The multifaceted meanings of a symptom

In this chapter, Papadima offers a brief historical overview of what self-harm through cutting has signified across different periods and contexts, and how those meanings have shaped our current psychiatric and psychological view of the phenomenon. She offers both psychoanalytic and sociocultural perspectives, drawing on the work of Sarah Chaney and Armando Favazza. Papadima argues that cutting should be understood as a symptom rather than a disorder in itself and thus has to be viewed both on an individual basis – as a unique expression of a young person’s particular distress – and within a broader social and peer-groups context. The author refers to self-harm via cutting as separate from suicidality and explains the importance of this difference, suggesting that there are multiple types of self-harm via cutting that the psychoanalytic clinician, and any professional working with self-harming adolescents, needs to have in mind. The author concludes by underlining the importance of careful risk assessment to formulate what type of self-harm the young person is engaging with and, thus, to make a treatment plan tailored to that.