Fighting with Oneself to Maintain the Interaction Order: A Sociological Approach to Self-Injury Daily Process

Fighting with Oneself to Maintainthe Interaction Order: A SociologicalApproach to Self-Injury Daily Process

Baptiste BrossardCentre Maurice Halbwachs (Paris)/University of Montréal

This article proposes an interactionist approach to self-injury behav-ior in youth. Mostly based on in-depth interviews with seventy peoplewho self-harm or who have self-harmed at some point in their lives,it describes the process of daily self-injuring. It shows that this practiceconsists less in the self-harm in itself than in a liminal emotional state,composed of several successive steps, and that self-injury makes sensebecause concerned individuals subjectively see it as the most practicalof known activities for releasing emotional troubles, then maintainingthe interaction order surrounding them.Keywords: self-injury, self-harm, youth, deviance, emotion work

Social scientists usually study violence through the sociological and historical back-ground of involved parties, in order to explain tensions, differences, and claimsbetween these parties. But what if the protagonists and the sites of violence arethe same person? This is the issue which I will address in this article, focusing onself-injury behavior. I define1 self-injury as intentional and repeated self-aggressiveactivity, subjectively performed to relieve “emotional malaise,” without the intentionof committing suicide (suicidal attempts), getting sexual pleasure (sadomasochism),or pursuing some esthetic goals (body art). It typically consists in self-cutting,self-burning, or self-hitting. I will name individuals who self-injure “self-injurers,”because this is both the common term used to designate them and a neutral expres-sion to describe those involved in this activity; in the same way we call someone whoplays football a footballer. Research indicates most self-injurers are adolescent andfemale.2 They often harm themselves when alone or at least hidden from the eyesof others. They do not secure social recognition, in the sense that even when thisbehavior could be widespread among some groups (like psychiatric patients), none

Direct all correspondence to Baptiste Brossard, Centre Maurice Halbwachs (Ecole NormaleSupérieure—EHESS—CNRS/Paris, France), Ecole Normale Supérieure, 48 bvd Jourdan, 75014 Paris,France; e-mail: [email protected] address: Département de sociologie, Université de Montréal Local C-5111, Pavillon LionelGroulx, 3150, rue Jean Brillant, Montréal, QC, H3T 1N8

Symbolic Interaction, (2014), p. n/a, ISSN: 0195-6086 print/1533-8665 online.© 2014 Society for the Study of Symbolic Interaction. All rights reserved.DOI: 10.1002/SYMB.118

2 Symbolic Interaction 2014

promotes it as a normal or positive behavior—at most it is perceived as a “commondeviance.”

How can we understand this kind of solitary behavior? Very seldom do soci-ologists study self-injury: this is apparently a psychological matter. Indeed, mostresearch has been done by psychologists and medical researchers, who interpretit, for instance, as a “coping” technique (Hasking et al. 2010; Walsh 2008), as theconsequence of a neurochemical dysfunction (Bloom and Holly 2011; Stanley et al.2010) or through epidemiological data (Whitlock et al. 2011). Some works never-theless analyze this practice from the sociology of deviance (Adler and Adler 2011,2007, 2005; Hodgson 2004). These works stress, among other things, the sociabilityof self-injurers on the Internet or the declared motivations of individuals to pursuethis deviant career. Here, I propose another (complementary) approach. Startingfrom a Goffmanian perspective, my aim is to describe how self-injurious behavior“fits” into the fabric of everyday life.

To proceed, I have compiled the narratives in which my interviewees related theireveryday life (see Methodology section), in order to describe a daily self-injuringprocess, which I will present in this article. The term “daily self-injuring” does notmean that self-injury occurs every day. The term emphasizes the fact that my anal-ysis focuses more on the daily routine than on the general sense of this behavior.Describing self-injury as a process shows that an interaction pattern surrounds thisbehavior and that it works as way of managing one’s emotions during ordinary inter-actions. To use Hochschild’s concept (1979), this constitutes a kind of emotionalwork—concurring with Chandler (2012) who speaks of an “embodied emotionalwork,” or with Adler and Adler (2011:67–73) who present self-injury as a way ofreleasing “overwhelming emotions.” How does this emotional work occur? Answer-ing this question will result in both a better understanding of self-injury and a fur-thering of theoretical remarks.

Indeed, a striking issue appeared during this research. Although the interactionistperspective has flourished in the last decades, there are almost no sociological studiesthat take into consideration a certain aspect of interaction, despite it being central toBlumer’s writings (1969) and fundamental to Cooley’s ([1922] 1964): the “inner con-versation” with which people anticipate and think about what they do. I endorse theview of Wiley (2006) on this point; for him this issue addressed by the fathers of sym-bolic interactionism has shifted to the sole study of social significations. By contrast,my work leads me to integrate this crucial intertwining between “real interactions”and “imagined interactions” because, as we will see, this dramatically determines thedaily dynamic of self-injury.

METHODOLOGY

From 2006 to 2011, I met with seventy people who self-harm or have self-harmedat some point in their lives. They were mostly women (only nine men), aged fromfifteen to thirty years. I conducted several in-depth interviews with them, as and

A Sociological Approach to Self-Injury Process 3

when possible. Informal interactions often followed. Depending on relations—Ichose to adapt to situations rather than over-standardizing my method—interviewswere sometimes completed by additional data: messages over the Internet or blogs,published or informal autobiographical texts, e-mail exchanges, and medical records.These meetings occurred in two ways.

I contacted the first forty-five interviewees on francophone Internet forums.3

These spaces offer an advantage by enabling me to meet noninstitutionalized people(Adler and Adler 2011). I first sent an e-mail to forums’ administrators, askingthem for an interview. Next, I met other forum participants by publishing a publicmessage, introducing myself and my work, benefiting from the trust gained with theadministrator who supported my request online. A small part of my interviews tookplace through instant messaging (about methodological issues of this specific surveyconfiguration, see Béliard and Brossard 2012). Like any ethnograph, I simply usedthe language and communication methods of the group I was studying. Wheneverpossible, I also met persons “face-to-face.” Using these two means of communi-cation allowed me to assess some narrative differences: to summarize, corporealfeeling seemed easier to describe in instant messaging, whereas people were moretalkative about their social trajectories when face-to-face. Most (but not all) of thoseI saw through this method were young adults, aged from eighteen to twenty-threeyears, with a strong educational background, probably because their closeness to theacademic world made them more at ease with the idea of speaking to a researcher.

I met the remaining twenty-five interviewees in two French psychiatric hospi-tals for adolescents. Presenting myself as a sociologist—and therefore independentfrom the care team—I asked patients if they would agree to be interviewed. Thiswas always with the agreement of professionals, who only refused to allow me totalk to patients whose mental states were considered “too weak” (often those whowere diagnosed as “psychotics”). Patients were very enthusiastic, because they felt sobored in hospital that they would have accepted any activity to do something. Theirsocial milieu was more diverse than that of those participating in forums and patientswere younger too (aged between fifteen and eighteen years).

In each instance I told interviewees that my research was concerned with“self-injury in general” and asked them to tell me their stories. I tried to be asinformal as possible to foster discussions on this intimate practice. To dispel theirfear of being seen as “crazy,” I did not hesitate to highlight that some things theyrelated had happened to me or to some of my acquaintances: as much as possible,my goal was to make these unusual conversations on an unusual behavior looklike ordinary discussions about ordinary life. The fact I am a man who influenceddiscussions, especially with women who had been sexually abused. Logically, theywere more suspicious about me. I think that being known to forum members (on theInternet) and to the care team (in hospitals) helped create a climate of trust.

Initially, the interviews concerned everything directly or indirectly linked tothe self-injury practice. Depending on how interviewees’ discourses on self-injurydeveloped, I encouraged them to speak about their broader social trajectories,


including relationships with parents, friends, teachers, and health professionals,use of the Internet, school life, cultural activities, social aspirations, and economicconditions. Each interview lasted between forty-five minutes and three hours.Some themes were harder to tackle (sexual assaults) than others (family life, whichalmost everyone identified as the “cause” of their problems). Interviewees took myrequest as an opportunity to take stock with an interlocutor other than a friend or apsychotherapist.

All interviewees had repeatedly self-injured for at least a couple of months: partic-ipating in Internet forums requires to think oneself as “sufficiently” involved in thispractice to join such communities, and the declaration of “having self-injured” in hos-pitals also requires a certain experience of self-injury. Here stands the common pointof my “sample,” given that some psychiatric patients had already frequented someonline spaces (or even learned there that these spaces exist) and that some forummembers had already been hospitalized (or even had hospital suggested by otherforum members). The greatest methodological differentiation relies on socializationinto these spaces: in psychiatry and on the Internet people indeed socialize by talk-ing about their self-injury, which implies a background analysis of how each spaceshapes the way in which self-injuries and life courses are recounted. Also, severalinterviewees had “quit” self-injury at the time of our meeting. But quantifying themwould raise difficulties: first, because some stopped harming themselves to “shift” toanother practice, like anorexia; second, because those who claim they have stoppedoften continue to self-injure during particularly difficult times, even once a year.

A MULTIPLE-STEP PROCESS

The first thing to understand is that self-injury does not encompass only theself-harming activity itself. In a sense, this is less a practice than a multiple-stepprocess that could result in the self-harming activity—yet if all these steps occur, theresult is a self-wound. In this paper, I will thus talk of a process to denote the wholesuccession of activities leading to one self-injury, while trajectory refers to the partof life where people self-injure within a longer time-scale. The distinction betweenprocess and trajectory is essential because while I am outlining each step of theprocess here, these steps change over time: I will present the “beginner” self-injurer’sprocess and then be more specific about what evolves during the trajectories of more“experienced” self-injurers.

TRIGGERING EVENTS

The process usually starts with an interaction that disturbs the person in question.This situation is not especially unusual, but it creates a feeling of misunderstanding,uncertainty, or injustice. “Something goes wrong,” as Emerson and Messinger (1977)state when they define a “trouble.” You do not know how to interpret something afriend may have said, an argument breaks out between your parents, someone in the


street stares at you in a disturbing way. When I ask Benoı̂t, a sixteen-year-old highschool pupil, to give me an example of what kind of situation makes him self-injure,he relates the following anecdote:

That day I had gone to class… I went back home, I went down to the kitchen toset the table, wash the dishes… They [his parents and two brothers] come, they“put their feet under the table,”4 I don’t talk during the meal… during familymeals I never speak. My father tells stories, you’ve heard them forty times before,always the same, so it annoys me. And then comes the moment of the cake, I clearthe table to set the plates for the cake, I take out the cake… "Go do the dishes!"They eat the whole cake, I do the dishes. I come back to the table; no-one’s left…I eat my cake in a hurry. What a nice birthday! The gifts this year were the worst.I got a pen and a toolbox to repair bikes and to repair stuff in my room. On mybrother’s birthday the month before, he got an X-BOX [a game console], so… ifyou like… it made me a little upset.So… afterwards, you went up to your room?Yes, I was angry and then I locked myself away… [Silence]

Much like the way in which Goffman (1967) describes “embarrassment,” one ofthe participants of the interaction does not know how to behave anymore, and triesto hide signs of misunderstanding because these signs could be socially stigmatizing.I chose this notion in order to conceptualize the trigger event because it includesevery identified triggering possibility: in any circumstance, from the death of a rela-tive to a minor quarrel with a friend, through obsessive thoughts about self-injury indaily life, the common point remains the perceived impossibility of behaving as usual.Embarrassment is not an emotion, but a kind of situation that may include emotions:not knowing how to behave while feeling rage, sadness, anxiety, or any “emotionaldeviance.”

One characteristic of the embarrassing situation is that it does not lead to any reac-tion. On the contrary, trigger events are embarrassing situations with no physical orverbal reaction from the embarrassed person. Such an observation can be explainedby the inability of finding any "solution" to resolve the problem or by the fear ofhow persons who have started this embarrassment might react. For example, Benoı̂tsays that he prefers not to disclose his discomfort. He fears facing hurtful remarksor indifference from his family. In the case of Clémence, a twenty-year-old sociologystudent, the fact her father is suffering from a serious illness makes her feel it wouldbe inappropriate to “provoke” an argument when her mother makes her angry.

THE AUTONOMIZATION OF THOUGHTS

The day continues. But the triggering event has initiated a trouble. The individual’smind focuses, wanders, extrapolates, rehashes. Some works show that self-injury hasto do with a loss of control (Chandler 2012). While this is true, the works do notidentify how this loss of control occurs. If I refer to what Charles Cooley ([1922]1964) calls “inner conversations,” the inner conversation here “runs on a loop,” and


thoughts seem to gradually autonomize from the situation in which they originate.The autonomization of thoughts can therefore be defined as a kind of inner conver-sation that follows an embarrassing interaction, but the topic of which is no longerthe embarrassing interaction.

Benoı̂t describes this passage. His father speaks “badly to me, for example, beforehe leaves, and [when I am alone] I think about what [my parents] said to me theday before, and about my school work and about everything… ” Elianor is fifteenyears old. She self-injures each time she makes a “mistake,” even a little one, likeusing her phone when her parents have forbidden her to do. And when her parentsdiscover the “mistake” she says she feels guilty, that she hates herself, that she is“a shit,” and so forth… until the wound. Cecilia seems to experience this step in amuch more physical fashion: when this seventeen-year-old high school student facesan interaction that reminds her of the death of her aunt, “it’s always the same context[… ], I don’t feel things anymore; I need to snap out of it.” She relates either “anxietyattacks” or “moments of emptiness, but total emptiness.” After a few minutes, shesays, she “cannot think anymore.”

The autonomization of thoughts sometimes updates subjectively negative aspectsof the individual’s social trajectory, especially events that are considered socially as“traumatic.” Thoughts emerging can then be associated with other significant ideas.To give a quick example, Eva, a twenty-two-year-old paramedic, says that during suchmoments, she could physically feel the presence of her sexual aggressor, whereas thetriggering event might just have been that she broke a plate or that her mother did notlike her clothes. Anne, a twenty-one–year-old unemployed woman, explains that shefeels a renewed sense of abandonment, going back to how she felt when her fatherdecided to sever ties with her.

Starting with a trouble arising from a particular interaction—the trigger—theindividual begins to feel anxiety in itself, disconnected from this trigger. This diffusefeeling can shift to what we commonly call an “anxiety attack.” Some physical signsreinforce this (tremors, nausea, and unusual bodily sensations). This emotional con-figuration seems to be a typically Western occurrence, if we concur with the anthro-pologist Lutz (1985) who writes that the perception of a “pure” malaise, with nospecial reason or identified source, has only been found in Western societies. Also,like a disturbing feeling, the autonomization of thoughts resembles an emotionaldeviance (Thoits 1985): when someone feels that what they feel is not “normal.” Itcan therefore denote one way of being subjected to social control at an emotionallevel.

At this point, people experience loneliness, whether in the literal sense or throughdisengaging from interactions: they are no longer able to undertake their daily activ-ities. Facing any interaction becomes difficult. Insofar as loneliness interrupts thepossibility of a direct control from other persons, we must wonder under what formsocial norms then remain effective. Goffman’s view (1967) on interactions as a kindof unceasing struggle where individuals try to save “face” is extremely relevant, butthis approach neglects the fact the struggle might be as crucial as when individuals


are or feel alone, because they must save face with themselves, without anyfeedback or judgment from another. Endorsing Cooley, according to whom indi-viduals are continually in the presence of others through “inner conversations,” Iassume that saving face, in addition to being a property of interactions, is an ongoingprocess affecting the “stream of thoughts.” Coping with loneliness requires socialresources, just as interaction does: any individual, “freed” from others’ glances,is however controlled by their own thoughts, their own regard, with the wholeconsciousness and imagination they are able to mobilize alone (Cooley [1922] 1964).

This issue often goes unnoticed, is taken for granted and is invisible. But inmy research, I met people who described some emotional deviances: in their nar-ratives, this process thus becomes explicit. “Anxiety”—a word so often used bymy interviewees—partly denotes the emotional state resulting from a difficultyin saving face with oneself. Benoı̂t cannot face his father’s remarks or anythingassociated with them, Elianor hates herself after her “mistakes,” Cécilia loses thefeeling of being in her body. This statement would explain why so many people startself-injuring during social phases when their “relationship to loneliness” changes,when it increases (staying at home during the holidays or on a teachers’ strike—mostinterviewees live in France) - or decreases (school trips).5 This relationship perhapsfosters a passage between daily events (potential triggers) and the autonomizationof thoughts.

THE SEARCH FOR EQUIVALENCES

Under such circumstances, it is impossible to stay focused, and by extension toperform one’s social role: high school students cannot keep up with their lessonsand workers are unable to do their jobs well. Individuals then seek some kind ofan escape. We must now place self-injury into an entire range of possibilities withwhich one can effect a change in one’s emotional state. I mean the set of knownpractices that could potentially stop the autonomization of thoughts through an“emotion work” (Hochschild 1979). I call these practices equivalences,6 because theyare interchangeable. Nevertheless, these practices offer varying “efficiency.” Julie,a sixteen-year-old high school student, answered my question about other practices:

Eating. A lot! Chocolate, cakes… but it doesn’t work as well… and I don’t wannabe fat. And sometimes, I scream, I listen to music really, really loud! I like it butyou know… it’s not the same…

Anne tells:

Generally, when I cry, I don’t self-harm. But there have been occasions when I’vecried and self-harmed at the same time. Those were times when feelings were sostrong I didn’t manage to relieve them any other way…

To them, self-injuring and crying or eating produce a similar effect—but withdifferent levels of efficiency. When they feel anxious, they consider what practice


would be possible and efficient. Crying or eating subjectively seems less “serious”than harming oneself. But when it does not “work” enough to relieve anxiety,or when they feel a too severe anxiety, they self-injure because they “know” or“believe”—depending on the point of view—that the latter is the most efficientoption available.

Each interviewee has many mini techniques to make himself/herself feel betterand come to self-injury because it is the most efficient one. These equivalences couldinclude talking to a friend, crying, playing sports, writing, eating, overeating, takingalcohol or drugs, listening to music, watching movies, playing video games, havingsexual intercourse or taking anxiolytics. Talking with friends being a very usual equiv-alence, Internet networks (and especially instant messaging) play an important rolein self-injury processes, insofar as friends/contacts are often online. Incidentally, thisobservation offers another view of Internet addiction among youths, which shouldnot systematically be seen as a problematic use of Internet, but also as one of thesimplest ways of finding people to speak with at any time of the day, when there isno possibility of meeting with them physically. This was especially the case amonginterviewees living in rural areas.

The set of available equivalences depends both on individuals’ primary and sec-ondary socializations. Through primary socialization, they experience an affectiveconditioning that provides them with some emotional resources. I refer to anthropo-logical and historical studies that show cultural variations in the managing of emo-tions from a very early age (like affection and handling babies; Stork 1986), and tosociological and psychological models that show social class, familial and individualvariations in this domain Brossard (2014a). For instance, Gayet (2004:28) stresseshow we are shaped, from our early childhood, to find emotional expressions thatappear adequate in the case of “difficult” situations, including crying (given that cry-ing is a common equivalence). Add to that socialization eating habits (overeatingbeing equivalence), speech and maintaining friendship networks (a useful skill torelieve the autonomization of thoughts) and writing (writing instead of self-injuring).Equivalences thus mobilize a set of socially situated skills.

Through secondary socialization, individuals acquire further emotional resourcesin addition, of course, to learning about self-injury from others or from the media(Adler and Adler 2011; Hodgson 2004). Some psychologists have fully understoodthis, trying to encourage their patients to replace self-injury with other activities whenthey feel bad. Walsh (2008) thus writes about “replacement skills.” Pommereau, Brunand Moutte (2009:103), for their part, advocate a therapeutic method based on draw-ing activities and coined the phrase: “a line rather than a wound.” In another vein,Internet forums also contain a lot of equivalences. For example, this message board,extracted from an Internet forum, deals with physical exercise:

I had only one idea in mind, banging my head against a wall, but I controlled it,I controlled myself, I have a certain control now… So I decided to put into prac-tice what I have often heard for a while, I mean doing intense physical exercise,because it secretes the same stuff in the brain (I’ve forgotten the exact word) as


self-injury does, or about the same. I used to do a lot of sport before, martial arts,soccer, and sometimes I used to play hockey in the street, etc. Now, I have nei-ther the will nor financial means anymore. Anyway, all of that is to say that thatnight, I spent an hour in intensive karate practice, I was hot, this did me so muchgood, yet it took me another good hour after to sleep, even if I was completelyexhausted. I wouldn’t say it gives as much satisfaction as self-injury, but it mademe feel good…

Why do people self-injure when they are aware of more socially acceptable meansof getting better? I will give three combined reasons for “choosing” self-injury indaily life—in addition to “deeper” reasons linked to the social trajectories of inter-viewees.

Firstly, insofar as the autonomization of thoughts affects the mental and physicalstate, individuals cannot manage some activities anymore. They are too disturbed tocall a friend, to write or to put any other equivalence into practice. Self-injury distin-guishes itself from any other possibility because of its practical easiness: it can be donein any physical and emotional condition. Louise, a twenty-three-year-old literaturestudent who has made a habit of speaking with friends in order to stop self-harming,had a “relapse” on the day when she felt too “locked up” to talk. Discussing yoursituation with someone requires a certain mastery of your emotional state:

I can’t really say what triggers it [self-injury], outbursts of rage actually, when I feelirritable, even when someone talks to me… So, there, this is what happened thissummer, the simple fact that someone had talked to me, I actually experienced itlike an aggression, and I really needed to calm that rage down, to let it out in oneway or another…Usually, do you have other means to… ?Usually I try to talk but that day I couldn’t, I was locked up and it really was aprison inside of me…

Secondly, equivalences often require some material features that do not fit everysituation. If you are a high school student, you cannot easily leave the classroom togo and cry. And even if you can excuse yourself to the restroom, when you come backeveryone can see your face and guess that you have been crying. However, you caneasily self-injure discreetly, while continuing to listen to the teacher. Here self-injurydistinguishes itself from any other possibility because of its material easiness. Anyonecan self-harm in any place with any objet, unlike many usual equivalences: it is hardto cry in public, to practice sport any time, to talk to some friends in the middle ofthe night, to eat when there is no food nearby. And self-injuring is fast. As Clémencesaid to me once on instant messaging, suggesting that she just cut herself: “I neededto calm down, I’ve got too much work today, I don’t have time to relax.”

Thirdly, in comparison to other equivalences, self-injury is the most “effective”behavior. Interviewees however say that whatever the situation is, they know thatself-injury “works”; moreover, that it “works the best.”

To conclude this point, sometimes equivalences are sufficient, and the processswings back to zero. This may explain why some people “quit” self-injury: they find


a sufficiently effective equivalence. Also, as interviewees consider self-harming tobe a morally reprehensible act (even as they describe a desire to do it), resorting toequivalences appears to them to be the best option. They sometimes describe a sortof “moral reluctance” that (seldom) makes them avoid self-harming. A commitmentcan, in the end, prevent someone from self-injury, accentuating this moral reluctance:a job where a scar would be visible or a promise made to a relative or a close friend.Otherwise, self-injury subjectively becomes the only way, or rather the most practicalway, to stop the autonomization of thoughts.

PREPARATION

Equivalences have been disregarded. The decision is made: a wound will be the wayof restoring a subjectively “normal” emotional state. But self-harming requires a min-imum of preparation, depending on the situation. Indeed, if it is possible to self-injurein any material setting—you can hurt yourself with your own nails—some featurescan improve the efficiency of the practice: finding a sharp or a burning object, seek-ing a place to do it, or preparing disinfectant in advance. The interviewees say thatthey may also make time to imagine self-injury scenarios, defining the place of thebody or anticipating who would be able to see the scars in the future. Michel, athirty-three-year-old unemployed man, used to burn himself with a big fork heatedon a Bunsen burner. He could spend several days anticipating what part of his bodyhe would choose and what this moment would “look like,” even to the extent of aban-doning work he had to do. Surprisingly, the simple fact of imagining while preparingan injury can partially relieve interviewees’ anxiety, precisely because at that momentthey are doing and/or thinking about something else.

In its most developed form, the preparation might consist of designing a stage (ina theatrical sense) for oneself, when the situation allows. This staging embodies theinner speech developed during the autonomization phase, reflecting a certain estheti-cization of suffering, materializing symbols and gestures that draw their inspirationfrom broader social representations of self-injury, like some rock music bands. Hereis one of the very concrete moments of influence of the cultural context on self-injury.Elsa, a twenty-year-old journalism student, used to cut her wrist. She then put someblood on her face and watched herself cry in a mirror. While self-harming made herfeel better, looking at her blood mingling with her tears increased her relief. Thisstaging beforehand requires preparation: waiting to be at home when her motherhas gone out or to be in an enclosed area with a mirror.

Maybe the most interesting issue of this preparation step lies in the interviewees’own imagination. Anticipating interactions that could result from the visibility of thewound assumes great importance in the last resort. Eva gives an example:

[… ] because actually, when I got to emergency to be stitched up, it’s true that Ioften did that… but I noticed early on, it should happen when there’s a psychi-atric nurse there. Because they were five [psychiatric nurses] and I got along verywell with them, and it’s true I often ensured I cut myself when they were here, to


speak with them. I wouldn’t succeed in… for example when I felt bad, what theytold me is to go to see them before cutting myself, but I said to myself… as if itwouldn’t be legitimate, as if… hmm… if I didn’t cut myself they wouldn’t takecare of me…

The material preparation can give rise to a more or less virtual opportunity to“seek help.” This means interactions that could lead to empathy expressed by others,indeed even encouragements to stop self-harming. A few interviewees told me thatthey might go to a supermarket to buy new razor blades, hoping that cashiers wouldprevent them from self-injuring. Of course, this never happens; this is why I qualifythese pleas for help as virtual. Louise relates this sort of story:

I felt very bad; I was on medication that wasn’t suitable at all. I blamed my psychi-atrist for it, because it had been months since I told him that my treatment wasn’tsuitable anymore. He was on holiday; I had the impression that he had completelyscrapped me… [… ] I was really, completely in distress… and I needed to dosomething to calm it down. So I went to buy razor blades and [… ]… it reallywas a cry for help, all I wanted was for somebody to prevent me from buyingthem, and at the pharmacy, when I bought stuff to take care of me [disinfectant], Iwanted someone to ask me to stop… nobody did that. So I cut myself again [… ]

She stages “in her mind” some anticipated interactions that have a very slimchance of actually happening. She imagines dialogues with cashiers or pharmacyemployees—who would have discouraged her from hurting herself—without givingenough signs to generate these interactions “in reality.” Interviewees who have toldme the same kind of story give up before “help” could have been found. Such aprocess is along the lines of what I mentioned earlier: in the end, interviewees almostnever intentionally upset the social order, although they can imagine doing so. Andwhen the preparation is complete, when nobody, no thought or no equivalence hasstopped the process, everything is ready for self-injury.

EVOLUTIONS OF THE PROCESS ALONG TRAJECTORIES

The daily process of self-injury evolves during the trajectory. Over time, those whoregularly self-harm tend to shorten, even by-pass, each of these steps, which graduallybecome briefer. Figure 1 sums up this evolution, given that, depending on the inter-viewee, each of these changes could occur in variable ranges of time and in differingorder.

The more individuals understand the emotional "relief" provided by self-injury,the more it becomes a habit, the more the self-injuring process does not need a “seri-ous” trigger to be set in motion. Louise explains that after a few months of regularself-injury, which followed “crucial” events (arguments with parents, memories ofbeing sexually assaulted), the trigger “can be stupid stuff. For example, my neighborborrows my dryer without telling me, or I ask him something and he forgets to doit… anything.” Marjorie, a thirty-year-old educator, has noticed such an evolution


FIGURE 1. Evolution of the Process

since she began to self-injure as a teenager. Before, she used to cut herself in reactionto conflicts with her mother or to events that made her think of her father’s death.When we met, she recounted doing it each time she felt bad, for instance after herroommate forgot to put a box of cereal back in the kitchen cupboard.

The "gravity threshold" of triggers thus progressively decreases. While defining“gravity” remains difficult because it involves a subjective boundary between whatis “serious” or not, two points can however be emphasized. Firstly, there is an ongo-ing process of modifying the definition of situations to turn them into problematicones. In other words, an argument is a shared problem, defined as such by interlocu-tors, but defining the cereal box story as a problem requires a stronger interpretativework. Secondly, and perhaps therefore, the degree of exceptionality changes: wemove from relatively exceptional events to others that have a greater chance of occur-ring every day—and this is a factor in the greater frequency of self-injures over time.Some respondents, after months or years, deliberately provoke a trigger event. Forexample, Marie, a fifteen-year-old high school student, says that she had sex with menshe was not “really” attracted to in order to feel bad. By drinking alcohol, Margaux,an eighteen-year-old unemployed woman, triggers some anxiety attacks herself.

Self-inflicted injuries can be so integrated into the probable course of everyday lifethat there is no need for any trigger anymore. Also, it seems that the autonomizationof thoughts gradually shifts toward an obsessive thought of self-injury, and that the


autonomization itself almost disappears from the process. Fabien, a twenty-year-oldeducation student, tells me that while he started self-harming to manage some kindof delusion crisis, he now cuts himself when he is bored, for instance when he hasnothing to do during holidays. Fanny, a fifteen-year-old high school student, reportsthat she “has fun” falling down voluntarily during her sport classes - this calms herdown and relieves boredom during the lessons. Maya, a nineteen-year-old sociologystudent, relates that she had—on rare occasions—self-injured “for fun.”

The search for equivalences becomes shorter, because individuals “realize”that self-injury is the most efficient way of releasing emotional trouble. And later,this phase is not necessary anymore: the decision is taken in advance. Camille, atwenty-three-year-old linguistics student, thus summarizes her former habit: “For aperiod it was like—got a problem, grab the scissors!”

The preparation becomes shorter too. After a while, people know precisely themanner in which they want to self-injure. Some self-injurers deliberately changedtheir method in order to optimize the emotional work. Marie turned from burningto cutting. Elianor did the opposite. Maya stopped stealing her father’s razor bladesto buy her own ones. Over time, people create routines and can put their “tools” forself-harm in a glasses case, a pencil case or a glove compartment; Adler and Adler(2011:83) notice this too. Matthieu’s Bunsen burner stands under his bed. Elsa hidesher razor blades under her bedside lamp. Margaux wears a hair-slide because sheprefers burning herself with it. And most of the students interviewed keep a bladeinto their pencil case “just in case.”

AN EXAMPLE OF A SELF-INJURY PROCESS

Narratives published on the Internet offer an eloquent illustration of the concreteform of the process. Indeed, very shortly after an injury they retrace the daily eventssurrounding the wound. They appear to be more precise than interviews in this case.For instance, the following text shows the series of process steps. However, rememberthat these steps do not mechanically follow each other: this is why I have selected aself-injury process that does not end in a wound. The text was written by Mélusine,a sixteen-year-old web user:

Sorry for coming here… But I need to calm down… Things go wrong! Thingsgo wrong, things go wrong, things go wrong… I don’t know what to do… I can’tgo on like this… I can’t stop going round in circles, I feel like I’m going to crackup! [… ] I MUST NOT!!

The author is losing her emotional control. This sounds like an autonomization ofthoughts, which leads to a difficult search for equivalences. Mélusine “goes round incircles,” is afraid she will “crack up.” No equivalence seems to be considered at thetime, a situation that fosters the idea that only a self-injury would “free” her fromher anxiety. Moral reluctance is the last rampart: “I MUST NOT!” The web userthen looks back on the genesis of her emotional state.


Today was a really shitty day. Today I really had a shitty day [… ] Last night andthis morning, everything was ok… I partied with friends, and it’s true that I hadthe blues, a bit, but everything was still OK, I had taken over. I smiled and it wasn’thypocritical. I “slept” at a friend’s house, then I came back home. [… ] I sat downat my computer, I spoke, I searched for things… In short, it went well. A friendwhom I really care about phoned to see me. We had a date. This guy is lovely. Idon’t tell him about my life but he takes so much care of me…

She explains that initially, she was not facing any specific difficulty, except a slightfeeling of sadness. No potential trigger had happened. “It went well.” Moreover, hersmile is qualified as sincere (underlying that if she had been feeling bad, she wouldnonetheless smile… ).

So I smile again for the day, but to be on good form I sleep a little. I wake up atthe time of the date, but as I feared, I’m feeling a bit down. He calls me… I tellhim that I haven’t left home yet… He’s sore at me… It’s normal… I say to him“No, don’t worry, I’ll be there in twenty minutes” but no… My ex-boyfriend, whoI still love, gives me a call and I don’t know if it’s because I’m tired or somethingbut what he says has more impact than usual. I don’t feel at all well… I cry. Hecries. We cry. I don’t manage to stop crying. He keeps me on the phone becausehe knows that I’ll go to see another guy. [… ] He’s feeling very bad and me, tookind, too fucking stupid, I support him, I help him and it all gets even worse…After an hour I end up hanging up on him and I go out to join the one who’s beenwaiting for me for an hour and a half now…

At this stage, Mélusine’s romances put her in an embarrassing situation, in thesense that she does not know how to behave anymore. This inability reinforces whyshe cannot self-control. A potential trigger emerges. Potential, because we do notknow yet what will occur after that. The young web user could progressively feelbetter, but this is not the case:

And there… I break down… My tears begin to flow and don’t stop. They gnawat me so much because they are full of pain. I can’t stand it anymore. I think ofthe guy waiting for me, and I say to myself: “No, you can’t go like this, calm downfirst.” So I call a friend… She doesn’t answer the phone. I try again and again.In the end she picks up… She doesn’t manage to calm me down. I hang up. Igo around in circles, I pace. I can’t stand it anymore. I can’t handle it. Now it’sfive o’clock and this nice guy finally texts me, saying he doesn’t want to see meanymore, he doesn’t like to be taken for a fool, that I have to call him if I wantto stay friends, otherwise “it’s over.” I can’t blame him, he’s right… But… From5 to 7 pm, impossible to calm down… I cry. I have panic attacks in the street,alone in my little street… There are a few passersby and they look at me as if I’mmad… And me, I’m waiting till this finishes…

Mélusine really enters into what I have called the autonomization of thoughts. She“breaks down” and finds herself unable to fulfill her social roles: “You can’t go likethis,” she says to herself. Looking for some practices that could stop this emotionalstate, she experiences the inefficiency of crying and of speaking with her friend. Everyusual equivalence seems to be obsolete. After the text message from the “nice guy”with whom she had a date, her anxiety worsens:


After a while, I look down at the ground and I spot a piece of glass. Images flashbefore my eyes… I think of hurting myself. NO! I MUST NOT DO IT!! I beepmy ex, to avoid screwing up. While he’s the one who hurt me so much, he’s also theonly one who knows how to calm me down… how to prevent me from screwingup when I feel like that. I didn’t want to but, even worse, I didn’t want to hurtmyself for this. NO AND NO!! He succeeds. I calm down and go back home. Ismile at my parents… We go out to eat, near to a bar where I often go…

Facing her hesitation to self-injure, stirred up by the view of the piece of glass,Mélusine tries to find equivalence. At the same time, she keeps face, smiling to main-tain the order of familial interactions surrounding her.

Everything goes well, I nearly calm down until I see a guy with who I had a messybreak-up with. I act like I don’t see him but then, shit, I’m not running away frommy problems. But no, I can’t move. A crisis starts again… I tell my parents thatI’m cold… They believe me but they are chatting with some friends and so wecan’t leave. So, I go to see this friend and we begin to talk when a mutual friend,completely drunk, begins to pour out everything and anything, very loudly. [… ]I’m feeling worse and worse. The same images flash in my head again. No! NO!!NO!!

While the process that might lead to a self-wound seems to stop, a new event dis-turbs the fragile equilibrium that Mélusine has just found. She faces a new potentialtrigger—seeing this embarrassing ex-boyfriend again—and the autonomization ofthoughts: “a crisis starts again,” “I can’t move.” But the material impossibility ofsearching for equivalences (given that she is in a restaurant with her parents) andthe accumulation of embarrassing events lead her straight to the perceived need toself-cut: “The same images flash in my head again.” A sort of emotion/interactionloop occurs: some interactions generate embarrassment, which generates embarrass-ing interactions and so forth. This illustrates how we can go beyond the oppositionbetween thinking that people who are more “emotionally fragile” self-injure and thatself-injuring makes them more emotionally fragile.

And then we go back home, I’ve told my mother that no, nothing’s upset me…[… ] I don’t wanna see them [these friends] for a while… I don’t wanna see any-one. I wanna hurt myself… But I must not. I keep myself busy. I keep myselfbusy. And I keep myself busy. It will pass. I know I won’t crack up. But I’m afraid[… ] but it calms me down a little, to write all this and it makes me cry. Howeverstupid it may seem, the need passes. Now I regret having thought about it.

Back at home, Mélusine can search for equivalences again. She tries diverse activ-ities, in vain. Then, while crying, she writes this message that we have just read, thistime “successfully”—as her desire to self-hurt fades away… until the next “crisis.”

CONCLUSION

This article has shown that self-injury consists less in the self-harm in itself thanin a liminal emotional state, composed of several successive steps that could be


interrupted at any moment, especially when an efficient equivalence is found.In other words, it is more of a disposition to act than a type of act in itself. Undersuch circumstances, every interaction becomes a potential trigger and the autono-mization of thoughts threatens almost every moment of daily life. Self-injury makessense then because concerned individuals subjectively see it as the most practical ofknown activities to release emotional troubles.

In this sense, what psychologists call an “addiction” and a “coping method” (bothare used to analyze self-injury) finds a sociological reformulation through what Bour-dieu (1980) has theorized as the practical sense: stated bluntly, individuals, dependingon their resources given by socialization, progressively adjust their behavior to theordinary situations that they face. This concept implies overcoming boundaries bothbetween what is conscious or not and between what is “rational” or “irrational”because, according to Bourdieu, it is impossible to measure individuals’ degree ofconsciousness using their daily activities. This allows for the capturing of a certainambivalence toward self-injury, which constitutes a subtle mix of intentionality (Ihave highlighted this dimension in this article) and impulsivity. Narratives show thatin any case, such a behavior reveals interaction dynamics: each step indeed involvesa fluctuating set of social constraints and interactants, actual as well as anticipated.Moving away from an intraindividual perspective thus remains the notable contribu-tion of a sociological perspective in comparison with a psychological one.

Finally, this behavior contains a kind of sociological paradox: a socially stigma-tized (“deviant”) manner of maintaining oneself in an emotional state that is per-ceived as “normal” or as falling within what is considered “standard.” Adler andAdler write that it “incorporates both prosocial (hyperconformist) and antisocial(nonconformist) elements” (2011:216). In effect, and beyond its apparent subversivedimension, self-harm works in quite a conservative fashion. With this self-controltechnique, embarrassing people and oppressive relationships that could trigger somediscomfort are never called into question. Embarrassed and/or offended individualskeep control over themselves. And the initial interaction order remains intact. Inthis perspective, we can then contextualize self-injury into what Elias (2000) callsthe “civilizing process.” The latter implies the passage, in Western societies, from aform of social control exercised on individuals by others individuals, to a form ofcontrol exercised by individuals over themselves. Elias suggests an overall inhibitionof violence, of aggressiveness, of desires, and a broader bodily management. Individ-ual impulses, instead of disturbing the social order, tend, instead, to reinforce it. Inregard to what has been described above, self-injury behavior perfectly fits with thismodel, like a paroxysm of the civilizing process.

NOTES

1. This definition is not “objectivist” but comes from gathering all the common points thatI have heard from concerned people with whom I have spoken during my research (see“Methodology”).


2. There is currently a debate on self-injurers’ demographical composition, since some works foundan equal proportion of men and women. Such statistical variations probably depend on themethod used to quantify self-injury—for instance, some research includes suicidal attempts insamples. I however continue to present self-injury as a predominantly feminine practice becausemost of the people I have met are women and because a review of literature showed that mostresearch still finds the same prevalence (Brossard 2014b).

3. Their aim is to provide psychological and social support to participants; I did not see “proself-injury” forums, which do exist however on the Anglophone web.

4. Pejorative French expression used when some people do nothing while another does everything.5. To give an historical frame, historians Ariès and Duby (1985) found that the rise in the need for

loneliness (such as being alone at home) begin in Western countries around the eleventh century.6. This term has the advantage of not implying that self-injury stands in a specific place, a pitfall

that would have occurred with the term “substitute”.

REFERENCES

Adler, Patricia A. and Peter Adler. 2005. “Self-Injurers as Loners: The Social Organization ofSolitary Deviance.” Deviant Behavior 26:345–78.. 2007. The Demedicalization of Self-Injury. Journal of Contemporary Ethnography 36(5):537 –70.. 2011. The Tender Cut: Inside the Hidden World of Self-Injury. New York: NYU Press.

Ariès, Philippe and Georges Duby. 1985. Histoire de la Vie Privée. Paris: Seuil.Béliard, Anne-Sophie and Baptiste Brossard. 2012. “Internet et la Méthode Ethnographique:

L’utilisation des Messageries Instantanées Dans le Cadre d’une Enquête de Terrain.”Genèses 88:114–31.

Bloom, Christopher M. and Shareen Holly. 2011. “Toward New Avenues in the Treatment ofNonsuicidal Self-Injury.” Journal of Pharmacy Practice 24(5):472–77.

Blumer, Herbert. 1969. Symbolic Interactionism: Perspective and Method. Englewood Cliffs, NJ:Prentice Hall.

Brossard, Baptiste. 2014. “La Socialisation Primaire aux Emotions.” Pp. 31–42 in Les Emotions: UneApproche de la Vie Sociale, edited by Samuel Lézé, Fabrice Fernandez, and Hélène Marche.Paris: Editions des Archives Contemporaines.. 2014. Se Blesser Soi-Même: Une Jeunesse Autocontrôlée. Paris: Alma Editions.

Bourdieu, Pierre. 1980. Le Sens Pratique. Paris: Minuit.. 1990. The Logic of Practice. Stanford, CA: Stanford University Press.

Chandler, Amy. 2012. “Self-injury as Embodied Emotion Work: Managing Rationality, Emotionsand Bodies.” Sociology 46(3):442–57.

Cooley, Charles H. 1964 [1922]. Human Nature and the Social Order. New York: Schocken Books.Elias, Norbert. 2000. The Civilizing Process. Oxford: Blackwell.Emerson, Robert M. and Sheldon L. Messinger. 1977. “The Micro-Politics of Trouble.” Social

Problems 25(2):121–34.Gayet, Daniel. 2004. Les Pratiques Educatives des Familles. Paris: Presses Universitaires de France.Goffman, Erving. 1967. Interaction Ritual: Essays on Face-to-Face Behavior. Chicago, IL: Aldine

Publishing.Hasking, Penelope A., Sarah J. Coric, Sarah Swannell, Graham Martin, Holly K. Thompson, and

Aaron Frost. 2010. “Brief Report: Emotion Regulation and Coping as Moderators in theRelationship between Personality and Self-Injury.” Journal of Adolescence 33(5):767–73.

Hochschild, Arlie R. 1979. “Emotion Work, Feeling Rules, and Social Structure.” American Journalof Sociology 85(3):551–75.

Hodgson, Sarah. 2004. “Cutting through the Silence: A Sociological Construction of Self-Injury”.Sociological Inquiry 74(2):162–79.


Lutz, Catherine. 1985. “Depression and the Translation of Emotional Worlds.” Pp. 63–100 inCulture and Depression, edited by A. Kleinman and B. Good. Berkeley: University ofCalifornia Press.

Pommereau, Xavier, Michaël Brun, and Jean-Philippe Moutte. 2009. L’adolescence Scarifiée. Paris:L’Harmattan.

Stanley, Barbara, Leo Sher, Scott Wilson, Rolf Ekman, Yung-yu Huang, and J. John Mann. 2010.“Non-Suicidal Self-Injurious Behavior, Endogenous Opioids and Monoamine Neurotrans-mitters.” Journal of Affective Disorders 124(1–2):134–40.

Stork, Hélène. 1986. Enfances Indiennes: Etude de Psychologie Transculturelle et Comparee du JeuneEnfant. Paris: Le Centurion.

Thoits, Peggy A. 1985. “Self-Labeling Processes in Mental Illness: The Role of EmotionalDeviance.” American Journal of Sociology 91(2):221–49.

Walsh, Barent W. 2008. Treating Self-Injury: A Practical Guide. New York: Guilford Press.Whitlock, Janis, Jennifer Muehlenkamp, Amanda Purington, John Eckenrode, Paul Barreira, Gina

Baral Abrams, Tim Marchell, Victoria Kress, Kristine Girard, Calvin Chin, and Kerry Knox.2011. “Nonsuicidal Self-Injury in a College Population: General Trends and Sex Differences.”Journal of American College Health 59(8):691–98.

Wiley, Norbert. 2006. “Pragmatism and the Dialogical Self.” International Journal for DialogicalScience 1(1):5–21.

ABOUT THE CONTRIBUTOR(S)

Baptiste Brossard is currently Postdoctoral Researcher in sociology at the Université of Montréaland Associated Researcher at the Centre Maurice Halbwachs (EHESS, ENS, CNRS) in Paris. He isco-founder and member of the editorial board of the scientific journal RESET. Research in SocialScience on & about the Internet. His PhD dissertation aims to propose a sociological approach toself-injury behavior, recently resulting in a book published in French (Se blesser soi-même, AlmaEditions, 2014). He now works on the diagnosis and care of Alzheimer’s disease patients.

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Fighting with Oneself to Maintain the Interaction Order: A Sociological Approach to Self-Injury Daily Process