When the Body Is the Target Self-Harm, Pain, and Traumatic Attachments

by Farber, Sharon Klayman

• ISBN13: 9780765702562
• ISBN10: 0765702568
• Format: Hardcover
• Copyright: 2000-08-01
• Publisher: Jason Aronson, Inc.

Summary

In this comprehensive and insightful work, Dr. Sharon K. Farber provides an invaluable resource for the mental health professional who is struggling to understand self-harm and its origins. Using attachment theory to explain how addictive connections to pain and suffering develop, she discusses various kinds and functions of self-harm behavior.

Author Biography

Sharon Klayman Farber, Ph.D., is a Board Certified Diplomate in clinical social work practice in Hastings-on-Hudson, New York

Table of Contents

Preface	xiii
Acknowledgments	xxi
Introduction	xxiii
Part I The Borderland of Self-Harm
The Mystery of Self-Harm: Concepts and Paradoxes	3	(42)
The Death Instinct Revisited	4	(1)
Purging, Bloodletting, and Exorcising the Demons	5	(1)
The Fear of Madness	6	(1)
The Body	7	(1)
Symptoms and Language	8	(1)
The Problematic Concept of Suicide	9	(1)
Pain and Suffering	10	(1)
Self-Harm and Pain in the Context of Culture	11	(5)
The Language of Pain and Violence Spoken on the Body	16	(1)
The Spectrum of Bodily Self-Harm	17	(13)
Other Self-Harm in the Spectrum	30	(2)
The Self-Harm Concept in the Literature	32	(8)
Self-Regulation, Self-Medication and Selfobject Hypotheses	40	(1)
Self-Regulation and Attachment Theory Illuminate Self-Harm	41	(1)
The Paradox of Self-Harm	42	(3)
How Common Is Self-Harm?	45	(52)
The Ubiquity of Self-Harm	46	(12)
Contagion and Group Factors in Self-Harm	58	(5)
Process Factors in Contagious Self-Harm	63	(2)
Self-Harm Is as Old as Time	65	(3)
Grooming and Attachments Gone Haywire	68	(5)
Self-Harm and Associated Psychopathology	73	(14)
Adaptation and Dimensions of the Self-Harm Spectrum	87	(2)
Navigating the Borderland and Exploring the Margins	89	(8)
Not Wanting to Know about Self-Harm: Trauma, Violence, and Chronic Mental Illness	97	(14)
Deinstitutionalization and the Chronic Mentally Ill	97	(2)
The Resistance to Understanding the Origins of Trauma	99	(3)
Wartime Violence	102	(1)
Holocaust Survivors	102	(1)
Rape, Domestic Violence, and Child Abuse	103	(1)
The Link between Self-Harm and Trauma Is Established	104	(7)
Part II Neglect, Violence, and Traumatic Attachments
Suffering and Self-Harm: Treating Oneself as the Other	111	(8)
Dehumanization of the Other and Violent Suffering	111	(1)
Effects of Violence	111	(8)
How Attachments Go Haywire	119	(40)
Attachment Theory and Research	122	(7)
Self and Mutual Regulation	129	(14)
Attachment Problems Woven into the Development of Critical Ego Functions	143	(16)
The Psyche-Soma and Traumatic Attachments to Pain and Suffering	159	(32)
The Psychosomatic Dyad and Alexithymia	161	(17)
From Passion to Perverse Omnipotence	178	(1)
Transitional Use of the Body as a Fetish	179	(2)
The Psychotic Core: Up Close and Personal	181	(4)
The Passionate Dance with Death, or The Last Tango?	185	(1)
Passionate Attachments and the Child's Survival	186	(2)
Attachment and Darwin's Theory of Natural Selection	188	(3)
Survival and Sacrifice: When the Prey Becomes the Predator	191	(20)
The Repetition Compulsion	193	(1)
The Dialectics of Safety and Danger, Predator and Prey	194	(2)
Becoming a Wild Animal	196	(1)
Fear of the Beast	197	(1)
Eat or Be Eaten, Kill or Be Killed	198	(1)
Ghosts of Predators Past and Primeval	199	(1)
From Defenseless Prey to Ferocious Predator	200	(2)
Primeval Fear of the Predator in a Past-Life Regression	202	(2)
The Adaptational Advantage of Anxiety	204	(3)
We Are the Gods and the Demons, the Lions and the Sacrificial Lambs	207	(4)
Trauma, Duality, and the Transformation from Prey to Predator	211	(52)
Chaos, Catastrophe, and Snapping	212	(2)
Trauma, ``Aloneness Affect,'' and Self-Harm	214	(1)
The Trauma Response	214	(1)
A Warm Body Is Better Than No-Body; Violent Touch Is Better Than No Touch	215	(2)
The Trauma Continuum and Defensive Altered States	217	(4)
``Doublethink'' and the Psychobiology of Trauma	221	(4)
State-Dependent Memory and the Return of the Repressed	225	(1)
Traumatic Attachments and Addiction to Trauma	226	(4)
Self-Harm: Self-Destructiveness or Survival Tool?	230	(1)
Self-Harm for Healing and Redemption	231	(2)
Addictive Traumatic Reenactments	233	(2)
Becoming One's Own Predator	235	(7)
Regression to the Immediacy of Bodily Experience	242	(21)
Part III The Body Speaks
The Body Speaks That Which Cannot Be Spoken	263	(24)
Self-Harm as Attempts at Self-Regulation	264	(2)
Transitional Functions of the Body in Self-Harm	266	(1)
How The Body Speaks	267	(4)
Approaching Symbolic Use of Language	271	(2)
Bodily Reenactments Speak to the Self	273	(3)
Repetitive Themes	276	(11)
Self-Harm, Gender, and Perversion	287	(36)
Gendered Embodiments of Self-Harm	288	(1)
Masochism and Gender	288	(2)
Trauma and Gender	290	(2)
Depression and Gender	292	(1)
Women Take Their Medicine; Real Men Drink You Under the Table	293	(2)
Gender Differences in Self-Harm in Institutions	295	(1)
Gender Differences in Eating Disorders	296	(1)
Body Alienation	297	(1)
Childhood Body Experience	298	(1)
Adolescent Development	299	(12)
Pregnancy and Breast-Feeding	311	(1)
The Aging Process	311	(6)
Sadomasochism and Other Perversions	317	(6)
The Addiction to Wanting:	323	(26)
``Do Not Want What You Cannot Have''	324	(1)
Destructive Narcissism and Hunger Diseases	325	(3)
The Addiction to More	328	(1)
Symptom Substitution	329	(1)
Adjusting the Medication	330	(3)
The Strongest Medicine for the Deepest Pain	333	(1)
Those Who Need the Strongest Medicine	334	(3)
Special Subgroups with Most Severe Hunger Diseases	337	(8)
Attachment and Hunger Disease	345	(4)
Part IV Clinical Implications
The Attachment Paradigm	349	(24)
The Therapeutic Alliance and Sadomasochism	352	(1)
``There Is No One There for Me''	353	(1)
Supportive Attachments	354	(2)
Typical Problems in Treatment	356	(5)
Treatment Objectives	361	(1)
Focus on Interactive Processes	362	(1)
Engaging the Patient	362	(2)
The Treatment Frame	364	(1)
Physical and Emotional Safety	365	(3)
Qualities Needed for Therapists Treating Self-Harming Patients	368	(5)
Diagnosis, Assessment, and Core Features	373	(10)
Assessment of Self-Harm	374	(1)
Criteria Used in Assessing Self-Harm	375	(4)
Diagnosis	379	(4)
Using Attachment Theory in Therapy of Self-Harm Patients	383	(42)
Core Features of the Self-Harming Patient	384	(30)
Attachments: Different Roads Lead to Rome	414	(1)
Power of the Family	414	(1)
Power of the Group	415	(10)
Transference, Countertransference, and Enactments	425	(38)
Projective Identification and Splitting	426	(1)
Therapist as New Object and Container	427	(1)
Therapist as Interpreter	427	(1)
The Patient's Persona and Transference	428	(5)
The Therapist's Persona and Countertransference	433	(2)
Enactments	435	(26)
The Power of Affective Experience	461	(2)
From Self-Harm to Self-Reflection	463	(36)
How The Story Is Told	464	(2)
Playing and the Creative	466	(4)
Playing with Secrets	470	(3)
Playing with Writing, Drawing, Music	473	(2)
Playing with the Dark Side	475	(2)
Playing with Humor	477	(1)
Playing with Dreams	477	(1)
Playing with the Body	478	(2)
Playing with Images of the Body	480	(2)
Resonating with Patients' Language and Metaphors	482	(3)
From the Language of the Body to Symbolization	485	(1)
Reenactments and Healing: A Paradoxical Circular Process	486	(7)
How Therapy Heals	493	(3)
Becoming Real	496	(3)
Appendix: The Study and Transitional Space	499	(22)
The Study	500	(7)
The Concept of Transitional Space	507	(2)
The Transitional Area of Experience as a Safe Space	509	(1)
The Study as a Safe Space	510	(2)
The Researcher as Idealized Reader	512	(1)
Wanting to Find Meaning in Their Suffering	513	(2)
Pain, Attachments, and Teddy Bears	515	(3)
Body Modifications and Transitional Space	518	(3)
References	521	(38)
Credits	559	(2)
Index	561