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Menninger, K.A. (1935). A Psychoanalytic Study of the Significance of Self-Mutilations. Psychoanal Q., 4:408-466.

(1935). Psychoanalytic Quarterly, 4:408-466

A Psychoanalytic Study of the Significance of Self-Mutilations

Karl A. Menninger

SUMMARY

Let us now try to get together the evidence contained in these studies that points to the motivation for self-mutilation and attempt to answer some of the questions raised in the beginning.

We see that self-mutilation is to be found under widely varying circumstances and conditions, including psychosis,

neurosis, religious ceremony, social convention, and occasionally as a behavior symptom in certain organic diseases. From representative examples of all of these we are able to detect certain motives in a fairly consistent pattern.

It would appear that self-mutilation represents the surrender or repudiation of the active rôle, accomplished through the physical removal or injury of a part of the body. Even if there were not already abundant psychoanalytic evidence to the effect that the prototype of all self-mutilation is self-castration, there would be strong reasons for inferring this from our material, in which we frequently find self-castration to be undisguised; and in the cases in which another organ or part of the body is substituted for the genital, the associations, fantasies and comparable analogies make it clear that the substituted organ is an unconscious representative of the genital. This may be, as we have seen, either the male or female genital but has the significance of activity generally associated with the male genital. This sacrifice of the genital or of its substitute appears to satisfy certain erotic and aggressive cravings and at the same time to gratify the need for self-punishment by a self-inflicted penalty.

The aggressive element in self-mutilation can be of both the active and passive variety. The act of self-mutilation can be directed toward an introjected object, as in the examples of those persons who, hating someone else, cut off their own arm, a process epitomized in the familiar expression of "cutting off one's nose to spite one's face". The passive form of aggression is even more conspicuous because it is directed toward real rather than fantasied objects; the provocative behavior of nail-biting children or of malingerers, who so exasperate their friends and physicians, clearly illustrate this.

The erotic gratification achieved by the surrender of the active in favor of the passive rôle is partly dependent upon the innate bisexuality of everyone and the unconscious envy on the part of men of the female rôle. There is also a tendency, however,

on the part of the erotic instinct to make the best of a bad bargain and to exploit the consequences of this rash expression of the aggressive, destructive tendency by erotization. In this sense the erotic gratification of self-mutilation is both primary and secondary.

Finally, there is the self-punishment implicit in self-mutilation, which has the curious Janus-like property of looking both forward and backward. The self-mutilation atones or propitiates by sacrifice for the aggressive acts and wishes of the past, and it also provides an anticipatory protection as if to forestall future punishment and permit further indulgences by the advance payment of a penalty. Incident to the latter, self-mutilation by the sacrifice of the aggressive organ safeguards the individual against the possibility (and therefore the consequences) of further active aggressions.

Our material does not enable us to dilate upon the nature of the aggressive fantasies from which the sense of guilt arises beyond saying that they are connected with castrating or mutilating fantasies originally directed toward the parents and siblings. We know from the work of many analysts that these are usually connected with the Oedipus complex and arise from the wish to kill or castrate the father and take the mother, or to kill or mutilate the mother for "faithlessly" preferring the father or a sibling.

It would appear from this summary that self-mutilation is the net result of a conflict between (1) the aggressive destructive impulses aided by the superego and (2) the will to live, whereby a partial or local self-destruction serves the purpose of gratifying irresistible urges and at the same time averting the prelogical but anticipated consequences thereof. The reality value of the self-mutilation varies greatly; the symbolic value is presumably much the same in all instances. To the extent that the psychological needs can be met by a symbolic self-mutilation with minimum reality consequences, as in such socialized forms as nail-trimming or hair-cutting, for example, the device is a useful one; but in those individuals whose

reality sense is diminished or whose conscience demands are inexorable the device is harmful.

In any circumstance, however, while apparently a form of attenuated suicide, self-mutilation is actually a compromise formation to avert total annihilation, that is to say, suicide. In this sense it represents a victory, sometimes a Pyrrhic victory, of the life instinct over the death instinct.

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