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DVD - Interventions for Cutters Substituting Self Control for Self Mutilation
Cutters continuing education addiction counselor CEUs

Section 26
Prison Cutters:  Rebellion against Extreme Control & Boredom

CEU Question 26 | CEU Test | Table of Contents | Self-Mutilation
 Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

Self-mutilation is a “complex behavior in which people deliberately alter or destroy their body tissue without conscious suicidal intent, or willingly allow others to alter or destroy their body tissue.” “Deviant” self-mutilation is “private, impulsive, [and] idiosyncratic.” Defining deviant acts is a difficult task, but a useful index is “the atmosphere of risk, secrecy, and wrongdoing surrounding the behavior [as] a clue to the perverse nature of an activity.” This guideline points out the influence familial and social culture has on defining the abnormality of an action by teaching the individual to react to certain actions with shame or disgust.

Different types of self-mutilation were first explored by Karl Menniger in 1935 when he wrote about culturally sanctioned forms and pathological forms. Most culturally sanctioned body alteration is performed during initiation rituals in which children or adolescents are demarcated as social and sexual beings, contingent on both the process of initiation and the final outcome of the ritual. An example is the male and female circumcision rituals in the Maasai culture. Although the significance is somewhat different for males than for females, the Maasai ritual mutilation marks the end of childhood and entry into the adult world for both sexes. Bearing the circumcision pain functions as a symbolic acceptance of the burdens of adulthood and rebirth into a new social role. A Maasai warrior explains, “You must put all the sins you have committed during childhood behind and embark as a new person with a different outlook on a new life.” Endurance of pain plays a significant role in imparting meaning to the ritual, as does the final body modification. The initiate passes through the liminal stage and emerges to reintegrate with society. Individuals may be attempting a similar journey with their “private” and “impulsive” actions.

Western society typically views body modification rituals as barbaric and defines similar actions by individuals as pathological. As of 1988 the epidemiology of self-mutilation had been scantily studied, but several correlations with various personality disorders had been researched. Prison populations often self-mutilate, while more than half of the self-mutilating population admits to having experienced symptoms of an eating disorder. The occurrence of self-mutilation in these specific populations points out the importance of social milieu when interpreting acts of self-mutilation.

Self-mutilation in the prison population is a unique phenomenon in which to explore the nexus between self-mutilation and environment. As an environment designed to place strictures upon the human body, prison is an environment Mary Douglas would concede is the epitome of control of physical expression. However, instead of inmates acquiescing to the prison system that attempts to maintain their physical existence at a survival level in which quietness, order, organization, efficiency, and tightly controlled time and space are the norm, inmates may rebel against their restrictions. Although some inmates may react by following the norms, other members of the control-oriented environment react by resorting to nonphysical “ethereal” expressions such as religion.

Others subvert the control the system exerts over them in any way possible. One of these ways is to flaunt control over their body. A study of inmates shows that the one thing inmates feel they are able to control is their body. Instead of quietly submitting to a structured regime in which they are told when to eat, sleep, and exercise, many inmates rebel and perpetuate a subordinate inmate culture. The dominant prison strictures remain as an umbrella environment, while the culture created by inmates is so powerful that many inmates feel it is inescapable. Assimilating to the inmate subculture is a response to the extreme privation of inmate life, especially during long-term imprisonment.

Inmates as single individuals in the prison institution have little power. They are placed in a dependent child-like position in which they can make few choices. Inmates are deprived of adult roles and sexuality and have little control over their interactions with other inmates or the outside world. Although some prison environments have been constructed to be as domestic and comfortable as possible, most prisons are both understimulating because of lack of a variety of activities, and overstimulating because of inability to escape the presence of other inmates or of guards or to control the quality of interaction with them. “Minutely controlled, stripped of autonomy, his self-image under severe attack, the inmate solves some of his problems through absorption of the inmate code. As the inmates move toward greater solidarity- so it is suggested- the pains of imprisonment become less severe.” Part of the inmate code is maintaining a façade of toughness and strength under any circumstances. Tersely explained by one inmate, “You have to perform” according to the inmate code of etiquette. This is especially true of men in maximum security, long-term lockup but pertains to less restrictive incarceration and women’s prisons as well.

In a circumvented way, prisoners often use self-mutilation to maintain a façade of toughness and status within the inmate subculture, while trying to cope with the larger prison environment. Self-mutilation by inmates is a complex action whose messages are unique to each individual and often unclear, even contradictory. Inmate self-injury is meaningful on many different levels: it may result from a failed suicide attempt or from untreated mental illness. It is often an adaptive strategy to gain personal, individualized attention within the prison. This interpretation of inmate self-mutilation implies that the inmate is trying to reintegrate into a social milieu that will provide him or her with recognition of his or her own humanity.

It is well recognized that acts of self-injury in prison are often attempts to obtain medical or psychological care. An often verbalized reason for self-mutilating is the hope that the act will result in relocation to a different part of the prison. Inmates know that as a strategic ploy for attention, self-injury almost always works. “Less drastic moves are ignored and more drastic moves bring retribution.” In at least one instance, inmates self-mutilated as a group to call attention to their prison conditions. In 1971, 226 prisoners at the Kansas State Penitentiary in Lansing, Kansas, slashed their Achilles tendons in protest of a prison policy that they considered repressive. In 1952 three dozen inmates “maimed themselves in a desperate attempt to attract public attention to the evils, the inhumanity, and the futility of the Louisiana penal system.” Self-mutilation in prison may result in redress. As the act of a lone inmate, it results in medical and sometimes psychological care. It may or may not be successful in winning attention for other desires, such as relocation. Explained as a cunning attempt to achieve a specific goal, it may or may not preserve an inmate’s reputation as tough enough to cope with prison life.

Self-injury communicates more subtle messages that contradict the proclamation of imperviousness. Although inmates often claim that cutting or otherwise self-harming is a premeditated manipulation of prison staff and policies, it is often more than a conscious adaptive strategy. The act of self-injury in a routine and dull environment may indicate frustration and hostility induced by extreme boredom. Inmates often report that self-mutilation relieves tension, and many incidents of self-mutilation are performed while in solitary confinement. This echoes the motivations of self-mutilators who are not imprisoned and who also report physiological and emotional relief. In an environment where the inmate is unable to freely express any emotion that may be construed as weakness, such as depression or sadness, self-mutilation may be a voiceless gesture of despair. In the prison environment where any sign of anger or outright rebellion will be punished, self-mutilation may signal repressed rage. Some inmates who self-mutilate report a satisfied feeling of revenge against the oppressive prison system when they obtain costly medical care and attention from staff. One inmate’s comment clearly shows that self-mutilation is a plea to be recognized and accepted as an individual rather than just another inmate. “I want to be noticed in here, you know, noticed as a person, and they want to be noticed as a person, so they break up their cell, and they say ‘Wow, look I’m alive, I’m a person. You see this? I cut myself, I’m bleeding, I have blood in me just like you.’”

Self-mutilation is not limited to inmates serving long-term sentences. One study showed an 86 percent occurrence rate in the population of adolescent girls at a correctional facility. A study conducted in 1991 of approximately 10,000 inmates, only 350 of whom were women, at minimum, medium, and maximum security facilities, showed that 3.9 percent of the men self-mutilated over a period of three and a half years, while only 2 percent of the women self-mutilated during this time. Interestingly, this ratio is a reverse of the ratio in the general population, noted previously, in which women who self-mutilate outnumber men who do 1.5 to 1. In an environment where inmate culture provides the only cohesive daily community in a restrictive environment, self-mutilation seems to serve several functions. It reduces psychological and physical tension with a minimum of negative repercussions from prison staff and other inmates. It expresses emotions that are not otherwise able to be articulated. Most important, it necessitates response from prison staff that confirms the inmate’s worth, and reminds the inmate that his or her flesh and blood are connected to the flesh and blood of all humanity Like the self-mutilator who cuts to emerge from a state of disassociation, the inmate is using the body to reintegrate into the corpus of the human race.
- Hewitt, Kim; Mutilating the Body: Identity in Blood and Ink; Bowling Green State University Popular Press: Ohio; 1997

Personal Reflection Exercise #12
The preceding section contained information about self-mutilation in prison. Write three case study examples regarding how you might use the content of this section in your practice.

Peer-Reviewed Journal Article References:
Griffiths, L., Bailey, D., & Slade, K. (2020). Exploring the listener scheme in a women’s prison: The importance of a gendered approach to peer support for women who self-harm in custody. The Journal of Mental Health Training, Education and Practice, 15(6), 347–360.

Martin, M. S., Potter, B. K., Crocker, A. G., Wells, G. A., Grace, R. M., & Colman, I. (2018). Mental health treatment patterns following screening at intake to prison. Journal of Consulting and Clinical Psychology, 86(1), 15–23.

Walker, T., Shaw, J., Gibb, J., Turpin, C., Reid, C., Gutridge, K., & Abel, K. (2021). Lessons learnt from the narratives of women who self-harm in prison. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 42(4), 255–262.

Online Continuing Education QUESTION 26
According to Hewitt, what are six reasons inmates may self mutilate? Record the letter of the correct answer the CEU Test.

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