cover image Cutting: Understanding and Overcoming Self-Mutilation

Cutting: Understanding and Overcoming Self-Mutilation

Steven Levenkron. W. W. Norton & Company, $25 (256pp) ISBN 978-0-393-02741-9

The psychotherapist whose books (including the novel The Best Little Girl in the World) have illuminated the nature and treatment of obsessive-compulsive disorder (OCD), anorexia nervosa and bulimia now shines the spotlight on another misunderstood behavioral disorder: self-mutilation. Levenkron begins by advising desensitization to the disturbing wounds, scars and blood-letting patients inflict upon themselves, redirecting focus toward the underlying issues. He likens cutting to OCD in that it is a compulsive act meant to relieve unbearable emotional pain, and to eating disorders in that it is a method of seizing control. Like anorexics, most cutters are girls, unable to express anger toward others, instead turning it against themselves. Levenkron is careful to explain that cutting is not the same as body piercing or tattooing, which reflect ""adolescent trendiness,"" and that cutters are not suicidal, their wounds life-threatening only rarely and accidentally. Cutting is done secretly, ""usually in a trancelike state,"" and ""the act of creating pain... or drawing blood, is in itself the goal."" Cutters then develop an ""addiction"" to this method of exchanging physical pain for emotional pain. With many examples from his practice, Levenkron provides clear and comprehensive information on the causes and effective treatments of this mysterious disorder, specific advice for therapists and an encouraging sense of hope for patients and their families. (May)