ANNOTATION

"...explores this hidden epidemic through case studies, startling new research, and the insights of self-mutilators themselves...an essential resource for victims, their families, teachers, doctors, and therapists."

FROM THE PUBLISHER

In A Bright Red Scream, Marilee Strong explodes the myths and stereotypes that have led many therapists to misdiagnose and mistreat cutters as failed suicides or masochists. Through interviews with dozens of psychiatrists, doctors, researchers, clinicians, and cutters, Strong explains how cutting can become a powerful coping mechanism for dealing with overwhelming emotional pain and gaining control over an out-of-control mind and body. She presents startling new biological research - including evidence of profound changes in brain chemistry and structure as a result of exposure to childhood trauma - that may explain why cutting is even more difficult to give up than alcohol or drug addictions or eating disorders. Finally, Strong includes information on what people with the affliction and those close to them can do to start the process of healing.

FROM THE CRITICS

Publishers Weekly

Strong's research into "cutters" combines journalistic passion with academic integrity. Through dozens of interviews conducted for a 1993 San Francisco Focus article, she explores the reasons that lead over two million Americans to injure themselves regularly and deliberately with such items as knives, razor blades and broken glass. Although most cutters are young women who have been emotionally, sexually, or physically abused as children, Strong's research shows that this specific type of self-harm also appears in other groups. Most interviewees here claim to use cutting to distance themselves from pain and rage, or to "feel something" after years of abuse have left them emotionally numb. The powerful first-person stories, in which the cutters describe their ritualistic methods and somewhat addictive cravings for seeing their own blood, highlight the problem and ultimately lead to understanding and sympathy for those who suffer from the disorder. (A foreword from University of Missouri-Columbia psychiatrist Armondo Favazza, author of Bodies Under Siege, discusses past difficulties in bringing the disorder to the public's attention.) In addition to presenting a psychological focus, Strong also investigates possible neurological and chemical changes that both abuse and cutting can cause. A brief foray into comparison with the American tattooing trend and scarification in other cultures proves to be the book's only weak point, drawing on hypotheses rather than concrete fact. The author recovers quickly, however, when she explores the comprehensive programs and treatments available to cutters. Riveting and dynamically written, this book is an important addition to psychological literature. Agent, Sandra Dijkstra. Author tour. (Oct.)

Booknews

Offers an empathetic discussion of this complex form of self-harm, as well as its foundations in prior trauma, its association with other forms of self-injury, and where hopeful solutions to self-injury may lie. Annotation c. by Book News, Inc., Portland, Or.

Kirkus Reviews

A compassionate and informed discussion of self-mutilation, the "addiction of the '90s," practiced by two million or more Americans. Self-mutilation has surfaced as a fad of pubescent girls, who use razor blades to carve their forearms with, for instance, names of their boyfriends. It's called "cutting" and is what Dr. Armando Favazza, in the preface, refers to as "superficial/moderate" self-mutilation. In other cultures or at other times, cutting, flagellation or similar forms of self- mortification have been regarded as physically healing, spiritually uplifting, or tribally bonding. Today Americans are horrified at the idea of painful blood-letting, associating it immediately with suicide. But the cutters described here are neither faddish or suicidal. They are using their razors, knives, broken glass, or cigarette lighters to live. Like anorexia and bulimia (also efforts to gain control), some forms of self-mutilation serve as controls for unbearable rage and emotional pain that would otherwise lead to a psychotic break. Many cutters have suffered sexual or physical abuse as children, and the trauma they carry with them as adults is similar to post-traumatic stress disorder, says Strong. Among the symptoms is dissociation, where mind and body separate, leaving "numbness and emptiness." For some, the only way to reunite the two is by hurting themselves, the pain returns them to awareness. It may also release "natural opiates," like endorphins, that minimize the emotional and physical pain; that may be one reaction that contributes to the addictive nature of the experience. Strong (a journalist who has written previously on child victims of war trauma) examines the theories ofphysiology, psychology, sociology, and neuroscience in relation to the need to self-mutilate; enriching her research are interviews with more than 50 cutters, some found on the Internet site where self- mutilators can talk to one another. The final two chapters discuss treatment alternatives. Humane, empathetic, and informed exploration of a frightening complex of behavior; it will be valuable to professionals, families, friends, and most of all to the cutters themselves. (Author tour)