped in the logic of repugnance. The hatred and denigration of the individual in the self-mutilator's acts of self-loathing point to the ego's untenable position between the contradictory and inconsistent demands of the ego ideal and the ideal ego. The ideal ego, written by Lacan as i(o), is the mirror or specular image, the image of who one must become to be lovable, the image of narcissistic perfection that would keep one always in the beatific gaze of maternal satisfaction and delight. The ego ideal is the calibration point or standard formed by those identifications given by the paternal register, or how the child measures himself on the standard formed by the dialectics of his Oedipal history. It is the injunction to hate oneself for never being able to fulfill the demand to become who one must be in order to be lovable. Self-loathing, as an application of this logical operation, points to the inability of the Imaginary to hold contradiction or inconsistency within its mirror illusion of wholeness and perfection. The subject is caught in the trap, lost in the Imaginary. For the pre-Oedipal child, the way out of its capture in the Imaginary dyad formed by its mother and itself is provided by the agency of the father. When the father functions adequately, the castration that results in submission to the Symbolic gives the subject a way to institute a bridge between the laws of its particular and specific family and those of its general culture. This is a bridge built on the empty grave of the dead father, erected with his bones. When the father is inadequate to the tasks of the Real, the Symbolic, and the Imaginary, then a "pathos-logical" structure is instituted, which Lacan has labelled as either phobic, neurotic (which could be either hysteric or obsessional), perverse, or psychotic. The type of psychic structure instituted is determined by the how and why of the father's necessary inadequacy as specified within the dialectics of parental desire.

What is a father? What does it mean to say that the father functions adequately in the Real, the Symbolic, and the Imaginary? A father is a cultural convention, something that is both produced and artificial. The function of the father is to be that third term that intervenes between and on behalf of the mother and child. The Real father is the one who is always in the way between the mother and child, who puts limits on the child's being with the mother. The Real father is the one who is always already there in the same place, in the bed beside the mother, being the one who "works on" the mother in ways that the child cannot comprehend. This is the obscene father of Freud’s “primal horde,” the one who has access to all jouissance.[27] The Real father operates with the lack in the Symbolic, or castration, to produce, as an object, the Imaginary phallus, or that which the child takes the mother to be lacking and which the child might become so as to be that which satisfies the mother's desire such that the child will never have to separate from the mother. The Symbolic father, or what Lacan refers to as the Name-of-the-Father, is the dead father who exists in name only. It is a place-keeper within the psychic economy of the mother that denotes the mother as a subject who lacks. The Symbolic father operates with the lack in the Imaginary, or frustration, to produce in the Real the objet a. Through his effect, the Symbolic father erects the structure of the subject as one which can bear the lack through the introduction to the law of desire, with the result that there is now the permanence of the subject as lacking and the institution of the object as transitory, replaceable, and exchangeable. The Imaginary father is the rival with which the child identifies by love and hate. He is the "scissors father" who has something "more" than the child, who has the penis the mother lacks. The Imaginary father operates with the "lack" in the Real, or privation, to produce, as an object, the Symbolic phallus, or that there is no signifier with which to speak of sexual difference. These three fathers come together at the time of Oedipus to stamp the subject with an imprimatur of legitimacy, creating the fantasm as the subject's way to recoup a measure of the jouissance lost in becoming a speaking being by having an impossible relation with the objet a.

For Lacan, the important father is the Symbolic father, or the Name-of-the-Father, in its action of the Symbolic on the Real. If the structure of the symbolic conventions displaces the subject from its being and sends it sliding down the endless rails of metonymy, then the function of the father is to create at least one knot of metaphor that quilts together a signifier and a signified, producing an allusive meaning.[28] In the operation of the paternal metaphor at the time of Oedipus, the Name-of-the-Father, as a pure signifier, is quilted together with the unknowable and unspeakable, and hence Real, desire of the mother, forming the point de capiton which stops the sliding of the signified under the signifier. This has the effect of erecting the Symbolic phallus, written by Lacan as the capital phi or“F,” as the signifier of desire. The Name-of-the-Father functions as a performative that, by opening the way into the Symbolic, makes promises to the child. First, by installing the mark of sexual difference, the Name-of-the-Father promises that the signifier it installs does in truth say something about the sex of the subject. The difficulty here is that the subject is faced with the incommensurability between its biological sex, the sex of the image of the other with whom the subject has identified in the institution of its ego in the Imaginary, its gender and sex role identifications as well as the prescriptions handed down by culture, its object of sexual gratification or the type of body and the locale on that body that is of interest to the subject (which is another way of saying where the subject believes his objet a will or may be found in the field of the other), its mode of sexual satisfaction or what brings it to orgasm, and this Symbolic mark of difference, which, of itself, has only to do with the subject’s relation to the signifier and whether the subject is “all” or “not-all” in the Symbolic. Second, the Name-of-the-Father bequeaths a place in a lineage, in the succession of generations, in the order of time. It establishes a boundary between the generations and between those who are kin, or of my family, and those who are not so that the subject might have an indication regarding to whom he might direct his desire, from whom he might expect a response, and with whom he could seek out the measure of jouissance left to him by the law, all going forward within the field delimited by the Symbolic law. But because paternity can only be confirmed by the mother, no one knows with certainty if he who is so named is our true father. And, since we can only witness our sibling’s birth, we also have to take as true her word that she is our mother. In this sense, we are all adopted as was Oedipus: we are never certain of whose desire it is that our existence is proof of, and we can never know for certain if the measure of jouissance we take is illicit, if our plea for “some more” will be heard, and how it will be responded to by the Other. Third, the Name-of-the-Father, by instituting a subject who lacks, who can bear their lack, who desires, conveys to the child that there is one who might satisfy or fill some of this lack, for whom he is of value or worth in the economy of desire of this other, yet to be encountered individual. While one can never get it all, one can exchange with others so that some of what one desires could be satisfied, so that some portion of that promised jouissance might return. However, the Name-of-the-Father is unable to tell you what you might be worth in this exchange, what your value might be in the interpersonal marketplace, what you might have to sacrifice in order to make this exchange, or what treatment you might have to accept. The Name-of-the-Father functions like the Sentinel who stands guard at the Gates of Hell. Having forsaken life for death and been made blind, the Sentinel stands watch to keep the Gates closed, to hold the horror from roaming free.[29]

Unfortunately, while most existing fathers are adequate to the task of making or speaking these promises, they are impossible promises to keep and, as such, undermine the efficacy of any particular or specific father. There is always a remainder, some piece of the Real that is, by necessity, excluded so that the entire Symbolic system can function. This is the objet a, the excluded Real internal to the barred subject, with which the barred subject has an impossible relationship, written by Lacan as the fantasm.[30] It is the barred subject’s way to whatever measure of jouissance left to him, but, since it is founded on méconnassaince, it appears to the subject as what he does not want, as what causes him to suffer, as a symptom. According to Zizek,[31

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