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First released in 2002. Routledge is an imprint of Taylor & Francis, an informa corporation.

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Additional resources for Bipolar Disorder: A Clinician's Guide to Treatment Management

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It is the same confusion of meanings as if we interpreted all cases of self-starvation (a similarly thin and observational category as ‘self-mutilation’) within the terms appropriate to anorexia nervosa (a specific, Western and deviant form of self-starvation), so forcing us, among other misunderstandings, to re-evaluate Gandhi’s political acts of food refusal as poorly understood symptoms of anorexia. Self-mutilation then may be both important and prevalent but there is little or no real reason to think that it is a near-universal mechanism and that self-harm is simply a culturally specific interpretation of it.

As such, while cutting your forearms counts as self-harm, drinking, comfort eating and smoking do not because they do not carry this meaning personally, culturally or socially. Perhaps this is why self-harm is so frequently represented as something irreducibly ‘other’ and uncanny, something almost uniquely disruptive to our ability to make sense. Its refusal to be contained by the objectivist paradigm carries a deconstructive capacity to disturb us and our typical assumptions (Derrida, 1976, 1991).

That said there is one other area that we might want to explore. The story leaves us at the end of the twentieth and beginning of the twenty-first centuries with a rough concept and a clear recognition of self-harm but if self-harm is a natural kind of a ‘thing’ then, now that we have noticed it, we ought to be able to define it precisely and in purely objectivist terms. Indeed, if it was something like a disease or a symptom of a disease then the objectivist paradigm suggests that defining it ought to be a relatively straightforward matter, something like ‘cutting nature at the joints’ and finding the right formula of words and ideas that can map its natural structure and so distinguish this universal and essential form, which would be true in all places and times, from the various surface details or incidental content (the icing on the cake) that may vary from one case to another, or one culture to another or one time to another (Littlewood, 2002; Timimi, 2002).

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