Community Mental Health Journal

, Volume 24, Issue 1, pp 22–30

The plight of chronic self-mutilators

  • Armando R. Favazza
  • Karen Conterio


Self-mutilation is a more common behavior than generally realized; its prevalence may be 750 per 100,000. From the responses of 250 subjects to a Self-Harm Behavior Survey we have learned that self-mutilation typically begins in early adolescence and may assume a chronic course characterized by severe psychosocial morbidity. Some chronic self-mutilators already are heavy and generally dissatisfied users of mental health services. The number of them seeking help may increase as a result of heightened public awareness. Community mental health facilities may be hard-pressed to meet the needs and demands of these clinically vexing patients.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Cautela, J.R. & Baron, M.G. (1973). Multifaceted behavior therapy of self-injurious behaviors.Journal of Behavior Therapy Exp Psychiatry, 4, 125–131.Google Scholar
  2. Cawte, J. (1974).Medicine is the law. Honolulu, University of Hawaii Press.Google Scholar
  3. Coid, J., Allolio, B. & Rees, C.H. (1983). Raised plasma metenkephalin in patients who deliberately mutilate themselves.Lancet, 545–546.Google Scholar
  4. Crabtree, L.H. (1967). A psychotherapeutic encounter with a self-mutilating patient.Psychiatry, 30, 91–100.Google Scholar
  5. Eliade, M. (1975).Rites and symbols of initiation. New York, Harper and RowGoogle Scholar
  6. Emerson, L.E. (1933). The case of Miss A: a preliminary report of psychoanalytic study and treatment of a case of mutilation.Psychoanalytic Rev, 1, 41–54.Google Scholar
  7. Favazza, A. (1987).Bodies under seige: Self-mutilation in culture and psychiatry. Baltimore: Johns Hopkins University Press.Google Scholar
  8. Herdt, G.H. (1982). Sambia nosebleeding rites.Ethos 10, 189–231.Google Scholar
  9. Jacobs, B.W. & Isaacs, S. (1986). Pre-pubertal anorexia nervosa.Journal of Child Psychiatry, 27, 237–250.Google Scholar
  10. Kafka, J.S. (1969). The body as a transitional object: A psychoanalytic study of a self-mutilating patient.British Journal of Medicine and Psychiatry, 42, 207–212.Google Scholar
  11. Kwawer, J.S. (1980). Some interpersonal aspects of self-mutilation in a borderline patient.Journal of American Academy of Psychoanalysis, 8, 203–216.Google Scholar
  12. Lincoln, B. (1975). The Indo-European myth of creation.History Religion, 15, 121–145.Google Scholar
  13. Menninger, K. (1938).Man against himself. NY: Harcourt Brace World.Google Scholar
  14. Mitchell, J.E., Boutacoff, C.I., Hatsukami, D., Pyle, R.L. & Ekert, E.D. (1986). Laxative abuse as a variant of bulimia.Journal of Nervous Mental Disease, 174, 174–176.Google Scholar
  15. Morinis, A. (1985). The ritual experience.Ethos, 13, 150–174.Google Scholar
  16. Novotny, P. (1972). Self-cutting.Bull Menninger Clinic, 36, 505–514.Google Scholar
  17. Pattison, E.M. & Kahan, J. (1983). The deliberate self-harm syndrome.American Journal of Psychiatry, 140, 867–872.Google Scholar
  18. Richardson, J.S. & Zaleski, W.A. (1986). Endogenous opiates and self-mutilation.American Journal of Psychiatry, 143, 938–939.Google Scholar
  19. Romanczyk, R.G. & Goren, E.R. (1975). Severe self-injurious behavior.Journal of Consulting Clinical Psychology, 43, 730–739.Google Scholar
  20. Rosen, D.H. (1972). Focal suicide.American Journal of Psychiatry, 128, 1009–1011.Google Scholar
  21. Ross, R.R. & McKay, H.B. (1979).Self-mutilation. Lexington, Mass: Lexington Books.Google Scholar
  22. Siomopolous, V. (1974). Repeated self-cutting; An impulse neurosis.American Journal of Psychotherapy, 28, 85–94.Google Scholar
  23. Toch, H. (1975).Men in crisis. Chicago: Aldine.Google Scholar
  24. Virkkunen, M. (1976). Self-mutilation in antisocial personality (disorder).Acta Psychiat Scandinavica, 54, 347–352.Google Scholar
  25. Whitehead, P.C., Johnson, F.G. & Ferrence, R. (1973). Measuring the incidence of self-injury.American Journal of Orthopsychiatry, 43, 142–148.Google Scholar

Copyright information

© Human Sciences Press 1988

Authors and Affiliations

  • Armando R. Favazza
    • 1
  • Karen Conterio
    • 1
  1. 1.Department of PsychiatryUniversity of Missouri-ColumbiaColumbia

Personalised recommendations