Late in her panoramic study of self-harm, Sarah Chaney describes herself as ‘a historian’ for whom writing about self-harm ‘has been a solution … in the way medicine itself never was’ (p. 239). I mention this not so as to position this book amidst the many personal accounts of self-harm published over the last five decades, but to signal the striking phrasing and iconoclastic thinking evident in Psyche on the Skin. Chaney’s goal, in setting out the history of medical models of self-harm, is to challenge the assumption that has underpinned so many of these attempts: that ‘self-mutilation can be thought of as a constant, universal human behaviour with a particular set of meanings’ (p. 12). Chaney aims to explain the different searches for that ‘particular set of meanings’ not only with detailed reference to medical cultures, mainly in Britain and North America since the late nineteenth century, supplemented by reference to literature, religion and popular culture. After an introduction which sets out the terms of problem and approach, the opening chapter has the widest cultural and historical range. More roller coaster than flight path, this ‘Pre-history’ considers debates among classical and early Christian writers about castration, after whom we encounter castrati (most famously Farinelli), processions of Christian flagellants (thirteenth to fifteenth centuries), and advocates and practitioners of bloodletting. The six remaining chapters focus on ‘hot spots’ in conceptualisations of self-harm—terms such as ‘attention seeking’, ‘borderline’, ‘delicate cutting’ and ‘hysteria’, each of which has been dominant in the literature in the twentieth century. There is a lot of careful detail here, balanced against a set of ‘bigger pictures’—trends in medicine, politics and culture, with particular attention to gender differences. I enjoyed the eclecticism and fast pace; it is worth noting also the careful scholarship and respectful tone. There are three notable strengths of Psyche on the Skin. The first is the range of methodologies and combinations of same. For example, although the touch is light, it is clear that large bibliographical and full-text datasets have been used to show the emergence of particular ideas about self-harm. There has also been archival slog, and the chapter on ‘The Emergence of Self-mutilation in Late Nineteenth-century Psychiatry’ brings these two modes together. It is based in part on the comparison of reports of self-harm in major medical journals, with documentation of patients in Bethlem Royal Hospital (pp. 64–5) over the same period. Doing this comparison allows Chaney to identify differences between forms of self-harm occurring in the hospital, and those thought worthy of discussion in the medical literature, which in turn can be linked to preoccupations around sexuality, and sensation: ‘castration, amputation and enucleation’ are the topics of published research, but constitute only a small part of patient records (p. 65). The final chapter, ‘Trigger Happy: Culture, Contagion and Trauma in the Internet Age’, uses interviews and the author’s experiences on internet forums as key sources, as well as popular music magazines. Imagine doing that, whilst also tracking down ‘un-numbered (discarded) slips for “self”’ in the Oxford University Press archives to establish that ‘self-mutilation’ might have been included in the first edition of the OED, having been submitted as a word, but was not (p. 253, n. 20). The second strength is the organisation and readability of this book, although the often elegant phrasing can disguise the complexity of the issues being raised. Early on, for example, it is noted that the assumption ‘that today’s ideas are “true” in a way that yesterday’s were not … suggest[s] that modern science is omniscient’ (p. 12). This problem—of the reliance of the very idea of ‘science’ as a truth which stands outside or above culture—is returned to in the conclusion. The third distinguishing quality is that this book demonstrates the specific capacities of ‘the monograph’. That might seem like a strangely obvious comment to make, particularly in a review, but so often books can seem like a body (the introduction) onto which legs (chapters) have been grafted. Chaney shows how the genre can be used to show the size of and complexity of its subject, so that the chapters are more like organs, each with their own specific job, rather than more of the same, and without which the whole cannot function. Thus, a monograph can fundamentally change the way we see not just a problem, but the foundations of the field(s) out of which that problem arises—or has been made to arise. In this case, by assembling a set of competing definitions, Chaney shows that the field of self-harm is contested and therefore contestable, not least by those who (like the author) have experienced medical treatment that they found alienating, or cruel. © The Author 2017. Published by Oxford University Press on behalf of the Society for the Social History of Medicine.
Social History of Medicine – Oxford University Press
Published: Feb 1, 2018
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