Why Do We Hurt Ourselves?: Understanding Self-Harm in Social Life

by Baptiste Brossard

Why does an estimated 5% of the general population intentionally and repeatedly hurt themselves? What are the reasons certain people resort to self-injury as a way to manage their daily lives? In Why Do We Hurt Ourselves , sociologist Baptiste Brossard draws on a five-year survey of self-injurers and suggests that the answers can be traced to social, more than personal, causes. Self-injury is not a matter of disturbed individuals resorting to hurting themselves in the face of individual weaknesses and difficulties. Rather, self-injury is the reaction of individuals to the tensions that compose, day after day, the tumultuousness of their social life and position. Self-harm is a practice that people use to self-control and maintain order―to calm down, or to avoid "going haywire" or "breaking everything." More broadly, through this research Brossard works to develop a perspective on the contemporary social world at large, exploring quests for self-control in modern Western societies.

Genres: Nonfiction

210 pages, Paperback

Published June 14, 2018

Reviews

[Jessica · Rating 3 out of 5]

This book is...... i n t e r e s t i n g. So much of the language felt very strange to me--I'm not sure if the original book was written in French and translated, but at the very least, it seems the interviews were translated from French, and, so, in some way felt.... weirdly similar in their language choices? Do teens in France really use "in fact" and "it is true that..." so regularly in conversation?? I don't know know! But also! The author's language itself felt strange to me, and perhaps it is a combination of a very small and subtle (and, in that way, more dissonant?) language barrier, but also, as one review I read elsewhere talked about, the author's reliance on very traditional and older sources of sociological and anthropological thought? In theory this shouldn't be THAT strange, but it did feel somewhat strange to me in combination with everything else. Or, perhaps I am simply just not used to such a distant, anthropological rendering of self harm? I t h i n k I like anthropology and often find it very useful, but so much of this felt like it came off as almost.... ridding the entire study of so much context? and maybe that is part of the point? but it also feels like that approach, like, carried whole chunks of the book in very strange directions that felt like they missed the point of so many things. And I do think it is good how he zoomed out and analyzed new things I don't necessarily think about, but it did it in a very, very strange way. I also feel like it lacked a certain kind of compassion, and perhaps that doesn't "belong" in such accountings, but having just read Theresa Mcshane's paper on interviewing people who self harm (https://www.researchgate.net/publicat...), I was very struck by their differences in methods. Not only in terms of interviewing (and, even, her personal reflections on how the interviews affected her), but also in terms of selection process--Brossard's sample felt so strange in addition to all the other strangenesses-- picking exclusively such young people, especially ones clustered in groups (an inpatient ward, a very wealthy outpatient program, and, especially, recruiting through internet forums for people who self harm, and then recruiting from t h o s e people's friends, too, is so strange, because they will all be so influenced by the forum's culture, which, from experience, is just...... a v. strange place tbh)? vs. Mcshane recruiting a more diverse (though small) sample. I do think we should study self-harm forums and internet cultures, but perhaps not as representative of the whole? Though I know he explicitly states that no sample is really capable of this.

I also felt kind of weird about the subtle ways of conceptualizing gender and gender issues in this book--not just about the one section on gender deviance, but about how the author's strange conceptions of gender ran throughout the book and affected how he presented the people he interviewed, including how it presented women's understanding of sexual relationships and sexual assault. Perhaps this has to do with language, but also.... I don't know. As I said, there was so many citings of the traditional male canon in sociology and anthropology, and then, like, once every 30 pages he might cite like one female scholar (besides Amy Chandler, a more recent sociologist working specifically on self harm). Rarely did I notice the citing of more contemporary feminist scholars, but to be fair, there was such a tilt away from contemporary theory in general, so who knows.

REGARDLESS! There truly were some valuable things in this book? As strange as some interviews were, and as much as I admittedly cringed reading the words of a bunch of teenagers (perhaps because I find my own behavior and words around self harm at this time so "self involved"? it's likely), they were actually very interesting to read and think about. Though I do wonder about what Brossard decided was not relevant enough for his thesis, what was left out, despite him proclaiming how good his methodology was to include large chunks of text. I know part of the point was to distance the analysis from past and current ideas about self harm in psychology, which I truly support, it often felt like the lack of depth in understanding the significance of certain things (emotions? behaviors? language use? idk), made his analyses just seem kind of clueless at times or at least very reductive or almost intentionally oblivious? At the same time, I wonder if I am not just so indoctrinated into psych that this is simply the result: seeing willful oblivion in the face of apparent significance? Who is to say.

I DID appreciate a zoomed out analysis on socioeconomic class, though. Do I think it is necessarily the end all be all of self harm? No. But do I think it is def related to family issue, yes. I really appreciated the level of detail about literally every interviewers family: the occupations and educational history of mothers, fathers, grandparents, brothers and sisters! It was quite interesting to analyze issues of family pressure to "do well," based on family background, going two generations back at points.

Regarding his general thesis, that self harm is a means of maintaining order, I think I do agree, to some extent. Here are some block quotes, from the very beginning, as the set up for thinking about self harm:

"In 1998, during an interview given to Le Monde Diplomatique, Pierre Bourdieu expressed some astonishment: “I have never ceased to be sur­prised by what might be called the paradox of doxa: the fact that the world order as it is, with its one­way streets and no­ entry signs, both literally and figuratively, its obligations and its sanctions, is roughly respected; that there are no more transgressions and subversions, no more offences and follies.” He opens a parenthesis: “One only has to look at the extraordinary agreement of the thousands of dispositions—or wills—required for five minutes of car traffic on the Place de la Bastille or that of the Concorde in Paris.” There is a backstage to this convergence of practical senses. When caught in the motorized anarchy of large urban roundabouts, every driver knows that they must take on themselves. This expression speaks for itself. For all these vehicles to reach their destination, the drivers must undertake multiple small actions in order to manage the proliferation of constraints. One driver might listen to music, sometimes singing and bob­ bing along to it. Another bites his nails, grips the gearshift, or chews his lips. A woman clenches her fists on the steering wheel or taps nervously on the dashboard, smoking cigarette after cigarette. Others will only sense slight physical signs of concentration. We could extend this painting infi­nitely, but the crucial point is that these actions are undertaken by these drivers to manage themselves, rather than to manage each other."

and from the very end:

"In line with this process, self­ injuries are deferred modalities uti­lized to manage interaction (hurting oneself after the interaction rather than reacting in the moment) and violence (harming one’s body rather than being aggressive toward someone else). They perfectly correspond to the nature of contemporary social life depicted by Elias. That is, they are a bodily investment that represents subversion more than it presents a possibility of disturbing the order.

Dominique Memmi has used this expression, “bodily investment,” regarding demonstrators. In the West, it has been a long time since a demonstration seriously threatened to shake the foundations of power . . . However, protestors continue to represent themselves through a defined set of physical postures. They present themselves bodily, as a popular menace. But, they represent this menace more than they threaten to enact it . . . As they hurt themselves, rather than attacking what they iden­tify as the source of their malaise, self­ injurers fall within this process, and in fact, support it. If they stage a threat toward their family, their school, their social milieu, the people around them, it is only their physical integrity that is truly threatened."

and, finally:

"In a society where the bodily maintenance of healthy individuals is subjected to powerful injunctions to self­ manage, voluntarily injuring one’s body constitutes one of the most elaborate, and extreme forms of self­-control, since the injured person transgresses the norm in order to better respect it. This small group of adolescents and young adults who self ­injure to manage their anger, disappointment, and feeling of isola­tion in the social world, embody a radicalized ideal of our civilization.

Hence, against the flow of contemporary worries regarding the excesses of deviants, we have dealt with a minority of dispersed individ­uals who, under the register of suffering, transgress the order to reproduce it: a self­ controlled youth."

This rings true, to some extent, though I don't know if I agree with other analysis mixed in with this, that people don't know what is "the source of their malaise." I think a lot of the people even cited in this book described their family themselves as "the source of their malaise," though you could then zoom out and say that much of that pressure in and through the family results from extremely inequality and globalized capitalism, which is similar to what the author suggests. And yet, still, I think the feelings about the family are quite legitimate, and it is less a problem of "not knowing where to direct their anger," than quite literally actually being unable to have enough power to enact that anger, and so it becomes internalized on the self, and persists, even once out, I feel. Indeed, if the idea is that civilization is the forcing of people to give up intense reactions for order, it's almost a kind of domino effect of everyone's (the family's?) intense emotions being displaced on the one person who can't effectively "self manage" not only their emotions, but the weight of everyone else's. Whether it is a father that beats his partner and child yet still maintains an air of respectability, or a bunch of very self controlled perfectionists, all that stuff is getting displaced somewhere, I really do believe. And perhaps it is all connected, anyway--the one's who self harm often experience harm at the hands of family members who l a c k "self control" (or maybe these boundaries are more complex than this thesis allows), but who are yet still embedded in the network of "civilization" and "injunctions to self-manage," and, interestingly, the middle people, who neither harm others or harm themselves, but simply try to suppress everything deeper and somehow manage it, bury it, maintain order through what appears to be a self managing, but it actually an oppressing of others--it is those middle people that interest me, tbh--the "neutral figure" in Brossard's theory, which, to me, is not at all neutral. And this idea of city traffic, and everyone equally managing themselves--while it is a good image, can it truly be so equally divided? just everyone neutrally and equally "self-managing" instead of managing other people? I truly do not think so--he even names the other family figure, the one who oppresses, ie. manages other people rather than themselves.

How Brossard could come to such a mostly/ maybe accurate conclusion about people who self harm without addressing the actual power dynamics of who, in fact, is not only injuncted to self manage, but who is actually MADE to self manage, is fascinating, actually. It seems like a deeply political matter indeed, and the comparison to "The People" who are left with only symbolic resistance and no means for actual power is quite apt. I suppose, though, that even as it is, Brossard's thesis would seem strange to most people: how could such a disruptive and seemingly violent group of people be, in fact, highly controlled, the epitome of civilized self management? How to talk about the paradoxes of disorder that surround self harm--I suppose that's what does not seemingly "make sense," and thus must be reckoned with. OR, perhaps I am just misdirecting my "malaise" inappropriately! WHO KNOWS. Sometimes it feels like the only place this pointing can be directed is, precisely, alarmingly, violently, at myself. Such is, simply, life? I'd like to think not, I'd like to think, someday, not.

[Rachel · Rating 4 out of 5]

As is true of many books written from a large body of research, one can glean the most insightful bits from the introduction chapter and the conclusion chapter. Everything in between gave helpful context but are mainly case studies. Brossard gives a clinical yet compassionate look at the practice of self-harm and illuminates an area often fraught with mystery. He ultimately presents a number of theories that give helpful content for anyone seeking to better understand this practice.

[Abdul Hadi · Rating 3 out of 5]

LEBIH BAIK SAKIT GIGI DARIPADA SAKIT HATI

Bagi penggemar novel atau film konspirasi, tentu tidak asing dengan film The Da Vinci Code yang diadaptasi dari novel berjudul sama ditulis Dan Brown. Terdapat salah satu adegan menarik di film tersebut ketika Silas, salah satu anggota Opus Dei (sekte ortodoks Gereja Katolik) melakukan penebusan dosa.

Cara penebusan dosanya adalah dengan mencambuk punggungnya sendiri, serta memakai rantai tajam yang diikatkan ke betisnya. Penebusan dosa dengan melukai diri sendiri tersebut bukanlah adegan rekaan sutradara saja, melainkan memang ritual keagaamaan kuno yang dipraktikkan bertahun-tahun lampau.

Mungkin terbetik di benak pembaca, kenapa ada orang melukai diri sendiri? Namun, sebenarnya, secara tidak sadar, praktik melukai diri sendiri sudah jamak terjadi di kehidupan sehari-hari tanpa kita sadari. Beberapa perilaku tersebut tertanam dalam praktik keagamaan atau seni-estetika, dan karena sudah terlampau lazim, banyak orang tidak sadar bahwa mereka telah melukai dirinya sendiri.

Tentunya, untuk menyamakan persepsi, perlu ada definisi yang disepakati bersama mengenai perilaku melukai diri sendiri. Secara definitif, Baptiste Brossard menuliskan bahwa melukai diri sendiri adalah perilaku ketika seseorang dengan sengaja melukai dirinya sendiri atau menempatkan dirinya dalam situasi berisiko yang dapat membuatnya terluka, baik itu secara fisik ataupun mental.

Dalam praktik sehari-hari, orang yang menindik telinga, perut, lidah, atau pusarnya tergolong perilaku melukai diri sendiri. Demikian juga menato, sunat, hingga menusuk lubang terlinga untuk memasang anting.

Akan tetapi, bukan hal demikian yang dimaksudkan dalam buku Why Do We Hurt Ourselves ini. Yang dibahas Baptiste Brossard adalah gangguan mental melukai diri sendiri, bukan melukai diri sendiri yang diterima secara sosial seperti di atas.

Ada enam kriteria melukai diri sendiri (self injury) yang dianggap sebagai kelainan yaitu (1) dilakukan dengan sengaja, (2) ada indikasi tindakan melukai diri sendiri, (3) terjadi berulang kali, (4) tanpa niat atau maksud bunuh diri, (5) tanpa maksud estetik atau seksual, dan (6) bertentangan dengan aturan sosial (hlm. ix–x).

Tindakan sunat memang dilakukan dengan sengaja, namun ia merupakan praktik atas ajaran agama atau kesehatan dan diterima secara sosial, bukan dianggap sebagai kelainan. Demikian juga tindik dan tato, dimaksudkan atas niat estetika, sehingga tidak digolongkan sebagai gangguan mental.

Lalu kenapa ada orang yang mengidap kelainan melukai diri sendiri? Heather Barnett dalam buku Cutting and Self Harm (2008) menuliskan bahwa gangguan self injury merupakan salah satu kelainan yang paling membingungkan ahli kesehatan mental. Tidak ada sebab pasti kenapa gangguan ini bisa terjadi.

Kendati demikian, pada 2013, American Psychiatric Association (APA) menerbitkan buku manual DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) untuk deteksi gangguan mental dan tetap memasukkan NSSI atau Non Suicidal Self Injury sebagai kategori gangguan mental terbaru. Gangguan mental ini jelas diagnosisnya, namun kurang bisa dipahami sebab kenapa bisa dialami individu.

Alasan Perilaku Melukai Diri Sendiri

Meskipun masih belum dipahami secara pasti sebab-musababnya, perilaku melukai diri sendiri memiliki alasan pasti kenapa self injury dilakukan.

Salah satu motif utamanya adalah untuk melarikan diri dari kenyataan. Maksudnya, orang yang melukai diri sendiri merasakan tekanan mental yang demikian kuat, karena itu, tindakan melukai diri sendiri, seperti membenturkan kepala ke tembok, menyayat kulit, menggores badan dengan benda tajam hingga berdarah, tujuannya untuk mengalihkan sakit emosional yang dialaminya kepada rasa sakit fisik.

Pelakunya mungkin mengamini lirik lagu Meggy Z: “Lebih baik sakit gigi, daripada sakit hati”. Maka, mereka yang melukai dirinya sendiri, lebih baik didera sakit fisik, daripada merasakan tekanan emosional yang tak tertahankan. Karena itu, luka di lapisan kulit merupakan pengalihan daripada luka batin (hlm. 8).

Jika selama ini gangguan self injury dibahas oleh ahli kesehatan mental, psikiater, atau psikolog, kali ini Baptiste Brossard menawarkan analisis dari sudut pandang sosiologi.

Bagi Brossard, proses melukai diri sendiri adalah cara untuk menunda penyelesaian masalah. Kendati masalah utamanya belum selesai, pelaku berusaha mengatur masalah emosionalnya sendiri melalui self injury.

Jika masalah itu berkenaan dengan orang lain, maka daripada melepaskan agresivitas kepada orang lain, pelaku mengarahkannya kepada diri sendiri. Dalam hal tertentu, perilaku melukai diri sendiri memang terjadi atas dasar ekspresi kekecewaan kepada orang lain, yang dilampiaskan kepada diri sendiri.

Hal ini memang sejalan dengan bahasan sosiologi, namun, dengan membatasi aspek analisis hanya berdasarkan satu bidang keilmuan, apalagi menjauhi muasal perilaku deviatif, yang sebenarnya merupakan kajian utama psikologi atau psikiatri menjadikan buku ini kurang komprehensif menjelaskan gangguan self injury.

Kendati demikian, Baptiste Brossard menawarkan sudut pandang secara sosial, yang selama ini luput diulas oleh ahli kesehatan mental. Karena itulah buku ini berharga untuk dibaca.

Ulasan saya di link: https://ekspresionline.com/lebih-baik...