Sexology, historiography, citation, embodiment: a review and (frank) exchange

Heike Bauer (ed.), Sexology and Translation: Cultural and Scientific Encounters Across the Modern World. Philadelphia: Temple UP, 2015, $34.95 pbk, 284 pages, ISBN: 978-1-43991-249-2

by Ivan Crozier, with responses from Heike Bauer

Editor’s note: we are very happy to here present Ivan Crozier’s review of ‘Sexology and Translation.’ The review is followed by a response from  the editor of that volume, Heike Bauer; then a response to the response; and then a response to the response to the response. We are grateful to both scholars for this lively and interesting exchange, which foregrounds crucial issues about historiography and field-making, which are central to work on sexology, but that span the human sciences much more widely too.

Sexology was a trans-European, transatlantic discipline, with important sexological works appearing in Italian, French, English and especially German before Havelock Ellis’s synthesis of the field in his Studies in the Psychology of Sex (1897-1928). As suggested by their footnotes, most of the main players read each other’s languages. They also read widely outside of the field, and rearticulated non-sexological views of sex from other fields, such as history, literature, law and anthropology. Understanding how they read and used the works of other sexologists and those of other sexperts who were not in the same field is a significant way to map out the intellectual history of one of the most important disciplines that framed many attitudes towards sexuality in the twentieth century. How authors in other fields interpreted and disseminated these sexological discourses is a useful way of assessing the impact that sexologists had.  These are not the same problem, but they both require an understanding of how knowledge is generated within a field.

It is obvious to students of sexological texts that translation is a key issue for understanding the field – both the translation of texts between languages and cultures, but particularly the translation of concepts and evidence between fields. This book attends to both types, but with varying degrees of success. Attending to translation is a potentially fruitful way for understanding topics such as how the field of sexology formed, whose work was considered significant, what effects these works had, where concepts were developed, etc. To do so, a theoretical framework is needed that can explain how the field developed in specific contexts; how it related to other fields in the human sciences, the law, literature and the arts; and how it produced specific sexological objects of inquiry and developed sexological concepts that appear similar to but are not identical to other conceptualisations of sex. Translation is a part of the key for understanding this process, but the archaeological insights into the history of sexology that derive from Michel Foucault and the historical epistemologists who have followed him are still necessary if we are to understand how sexology functioned as a field. Not all of the chapters collected in this volume together satisfy this requirement equally.

This book gathers twelve chapters that addressed both the translation between languages/cultures and between fields. On the whole, the problem of language and context translation is done significantly better.  Drawing on contemporary translation studies, many of the chapters explain how sexological works were turned into texts in other languages, attending to the differences in cultural context, and exploring the political issues that framed these translation efforts. An exemplary such chapter was Brian James Baer on Russia, but other fascinating essays addressed the translation of European sexological discourses into Hebrew, Arabic, Chinese, and Japanese. Cultural contexts also changed, with pieces following the influence of sexological texts as far as Peru, Palestine, Egypt and the Far East. And the translation of specific words over a longue durée timescale is seen in Peter Cryle’s scholarly attention to the concept of frigidity from ancient Latin and Greek into nineteenth-century German and French medicine before the psychoanalysts turned away from medical expertise to explain a lack of desire. Liat Kozma‘s chapter on the Middle East also explores the translation of professional texts into practical lay sexual advice, not as a history from below, as those following Roy Porter have emphasized, but as sexual advice by doctors trying to shape the sexual politics of their context by importing some European sexological concepts. In these ways this book adds importantly to our understanding of the spread of sexology outside of the much more commonly studied European texts.

Translation between fields is where many more scholars had more trouble, and it is with this problem that a solid introduction that conceptualised what was at stake when concepts are rearticulated between fields would have helped (the rather busy one-page editorial interjections between the three sections of the book didn’t offer this, either).  “Literary sexology”, a term used by the editor elsewhere to describe how sexological knowledge made its way into literary texts, shows some of the problems with treating the objects (sex) within the different fields as equivalent, and forgets the fact that they are produced differently (relying on different practices, different styles of reasoning, different forms of evidence). Reading the surfaces of texts elides knowledges with very different epistemological values, which is not to say that some fields are more important, only that they produce different things and rely on different networks of power. We see this all of the time in the primary sources when sexologists qualify their uses of non-sexological texts, but many scholars have trouble with these differences.

Rather than arguing that sexology is bigger than the field actually was, so as to include literary and other texts where sex is addressed in that earnest late-nineteenth century way, it is better to understand some manifestations of sexological knowledge as formed by the rearticulation of sexual knowledge into and out of the field of sexology. A text purporting to be factually engaging with sex is not necessarily sexological. Proceeding along these lines depends on the kind of historiographical framework being used, but with decades of historical epistemological engagement with these issues since Michel Foucault, Arnold Davidson and others, there is no excuse to mash texts together looking for, in Foucault’s terms, points of equivalence.’ Different strategic choices are made when a historian accentuates either discontinuity or continuity.

Failure to conceptualise the field was also a problem in Jana Funke and Kate Fisher’s chapter that argued for the inclusion of Edward Carpenter’s contributions within the sexological field, which I have argued against because of the difference in style of reasoning (his is much more literary/historical, and romantic not psychopathological), the differences in evidence used (he did not include case histories, but appeared as one in Ellis’ Sexual Inversion), and the fact that – despite interesting archival evidence that Albert Moll corresponded with him – most sexological texts after his publication did not refer to his work in any significant way (unlike that of Ellis, Moll, Krafft-Ebing, etc.).  He remained an outsider, conceptually, which is not to undervalue his contributions – but rather to see them for what they were: ground-breaking homosexual rights activism rather than sexology. Carpenter does not need to be made into a sexologist to be important. If the field of sexology had been conceptualized more thoroughly, this kind of archival slavery could be avoided.

There is no need to end on a critical note. Katie Sutton’s consistently-strong work shows that a more sophisticated approach to sexological knowledge and its vicissitudes outside the field is possible. She maps effectively how transgendered people interacted with sexological categories, and shows how these interactions were rearticulated in non-sexological fields, such as in novels, films and magazine columns with a transgendered theme from the Weimar Republic. This was the strongest essay in the collection. Overall, this book will not satisfy those with a need for rigorous conceptual analysis as much as those who require specific engagement with translation of sexology into other cultural contexts.

 

Heike Bauer’s response to the review:

Following in the vein of influential scholars such as Gillian Beer, who in the early 1980s pointed out that nineteenth-century science and literature shared a common language, recent research on sexology by Veronika Fuechtner, Anna Katharina Schaffner and Robert Deam Tobin, among others, has shown that the science of sex was a porous field. The main point of Crozier’s critique – that sexology should be located within an idealized, tightly bound domain of science proper, and most definitely not in the literary realm – is both historically inaccurate and critically outdated. Sexology was constituted from the contributions of medical professionals, legal and social scientists, anthropologists, social reformers as well as authors, literary critics and all kinds of cultural commentators who individually and collectively turned their attention to questions of sex. As sexual bodies and behaviours came under scrutiny in the clinic and courtroom, literary and cultural commentators explored the vagaries of desire and the implications of gender norms. Sexual debates as we known them today emerged on the intersections between these different fields rather than just within a distinct, clearly disciplined sexual science. In the collection I therefore use the term ‘sexology’, alongside sexual science, in line with other critics to give a name to the discursive force that gathered momentum around the sustained attention paid to questions of sex in different contexts and countries from around the 1880s to the 1930s. The deliberately loose definition not only captures the historical permeability of the field of sexual research. It also drives a key aim of the collection: to examine the coeval emergence of similar sexual debates in different parts of Europe, Asia, South America and the Middle East.

By policing the boundaries of European sexology, Crozier simply looks for evidence of an assumed one-way traffic of sexological ideas from the West into other parts of the world. He attacks Kate Fisher and Jana Funke’s essay, which argues that the English sexual science around 1900 was ‘a cross-disciplinary field that did not erect exclusionary credentials around its practice’ for including the poet and reformer Edward Carpenter in a discussion of sexual science. At the same time Crozier praises the essays that explore the translations of European sexology into other contexts, including Japan. Yet Michiko Suzuki’s chapter, which examines the reception of Carpenter in Japanese feminist circles, explicitly reads Carpenter’s work as a contribution to sexological and broader sexual debates both in Europe and Japan. For Crozier, then, Carpenter only counts as a sexologist when he can be figured as the harbinger of European knowledge into the East.

Jack Halberstam has pointed out that the problem with disciplinary correctness is that it all too often ‘confirms what is already known according to approved methods of knowing’ (2011: 186). Ivan Crozier’s review of Sexology and Translation shows how methodological rigidity and the guarding of disciplinary boundaries obscures the insights gained from interdisciplinary and multidisciplinary research. Insisting on a narrowly defined approach to sexology, his claims support the critically outdated yet perniciously resilient view that modern debates about sexuality originate in Western science from where they were transmitted into a sexually undisciplined Orient. Rather than engaging with the insights and findings presented, the review merely demonstrates how gendered and racialized assumptions about the production of knowledge shape readings of research that pushes against them.

 

Crozier, responding to Bauer:

It appears that many specialists in literary studies have trouble with the idea that discursive fields have boundaries.  Apart from Michel Foucault describing how to approach such fields in his Archaeology of Knowledge, the disciplines of History and Philosophy of Science and Science Studies have developed this well-established concept in historical and sociological terms (especially since Gieryn, 1983), but occasionally when someone studying literature looks at a scientific field, they seem to see a porous mess of texts that anything can seep into and out of like a poorly-squeezed sponge (possibly because literature is a porous field in different ways to the sciences?). By looking at scientific discourses in this way, these cultural approaches remove the discourses from the social contexts in which they were produced. Perhaps they are so over-whelmed by the shared common language which Gillian Beer taught them to see that they do not realise that the concepts, styles of reasoning, uses of data, statuses of the authors, and other social-epistemic factors are not shared between fields? There is, as we have known since Gaston Bachelard, an epistemological rupture, which means that sexology and other disciplines (such as the law) construct sex differently. The original authors of these texts were aware of these different fields, probably because so many of them spent a long time in medical school learning how to look at the world in a particular way; likewise the historians of science who discuss their work. But apparently Heike Bauer has trouble with the idea that we should look at sexological texts as belonging to a specific field if we are to understand their production – not everything can be crammed into this field, and other texts will need to be positioned in their respective discursive fields.  So a line needs to be drawn: those who believe that the human sciences have a status deriving from specific practices; and those who think that there is no demarcation between scientific and non-scientific forms of knowledge… tl;dr: I’m a splitter, she’s a lumper.

Bauer makes a grand statement about sexology being a ‘porous field,’ but what does she mean by this?  Without simply relying on a metaphor that some things (she doesn’t specify in her response, but we might assume she means concepts, words, politics, what else?) somehow seep in and out of the leaky vessel of sexology, it is important for the historian of ideas to understand the social processes by which this happens (no one is denying that it happens; but some of us want to know how). It is through a process of rearticulation, as anyone versed in post-foucaultien historical epistemology knows. And as such, these discourses are not found ‘within an idealized, tightly bound domain of science proper,’ as Bauer incorrectly supposes I think, but rather in a sui generis scientific field that emerged in specific ways, relates to other (scientific and non-scientific) discursive fields through particular socially-acceptable mechanisms, and produces knowledge for this specific field. Sure, these discourses are not bound forever to remain in the field, and occasionally novelists, lawyers and others pick up on these discourses and turn them into something else for their own ends, just as sexologists can draw on these other fields – but without a solid understanding of what is happening in the production of discourses within the human sciences, the work that follows can be pretty flakey.  There is nothing new here – following Michel Foucault, Arnold Davidson, Ian Hacking, and the Edinburgh School in the Sociology of Scientific Knowledge, I have been saying versions of this for almost 20 years, as Bauer knows from my work that she cites in her book. None of us think that there is a unified field of ‘science proper,’ just different competing fields. Framing the translation between these fields is what could have made Bauer’s book interesting, as some of the chapters show, but which eludes her introduction.

In her response, Bauer relies on Jack Halberstam to suggest that I am enrolling gendered and racialized assumptions because she imagines that I am talking about ‘modern debates about sexuality originat[ing] in Western science’ and oozing out across the world, but I am not.  I am simply saying that discourses produced within fields of the human sciences have specific rules of construction that make them different to literary texts, and to fail to look at these texts in their original social context is to miss a lot of important detail.  To put it another way, there is no literary sexology – there is sexology that rearticulates ideas presented in literary and other non-scientific sources when speaking to other members of the same field, for example when Havelock Ellis writes about Baron von Sacher-Masoch’s Venus in Furs when discussing masochism, enrolling it as evidence (rearticulating it to make it sexological). When people outside this field use these sexological ideas, they are no longer doing sexology, which is fine.  To try to make everything a form of sexology just because it speaks about sex is to give the science an inflated status. I think we can do better than this.

Ultimately, I thought Sexology in Translation was an average book whose editor was unable to introduce a historiography properly equipped to deal with the construction of sexological knowledge, which is a shame as it was surely her most pressing task so that she could help her readers understand the translation of objects and concepts between fields.  Some of the better contributions do this (especially Katie Sutton’s), as do other historians of sexology, but many of Bauer’s contributors are happy to wallow around in the common language of sex.  All writing about sex is not sexological, and when it is, it follows a ‘grammar’ specific to that discursive field.  That doesn’t mean that other (literary) writing can’t speak about sex; it just means that these literary sources are not found among the human sciences.

 

Bauer’s response to Crozier, and the final word:

That Crozier wants this collection to be a different book – one that engages specifically with the methodologies and concerns of his own research – is clear, not least because he mistitles it Sexology in Translation. But this book takes a different approach. It examines the coeval emergence of sexology in different parts of the world in terms of a dynamic exchange between distinct discourses and disciplines. Understanding disciplinary porosity in this context is not a denial of the discrete practices, conventions and genealogies that forged a modern sexual science. Instead it focuses on the intersections as well as the differences between discursive fields to gain deeper insights into how modern ideas about sex were formed, disciplined and transmitted, and to what effect.  Such an approach does not dismiss the significance of social context. On the contrary, the essays in the collection show that attention to social context is fundamental to understanding whose existence was on the line in sexological discourse formation.

In many ways talking about sexology in the nineteenth-century is anachronistic. While according to current scholarship the term was first used in English in 1867 in relation to social philosophy, the profession of ‘sexologist’ only took shape in the West in the way in which it is still practiced today when the centres of sexual research shifted from Europe to North America after World War II. Many of the people we today associate with the emergence of European sexology – such as the psychiatrist Richard von Krafft-Ebing, author of the influential medico-forensic study Psychopathia Sexualis – did not self-identify as ‘sexologists’ even as they staked out a specialism in sexual matters. The work of some male non-scientists such as the literary critic John Addington Symonds was readily accepted as, and widely cited by, the emerging sexological literature. The contributions of women in contrast was often overlooked or dismissed. Edith Ellis, for instance, a feminist reformer who was married to Havelock Ellis, entered sexological literature as a case study (she was in a relationship with another woman) rather than being cited for her radical critique of the institutionalisation of ‘love’. Framing these developments solely in terms of epistemic ruptures, competition between different fields and definitional struggles over what should count as sexology proper not only reduces the complexity of this history. It also fails to consider whose contributions were obscured or excluded in the scientification of sex.

Sara Ahmed has pointed out that citation practices are ‘a way of reproducing the world around certain bodies.’ Crozier’s alignment with an all white male line-up of influential thinkers in the history and philosophy of science illustrates this point. Rather than engaging with the most recent scholarship on the histories of sexuality and sexology, he turns backward. As he says, ‘there is nothing new’ in his critique.

Heike Bauer is a Senior Lecturer in English and Gender Studies at Birkbeck College, University of London.

Ivan Crozier is currently an historian of psychiatry at Sydney University.

 

Book Review Essay: ‘Psyche on The Skin’ and ‘A History of Self-Harm in Britain’

Sarah Chaney, Psyche on the Skin, Reaktion Books, London, 2017, £20.00, 320pp. ISBN 9781780237503;

Chris Millard, A History of Self-Harm in Britain: a genealogy of cutting and overdosing, Palgrave, London, 2015, £15.99 and available open access. ISBN  9781137547736.

by Ivan Crozier

People have always changed their bodies in permanent ways – whether with tattoos, scars, tongue splits, brands, piercings, genital modifications (from religious circumcision to self-bifurcation), or through cosmetic surgery. These changes give the body a particular meaning that is entirely dependent on the social context. Sometimes, scarification is done to show belonging to a particular ethnic group (a Mossi man from Burkina Faso was traditionally initiated with specific facial scars made with a hot knife), while other scars might be consensually produced as a part of a heavy sadomasochistic scene, and yet others – as these two books show – might be the result of a distressed teenager engaging in a self-harming practice which increasingly became viewed as a ‘cry for help’ within psychiatric discourses, and which necessitated the intervention of mental health professionals. These acts of body modification only take on their meanings within certain social groups. In some cases, self-injury is framed as resulting from a disturbed mind. Psychiatry is the dominant current way of understanding deliberate self-inflicted injuries in the west, but this was not always the framework, and, as these two books show, there is much to suggest that psychiatric power is being resisted in current corporeal practices.

The abhorrence that has framed self-injuring is partly tied up in ideas about pain as a wholly negative experience, with those willing to engage in it consciously believed to be mentally disturbed and requiring psychiatric attention. This is the main reason that sadomasochistic practices come under the scrutiny of psychiatrists. Another important framework for considering self-harm is the social and legal status granted to suicide. Self-harm was developed as a category within psychiatry, firstly believed to be ‘failed suicide,’ and then ‘para-suicide,’ before becoming a different category altogether (Non-Suicidal Self-Injury, as it is in the  of fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-5), where it made its first appearance as a self-contained condition in 2013). The links between the legal and medical status of self-harm created the conditions whereby psychiatry could develop a theoretical apparatus for constructing a new category, although other social factors also shaped the way psychiatrists’ thought about self-harm. For example, self harm was increasingly gendered as feminine. This was because it was seen to be the result of domestic distress, where sometimes women hurt themselves to guilt their partners into not leaving them. This gendered conception of self-harm is still seen today, with American psychiatric research showing that adolescent females are the most typical group to cut themselves. What acts of self-injury mean depends very much on how they are understood by the different psychiatric discourses that have attended to them, as well as by the people who commit them.

Sarah Chaney and Chris Millard, in their respective volumes, ally themselves to a view of psychiatric knowledge that derives from historical epistemology. They both use Ian Hacking’s concept of ‘making up people’ to develop the ways that psychiatry produces specific objects of knowledge which are then transported to society through the expansion of psychiatric power – via psychiatric social workers, structures like the National Health Service (NHS) in the UK, and education programmes. The increased prevalence of the self-harmer is in part produced by the sustained and expanding psychiatric attention. By adopting this historical-epistemological standpoint, both books show that self-harm is ‘transient’ in Hacking’s sense; that it is not a stable category, but one which changes over the course of the history of psychiatry: the teenage girls who cut themselves, and discuss what this means to them, on the internet today are not the same as the women in the 1960s who poisoned themselves so their boyfriends wouldn’t leave, even though psychiatry has placed them both in the category of self-harm. How Chaney and Millard develop this analytic framework is not identical, but rather illustrates two different modes of medical historiography: (1) a macro, longue durée approach with an engaging narrative that bears some of the hallmarks of Roy Porter’s influence (Chaney); (2) an extremely detailed micro-history of the development of the concepts of self-harm within the context of British psychiatry, but with close attention to the sites where new psychiatric practices developed (such as the Edinburgh Royal Infirmary and the Institute of Psychiatry in London) and which owes much more to the historical Sociology of Scientific Knowledge as applied to medical practices (Millard). Both books problematize psychiatric knowledge, and seek explanations for the shape that it took by looking at the social and conceptual frameworks in which this knowledge was developed, with the resulting works being very different, yet complimentary.

Sarah Chaney’s fantastically illustrated Psyche on the Skin is written for a popular audience and anyone with a personal or professional interest in the subject will be well-rewarded by her book. Chaney uses history to refute the idea that self-inflicted injuries have a universal meaning by showing a variety of episodes where individuals hurt themselves, but were not considered to be episodes of self-harm in a modern psychiatric sense. She discusses practices such as blood-letting, where cutting the self was considered to yield positive results, and castration, which some believed to be beneficial (in particular members of the Skoptsy sect in Russia). Such practices have existed since the ancient world, without any speculation about the individual’s mental health. Chaney’s main focus, and her best research, is on the Victorian period. Using hospital records from Bethlem, as well as a thorough examination of existing medical literature, Chaney shows that self-mutilation was relatively common among the mentally ill in the Victorian period (with 11% of the Bethlem patient population hurting themselves between 1880-1900, employing methods such as burning, biting, plucking, cutting, castration and ocular enucleation). In these instances, self-harming was considered to exemplify the ‘morbid instinct’ that characterised insanity in this period. Self-harm was not a psychiatric object in itself, but was a manifestation of insanity. Self-mutilation, like suicide, was considered an unnatural practice by Victorian psychiatrists (or alienists, as they were typically known in this period) because it was not perceived to benefit the patient. Sexual self-mutilation was addressed as a part of the increased attention to sexuality seen in Victorian and Edwardian medicine.  Practices such as masturbation were seen as self-harming, because of the assumed deleterious effects, and a number of the patients whose records Chaney examined spoke of wishing to be castrated in order to prevent this vice (interestingly, some others wished for castration as a form of gender reassignment).

Other instances of self-harm were associated with hysteria, including the practice of piercing oneself with sewing needles (by 1897 there were enough cases of this practice reported in the medical literature for the women who regularly pierced themselves to be given the name of ‘needle girls’). Particular traits, such as deceit, came to be associated with self-harm, because efforts were made to conceal self-injury and the motivations behind it – and this association apparently remains today. Sometimes the reported self-harm practices were of a sexual nature, such as the insertion of hairpins into the urethra – which, although considered to be a form of self-mutilation by physicians at the time, may have been the result of poorly executed urethral masturbation (urethral sounding).  Chaney’s survey of the literature on self-harm attends to the psychoanalytic writing on the topic, including a long discussion of Karl Menninger’s Man Against Himself (1938) She also discusses the changes in later psychiatric theories of self-harm, from re-writing it as a practice associated with Borderline Personality Disorder and Post-Traumatic Stress Disorder, to an analysis of Armando Favazza’s Bodies Under Seige (1987). The latter utilised cultural-psychiatric approaches to looking at self-harm relativistically, and suggested that – contrary to much preceding psychiatry – self-harm was often an attempt at self-healing, by taking control of the body in a deliberate way, focusing, and submitting to the pain and then the relaxed feelings that followed such activity. Pain is typically considered negative in the Western imagination, but there are many instances where submitting to pain can bring positive results.

Chaney does not limit her work to psychiatric discourses alone, but provides a welcome analysis of some literary and other artistic depictions of self-harm, giving non-psychiatric voices a legitimate place in her study. Finally, and very importantly, Chaney examines the role played by the popular press and especially the internet in the culture of self-harm – both as a place where information about self-harm could circulate, both from ‘official’ health-care sources, and in patient-led ‘survivor group’ discussions. These non-psychiatric sources are an important part of the ‘making up’ of self-harm. Chaney’s work is both broad and rich and is written in an engaging way that will make this book a valuable resource for anyone trying to understand self-harm practices outside of the narrow confines of psychiatric discourses.

Chris Millard’s A History of Self-Harm in Britain is exhaustive in its genealogical approach to the concepts of self-harm in Britain, and as such is an exemplary case study in the sociological reconstruction of psychiatric knowledge. Most importantly, although he relies heavily on published British medical sources and theses (and it appears that he did not miss a single work), Millard does not fail to examine the practices that allowed for the development of these concepts. He shows how self-harm first emerged as a psychiatric problem by looking at how ‘failed suicide’ attempts (through traumatic injury as well as self-poisoning) in the 1910s and 1920s led to the injured person being taken to voluntary hospitals and workhouse infirmaries, in order to deal with the self-inflicted harm; after the 1930 Mental Treatment Act, which saw mental health becoming more integrated into general medical practices, these ‘failed suicides’ were able to be assessed more readily by psychiatrists. This situation was further stimulated by changes in the law regarding suicide (it was decriminalised in the UK in 1961), which Millard shows led to the integration of therapeutic regimes, joining the somatic approach of casualty departments to acute psychiatric care for the damaged person. The NHS further expanded the remit of psychiatry (especially via psychiatric social workers) into the homes of self-harmers, where a detailed picture began to emerge about the kinds of people who hurt themselves and their motivations for so doing. These practices of observation, which Millard examines in particular detail by assessing the role of the Observation Ward at Edinburgh, led to a psychiatric intervention into what had been a problem within physical medicine (the ‘failed suicide’ became a psychiatric category that could be followed home once their health returned for further investigation). Psychiatric explanations began to be offered to explain why the person had done such violence to themselves. A complex picture emerged whereby self-harm (especially overdosing) was considered to be a cry for help rather than a genuine attempt to end a life. By focusing on the changing practices within psychiatric care, Millard offers a compelling explanation for the development of this new psychiatric category, rather than just following its emergence through the pages of the Journal of Mental Science. Although in Britain the main focus for this argument was on self-poisoning (which makes up the largest number of hospitalizations for self-harm), increasingly under the influence of American psychiatry, it is self-cutting that has come to embody the exemplar of the contemporary self-harmer.

Millard is at his most remarkable in his conclusion, where he expands his argument in brilliant fashion to discuss the movement of self-harm from a communicative indication of internal suffering to an individualised, neurological issue by mapping these changes in psychiatry onto the ideological changes that followed the demise of social ideals to an embrace of neoliberal ideologies. He writes:

‘This political shift broadly coincides and intimately corresponds to the much more individualistic reading of self-damage, based on emotional self-regulation.  Indeed, neo-liberalism’s stress on individual actor’s radical freedom to make choices for their own benefit fits well with a model of self-harm that emphasises the individualistic, private feelings of tension, and the regulation of these through cutting. The coincidence of neo-liberal political ascendency from the early 1980s in the United States and United Kingdom, and the displacement of the social setting from understandings of self-damage are not chance occurrences.’ (205)

Self-harm is one of many examples where psychiatric care has moved to emphasise individuals, who can be put on medication regimes, rather than the more communal view of mental health and community therapy that flourished between the 1950s and 1970s.

Sometimes the detail in both books could have been significantly lessened.  To pick two examples, Chaney’s discussion of Freud’s Wolfman, and Millard’s 6 page exegesis of Samuel Waldenberg’s MPhil thesis on wrist-cutting, could have both have been much shorter without losing any significance to the respective books; this is probably an artefact of the two books having been converted out of PhDs. Furthermore given the foucaultien framework that was developed by Ian Hacking and which has influenced these two authors, it was a little surprising that more was not said about resistance. Sarah Chaney does end her book by looking at the ways that some self-harmers have responded to their condition, by taking back their lives from the medical practices in which they were framed as self-harming, through the production of literary, artistic and even historical works. On the other hand, Millard’s book gives little sense that any of the sufferers were anything other than passive actors in a complex medical system – which sits a little uncomfortably with his critique of neo-liberalism, which may even encourage such radical self-determination. It would have been very interesting to think even more broadly about the ways that self-harmers actively resist these medical discourses – as can be seen, for example, on the kinds of internet discussion forums on self-harm (as examined by Helena Mattingley’s 2009 Edinburgh University MSc thesis on self-harm). The making up of people is – as Hacking realised – not simply a top-down process. Individuals sometimes respond directly to these psychiatric regimes, and have otherwise developed their own strategies to cope with their struggles.  Often, taking control of their own body –by cutting it, or via some of the many other bodily practices that are increasingly prevalent, such as tattooing, sadomasochism, or other extreme bodily practices – is often seen to give a sense of asserted autonomy in a world where people increasingly are regulated. Placing the self-harmers in relation to these other bodily practices would help break them out of the psychiatric framework in which they have been confined.  The body can be a site for resistance, as well as a frame for the deployment of power.

I strongly recommend these two books for anyone interested in the topic of self-harm. They show two faces of the history of psychiatry as it is currently emerging from the University of London, and should be widely read.

Ivan Crozier is an Associate Professor and ARC Future Fellow in the History Department, of The University of Sydney, Australia