Editing Self-harm (section)

==History==
{{Synthesis|section|date=August 2023}}
[[File:A day of mourning, annual celebration of Muharram in Bahrain.jpg|thumb|The results of self-flagellation, as part of an annual Shia mourning ritual during [[Mourning of Muharram#Self-flagellation|Muharram]] ([[Tatbir]])]]
[[File:Maya Cave 224, mural of the Mourning of the Buddha with drawing.jpg|thumb|Mural of the Mourning of the Buddha, with various figures in ethnic costumes]]
[[File:flagellants.png|right|thumb|[[Consequences of the Black Death#Religion|One of the consequences]] of the [[Black Death]] was practiced [[self-flagellation|self-flogging]].]]
[[File:Zanjir b&w.jpg|thumb|A ritual flagellation tool known as a ''zanjir'', used in Shia Muharram observances]]
Although the 20th-century psychiatrist [[Karl Menninger]] is often credited with the initial clinical characterization of self-harm, self-harm is not a new phenomenon.{{sfn|Angelotta|2015}} There is frequent reference in 19th-century clinical literature and asylum records which make a clear clinical distinction between self-harm with and without suicidal intent.{{sfn|Chaney|2012}} This differentiation may have been important to both safeguard the reputations of asylums against accusations of medical neglect and to protect patients and their families from the legal or religious consequences of a suicide attempt.{{sfn|Chaney|2012}} In 1896, the American ophthalmologists George Gould and Walter Pyle categorized self-mutilation cases into three groups: those resulting from "temporary insanity from hallucinations or melancholia; with suicidal intent; and in a religious frenzy or emotion".{{sfn|Gould|Pyle|1896}}

Self-harm was, and in some cases continues to be, a [[ritual]] practice in many cultures and religions.

The [[Maya priesthood]] performed auto-[[sacrifice]] by cutting and piercing their bodies in order to draw blood.<ref>{{cite book |vauthors=Gualberto A |year=1991 |title=An Overview of the Maya World |pages=207–208 |publisher=Produccion Editorial Dante |isbn=978-968-7232-19-5}}</ref> A reference to the priests of [[Baal]] "cutting themselves with blades until blood flowed" can be found in the Hebrew Bible.<ref>{{Bibleverse|1|Kings|18:28|HE}}</ref> However, in Judaism, such self-harm is forbidden under [[Mosaic law]].<ref>Maimonides, [[Mishneh Torah]], ''Hilchot Khovel u-Mazik'' ch. 5, etc. ''See also'' [[Damages (Jewish law)]].</ref> It occurred in ancient Canaanite mourning rituals, as described in the [[Ras Shamra]] tablets.

Self-harm is practised in [[Hinduism]] by the ascetics known as ''[[sadhu]]''s. In [[Catholicism]], it is known as [[mortification of the flesh]]. Some branches of Islam mark the [[Day of Ashura]], the commemoration of the martyrdom of Imam Hussein, with [[mourning of Muharram#Self-flagellation|a ritual of self-flagellation]], using chains and swords.<ref>{{citation |publisher=Jafariya news |vauthors=Zabeeh I |title=Ashura observed with blood streams to mark Karbala tragedy |url=https://www.jafariyanews.com/2k5_news/feb/20ashur.htm |access-date=2011-09-04}}</ref>

[[Dueling scar]]s such as those acquired through [[academic fencing]] at certain traditional German universities are an early example of [[scarification]] in European society.<ref name="DeMello p 237">{{cite book |vauthors=DeMello M |year=2007 |title=Encyclopedia of body adornment |publisher=Greenwood Publishing Group |page=237 |isbn=978-0-313-33695-9}}</ref> Sometimes, students who did not fence would scar themselves with razors in imitation.<ref name="DeMello p 237"/>

[[Constance Lytton]], a prominent [[suffragette]], used a stint in [[Holloway Prison]] during March 1909 to mutilate her body. Her plan was to carve 'Votes for Women' from her breast to her cheek, so that it would always be visible. But after completing the ''V'' on her breast and ribs she requested sterile dressings to avoid [[bacteremia|blood poisoning]], and her plan was aborted by the authorities.<ref name="BBC Schama 1">{{cite web |work=BBC |title=Victoria's Sisters by Simon Schama, Lady Lytton's self mutilation gesture for 'Votes' |url=https://www.bbc.co.uk/pressoffice/pressreleases/stories/2002/05_may/09/victoria_sisters.shtml}}</ref> She wrote of this in her memoir ''Prisons and Prisoners''.

[[Kikuyu people|Kikuyu]] girls cut each other's vulvas in the 1950s as a symbol of defiance, in the context of the [[campaign against female genital mutilation in colonial Kenya]]. The movement came to be known as ''Ngaitana'' ("I will circumcise myself"), because to avoid naming their friends, the girls said they had cut themselves. Historian Lynn Thomas described the episode as significant in the history of [[FGM]] because it made clear that its victims were also its perpetrators.<ref>{{cite book |vauthors=Thomas LM |chapter='Ngaitana (I Will Circumcise Myself)': Lessons from Colonial Campaigns to Ban Excision in Meru, Kenya. |veditors=Shell-Duncan B, Hernlund Y |title=Female "circumcision" in Africa: culture, controversy, and change |date=2000 |publisher=Lynne Rienner Publishers |location=Boulder |isbn=978-1-55587-995-2 |chapter-url=https://books.google.com/books?id=rhhRXiJIGEcC&pg=PA129 |pages=129–131}}(131 for the girls as "central actors")</ref><ref>{{cite book |vauthors=Thomas L |title=Politics of the Womb: Women, Reproduction, and the State in Kenya |location=Berkeley |publisher=University of California Press |year=2003 |pages=89–91}}{{pb}}
Also see {{cite journal |ref=none |vauthors=Thomas LM |title="Ngaitana (I will circumcise myself)": the gender and generational politics of the 1956 ban on clitoridectomy in Meru, Kenya |journal=Gender & History |volume=8 |issue=3 |pages=338–363 |date=November 1996 |doi=10.1111/j.1468-0424.1996.tb00062.x |pmid=12322506}}</ref>

===Classification===
[[Karl Menninger]] considered self-mutilation as a non-fatal expression of an attenuated death wish and thus coined the term ''partial suicide''. He began a classification system of six types:
# neurotic – [[nail-biting|nail-biters]], pickers, extreme hair removal, and unnecessary cosmetic surgery
# religious – self-flagellants and others
# puberty rites – hymen removal, circumcision, or clitoral alteration
# psychotic – eye or ear removal, genital self-mutilation, and extreme amputation
# organic brain diseases – which allow repetitive [[Stereotypic_movement_disorder|head-banging]], hand-biting, finger-fracturing, or [[autoenucleation|eye removal]]
# conventional – nail-clipping, trimming of hair, and shaving beards.<ref name="1935 Menninger article">{{cite journal |vauthors=Menninger K |year=1935 |title=A psychoanalytic study of the significance of self-mutilation |journal=[[Psychoanalytic Quarterly]] |volume=4 |issue=3 |pages=408–466 |doi=10.1080/21674086.1935.11925248}}</ref>

Pao (1969) differentiated between ''delicate'' (low lethality) and ''coarse'' (high lethality) self-mutilators who cut. The "delicate" cutters were young, multiple episodic of superficial cuts and generally had borderline [[personality disorder]] diagnosis. The "coarse" cutters were older and generally psychotic.<ref name="Pao (1969)">{{cite journal |vauthors=Pao PN |title=The syndrome of delicate self-cutting |journal=The British Journal of Medical Psychology |volume=42 |issue=3 |pages=195–206 |date=August 1969 |doi=10.1111/j.2044-8341.1969.tb02071.x |pmid=5808710}}</ref> Ross and McKay (1979) categorized self-mutilators into nine groups: ''cutting'', ''biting'', ''abrading'', ''severing'', ''inserting'', ''burning'', ''ingesting or inhaling'', ''hitting'', and ''constricting''.<ref name="Ross and McKay (1979)">{{cite book |vauthors=Ross RR, McKay HB |year=1979 |title=Self-Mutilation |publisher=Lexington Books |isbn=978-0-669-02116-5 |url=https://www.ojp.gov/ncjrs/virtual-library/abstracts/self-mutilation |access-date=2024-03-27}}</ref>

After the 1970s the focus of self-harm shifted from [[Freudian]] psycho-sexual drives of the patients.<ref name="Roe-Sepowitz">{{cite thesis |vauthors=Roe-Sepowitz DE |degree=Ph.D. |title=Indicators of Self-Mutilation: Youth in Custody |year=2005 |publisher=The Florida State University College of Social Work |pages=8–10, 77–88 |url=http://etd.lib.fsu.edu/theses_1/available/etd-09132005-192859/unrestricted/DominiqueRoeSepowitzDissertation.pdf |access-date=2009-06-15 |url-status=dead |archive-url=https://web.archive.org/web/20120225213713/http://etd.lib.fsu.edu/theses_1/available/etd-09132005-192859/unrestricted/DominiqueRoeSepowitzDissertation.pdf |archive-date=2012-02-25}}</ref>

Walsh and Rosen (1988) created four categories numbered by Roman numerals I–IV, defining ''Self-mutilation'' as rows II, III and IV.<ref name="Walsh and rosen (1988)">{{cite book |vauthors=Walsh BW, Rosen PM |year=1988 |title=Self Mutilation: Theory, Research and Treatment |publisher=Guilford. of N..Y, NY. |isbn=978-0-89862-731-2 |url=https://archive.org/details/selfmutilationth0000wals |page=7|url-access=registration}}</ref><!-- this is the source for the entire table below -->

{| class="wikitable"
|-
! Classification
! Examples of behavior
! Degree of Physical Damage
! Psychological State
! Social Acceptability
|-
| I
| Ear-piercing, nail-biting, small tattoos, cosmetic surgery (not considered self-harm by the majority of the population)
| Superficial to mild
| Benign
| Mostly accepted
|-
| II
| Piercings, saber scars, ritualistic clan scarring, [[sailor tattoos]], [[gang tattoos]], minor wound-excoriation, [[trichotillomania]]
| Mild to moderate
| Benign to agitated
| Subculture acceptance
|-
| III
| Wrist- or body-cutting, self-inflicted cigarette burns and tattoos, major wound-excoriation
| Mild to moderate
| Psychic crisis
| Possibly accepted by a handful of similar-minded friends but not by the general population
|-
| IV
| [[Castration|Auto-castration]], [[self-enucleation]], [[amputation]]
| Severe
| Psychotic decompensation
| Unacceptable
|}

Favazza and Rosenthal (1993) reviewed hundreds of studies and divided self-mutilation into two categories: ''culturally sanctioned self-mutilation'' and ''deviant self-mutilation''.<ref name="Favazza and Rosenthal (1993)">{{cite journal |vauthors=Favazza AR, Rosenthal RJ |title=Diagnostic issues in self-mutilation |journal=Hospital & Community Psychiatry |volume=44 |issue=2 |pages=134–140 |date=February 1993 |doi=10.1176/ps.44.2.134 |pmid=8432496}}</ref> Favazza also created two subcategories of sanctioned self-mutilations; ''rituals'' and ''practices''. The ''rituals'' are mutilations repeated generationally and "reflect the traditions, symbolism, and beliefs of a society" (p.&nbsp;226). ''Practices'' are historically transient and cosmetic such as piercing of earlobes, nose, eyebrows as well as male [[circumcision#History|circumcision]] while ''deviant self-mutilation'' is equivalent to self-harm.<ref name="Roe-Sepowitz"/><ref name="Favazza (1996)">{{cite book |vauthors=Favazza AR |year=1996 |title=Bodies Under Siege, 2nd ed |publisher=Baltimore: Johns Hopkins Press. |isbn=978-0-8018-5300-5 |url=https://books.google.com/books?id=BwQT9fdZNdgC&q=Favazza,+A.+R.+(1996).+Bodies+Under+Siege,+2nd+ed.+Baltimore:+Johns+Hopkins+Press.&pg=PR9 |access-date=2009-06-22}}</ref>