Abstract

This paper addresses the overlapping ways in which self-inflicted injury was understood in relation to an absence of pain during the long nineteenth century, arguing that a clear distinction between bodily and mental suffering cannot be made in this period. The medical view that self-infliction of injury must necessarily be pathological is shown to have emerged from earlier philosophical approaches to pain. This was cemented by the formation of a somatic model of self-mutilation, based on the concept of cutaneous anaesthesia, particularly in the work of Wilhelm Griesinger in Germany. In contrast, the words of asylum patients provide a much broader spectrum of ways in which injuries might have been understood. Nonetheless, the meanings attributed generally emphasize self-mutilation as a response to physical, rather than emotional, pain, indicating the widespread nature of physical aetiologies of insanity. Such a somatic approach also permeated psychological models of self-inflicted injury in the late nineteenth and early twentieth centuries, as shown through examination of Richard von Krafft-Ebing’s concept of ‘sexual anaesthesia’, William James’s association of anaesthesia with the absence of emotion, and self-mutilation and fixed ideas in the work of Pierre Janet. The study of self-mutilation thus provides an interesting angle from which to explore the complexity of notions of body and mind, in relation to concepts of pain.

Highlights

  • In her influential text, The Body in Pain, Elaine Scarry made a stark division between physical and psychological pain, suggesting that while the latter has permeated almost every form of literature, the former receives little attention.[1]

  • I explore the somatic context suggested by German psychiatrist Wilhelm Griesinger and picked up to some degree in British asylum psychiatry

  • Self-mutilation was regarded as physiological evidence of insanity through revelation of the seemingly objective symptom of absence of pain sensation

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Summary

Introduction

The Body in Pain, Elaine Scarry made a stark division between physical and psychological pain, suggesting that while the latter has permeated almost every form of literature, the former receives little attention.[1]. I explore the somatic context suggested by German psychiatrist Wilhelm Griesinger and picked up to some degree in British asylum psychiatry In this approach, self-mutilation was regarded as physiological evidence of insanity through revelation of the seemingly objective symptom of absence of pain sensation. I explore the asylum practices of those writing on the topic, including George Savage, Theo Hyslop, and Daniel Hack Tuke (all variously associated with the Bethlem Royal Hospital), and James Adam (superintendent of the Crichton Royal Institution in Dumfries and, later, West Malling Place Asylum) The views of these elite practitioners should not be taken as reflecting the opinions of all alienists of this period. Such reflects the nineteenth-century usage of both terms, which were very broadly defined by alienists and those around them.[5]

Self-Mutilation and Suicide
Physiology and the Somatic Model of Self-Mutilation
Between Somatic Reasoning and Psychological Meaning
Conclusion
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