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

[[ASIN:0140280537 A Bright Red Scream: Self-Mutilation and the Language of Pain]] by Marilee Strong, just as the title indicates, is a book about the issue of self-mutilation.

Also called self-injury (or S.I.), self-mutilation is a condition in which it's sufferers deliberately cut, burn or otherwise hurt themselves in order to deal with the stresses, difficulties & traumas in their lives. It is an increasingly prevalent phenomenon that occurs primarily with teenage girls (though it does affect those of other age groups and/or genders). It is differentiated from suicide attempts in that self-injurers do NOT have any overt intent to kill themselves (though admittedly, for many self-mutilators [including myself!] any accidental death resulting from self-injury would've been or would be just an "added bonus") and instead just hurt themselves as a coping mechanism. Unlike those who are able to express their feelings and emotions (especially "extreme emotions") through words or tears, for those of us who are self-injurers, hurting ourselves is our only outlet to deal with pain & trauma and still be able to go on living. As ironic as it sounds, self-injury provides relief by distracting us from the emotional pain (which we are unable to control) and replacing it with physical pain (that we CAN control) and giving us the strength to be able to cope with it all.

As a recovering "cutter", I've read not only Steven Levenkron's [[ASIN:B008KU939Q Cutting: Understanding and Overcoming Self-Mutilation]] and his novel, [[ASIN:0140266259 The Luckiest Girl in the World]] but also Karen Conterio & Wendy Lader's book [[ASIN:0786864648 Bodily Harm]] as well as Dr. Armando Favazza's book [[ASIN:0801853001 Bodies under Siege]] and several novels about self-mutilation.

However, when I was first self-injuring -- primarily during my teens (in high school during the early to mid 90's) and for several years thereafter, there was little to NO information or awareness about the issue of self-injury. As far as I can remember, not only were there no books about this issue, but there was NO information of ANY KIND (magazine articles, medical journals, research papers, nothing!) available ANYWHERE! Not to mention that, in those days, though the Internet WAS in existence, it was not yet in as widespread use as it is these days (only a small number of people were even connected to the World Wide Web and even then, it was with an extremely slow dial-up Internet connection using the phone line!) So "Googling" self-injury or self-mutilation was not an option either. It was not until 1996 when the issue of self-injury, first got media attention with articles in [[ASIN:B000LXS9PE Seventeen]] magazine and "Sassy" magazine. Until then, the only mention of self injurious behavior were either in context to those with autism who engaged in repetitive head-banging & other similar behavior, OR those who committed major self-mutilation (like amputating limbs, gouging out eyes, or slicing off genitals) and/or practiced self-flagellation as religious rituals or for other purposes. But there was little to nothing about general "cutters" and other self-mutilation.

Back then, there was literally NO information about self-injury available anywhere! No books, no magazine articles, no made-for-TV movies, NOTHING!!

Therefore, there was a LOT of stigma, discrimination and myths about self-mutilation -- so much so that any time the teachers, or the school administration (principal, vice-principal, guidance counselors, etc.) discovered any cuts or other injuries, I was kicked out of school for days/weeks/months at a time. With ZERO thought or concern for how missing so much school would affect my education & academic progress, as well as the long-term impact it would have on my future, literally every single time they'd see any new cuts or scars, they'd suspend me, or even kick me out. As a result, I missed most of high school, and then, despite not having sufficient academic credits to graduate, I was forcibly graduated against my will, just because my ignorant jerk principal didn't want to deal with a "cutter" (though given how prevalent self-injury is, especially among teen girls, I'd be willing to bet there were other many other secret "cutters" in his school) which in turn, had a major negative effect, putting me in an existence of never-ending limbo, and basically ruined my life (or at the very least, destroyed any possibility to be able to achieve the goals necessary to have an even halfway decent future)

So, personally, I'm glad for books (as well as movies & other media like magazines, Internet websites, etc.) such as [[ASIN:B0084QTIXW A Bright Red Scream]] that helps bring these important issues out of the closet. That way, hopefully, if those directly involved with teens & those who call themselves "experts" (like psychiatrists & psychologists) but who actually do more harm than good, educate themselves about issues like self-injury, by reading books like [[ASIN:B0084QTIXW A Bright Red Scream]] they will know WHAT TO DO & especially, WHAT NOT TO DO when dealing with self-injurers!

Thus, once educated, they'll be able to hopefully show more (or UNLIKE my ignorant & insensitive high school principal and teachers, even, ANY!) compassion & understanding so that those suffering from these problems, will be more inclined to get help without shame or fear of "getting in trouble" -- whether it's getting kicked out of school (like I was) and/or locked up for days, weeks, months or even longer in a mental hospital. Thus, they will NEITHER have to "suffer in silence" NOR suffer like I did/I have.

Which is why I wish that THIS book was around when I was in high school (not that there's any guarantee that it would have prevented what happened, but who knows??). There is an especially relevant passage (or at least relevant to my situation back then) in the section "Patient, Do No Harm" (on pages 171 and 172 in my copy of the book). In that passage it says:

"A point of controversy in the treatment of self injury is whether patients should be required to give up cutting while they are in therapy. The SAFE program requires it for admission although patients are given a second chance or two if they can prove their dedication to recovery and many therapists will refuse to see patients if they continue to cut. Other experts believe that asking a patient to give up such a crucial coping mechanism too soon could be dangerous, even deadly.
'With cutters I don't want to take away something that they feel to be necessary until they're ready to let go of it,' says Scott Lines. 'Who am I to presume that they can manage without this behavior? If you view cutting as an attempt at a self-cure, then take away that mechanism, they might become psychotic or suicidal.'
Still other therapists believe that to demand that a patient stop cutting may not be very dangerous but futile, setting up the kind of power struggle that ensues when a doctor or therapist tries to force an anorexic to eat.
'It may result in more cutting as the patient says 'I'M the one in control and I'm going to make you feel as helpless as I feel,' says New York therapist Steven Levenkron, one of the nations leading experts on anorexia. Levenkron, who has also written a book on the treatment of self-injury says he does NOT ask his patients to stop cutting until they no longer need it. In the meantime, however, he offers them substitute outlets such as writing in a journal or calling him if they feel like cutting. And he helps his patients create a vocabulary of emotions -- 'because once you say it,' explains Levenkron, 'you can handle it.'
When the Masters and Johnson clinics began treating trauma related dissociative disorders 15 years ago, they made a conscious decision to treat cutters humanistically, not like dangerous mental incompetents. 'We would not jump on them and put them in restraints' says Schwartz. 'We would not put them in all closed, locked unit. We would not medicate them. We wouldn't even tell them they had to stop. Instead we would sew them up or give them a Band-Aid and say in a very compassionate way, 'We're sorry you are doing this and soon we'll give you the tools to stop.' Then very systematically we'd give them skills to get in control of it."

That passage was especially relevant (and really resonated) to me, because when I was in high school I was essentially forced to sign a similar "No-Harm Contract" by the school administration. It prohibited me from any self-injury on penalty of being removed from (kicked out of) school until I "got help", had stopped self-injuring & had "a doctor's certification that I was no longer a threat to myself" (or anyone else)

But just like the therapists & other experts warn about in the aforementioned/above passage, being forced into giving up self-injury before I was ready (and with no other outlets) totally backfired. As all the pressure (and need to cut) built up, I soon became so depressed, and at times, even suicidal, that, one Sunday night, like a rubber band stretched too far, I just snapped. I literally went on self-injury "binge" -- cutting myself all over my body, slashing myself and even carving words & symbols into my hands, arms, legs/calves, thighs, stomach, bikini area, everywhere. Of course, with that many cuts, even with wearing long sleeves and long pants, there was no possible way to hide all of the wounds -- especially not from a faculty & school staff who were already warned to be on the lookout for any new cuts or other injuries.

Sure enough, the very next day at school, I got busted by the administration (though I still have no idea [and of course, will probably never know!] who or what "ratted me out", essentially getting the ball rolling on the downward spiral of the rest of my "life"!) and I got kicked out of school, missing six months out of my senior year and basically, only coming back just to graduate with a meaningless diploma that I never really earned in the first place. A diploma which, given the total lack of education & knowledge behind it, did NOTHING but trap me in a perpetual Catch-22 limbo -- unable to go back (as merely having a HS diploma prevents qualification for enrollment in adult high school or GED courses -- so ironically, I probably would've been better off if I'd just dropped out of school altogether when I first got kicked out in the spring of my freshman year) but yet also unable to go forward & "move on" (due to being so academically behind [from having missed large chunks of high school] and unable to pass even remedial courses in community college without cheating, eventually dropping out altogether)

So I can't help wondering if, had this book been published just a few years (or better yet, 5 or even 6 years) earlier, and the school administration had been more educated about the issue of self-injury, adopting/maintaining an attitude or stance like those of Scott Lines & Steven Levenkron (the experts & therapists interviewed for this book) featured in the above passage, instead of arbitrarily kicking me out of school for being a "cutter", if it might have prevented and/or changed the outcome.

Of course, it's all just speculation. Because, unfortunately, this book came out a few years after I'd already "graduated" high school -- too late to be of any help to me, other than as retrospective insight, and in some ways, taunts of all that will never be now.............

[[ASIN:0140280537 A Bright Red Scream]] is an extremely well written and researched book that illuminates exactly how & why self-injury occurs.

Self-mutilation isn't something people just choose to do without any valid/genuine reason. It is NOT done for attention, it is NOT done because its a fad or the "in thing" to do, and its not even done because of being "goth", or "emo" or whatever else. It's an expression of extreme pain with a deep-seated basis in one's childhood and/or history. Self injury are also NOT suicide attempts (as many suspect) and Marilee Strong makes a passionate case as to why those who cut, burn or otherwise injure themselves, are just trying to cope & stay alive. For self-mutilators, basically, it is just an extreme way of trying to save one's own life.

Ms. Strong does not criticize or condemn self-injurers or label us as insane, disgusting or crazy, and she doesn't act like we "need to just get over it" or "just stop it already"! She seems to understand why, for self-injurers, when even our loved ones (who don't & can't understand) beg us to "Please Stop That!" it still isn't so easy to give up. She doesn't even demand that self-injurers stop hurting themselves, understanding that cutting or burning is sometimes the ONLY thing that saves our lives & keeps us from committing suicide, while at the same time offering treatment options with concrete ways of stopping the pain altogether

I LOVE this book and I only wish it had been around when I was growing up! It probably would've saved me from so much needless misery!!!!