Abstract
Kay Inckle, Flesh wounds? New ways of understanding self-injury. Ross-on-Wye: PCCS Books, 2010. 244 pp. £18.00. ISBN 9781906254292 (pbk)
This beautifully crafted and moving book begins with a warning to the reader to ‘practice self-care’ when reading this book. It is the culmination of a two-year research project and is ‘intended as a resource for people who hurt themselves and for those who live and work with them’ (p. 1). This may appear to be another self-help book, promising to make the reader assertive, stress-free, successful or slim; but this book is not like that. The topic of this work is serious: it is about people who are in pain and who harm themselves. This work is neither didactic, nor does it proselytize and, most important of all, it does not judge and it guides the reader in not judging either.
The main part of the book is a series of fictional narratives drawn from the interviews, focus groups and other material gathered from the research project. The appendices contain further information for the reader: guidance on methods of harm-reduction, details of organizations offering support and an explanation of the methodology used. The appendices ground the work in current theory and practice, ensuring that there is help available should any reader require it. Inckle describes her approach as ‘ethnographic fiction’ and she cites the anonymity of the subject as a major benefit of this approach. The stories are a kind of bricolage, or collage made up from excerpts, incidents, moods and feelings from a variety of sources and subjects. No one story is attributable to one person. Thus, Inckle believes that she is able to give voice to subjects who would not otherwise have spoken so frankly, if at all. Inckle also argues that a more conventional approach, such as the use of case studies for example, would not allow for the expression of the complexity of the subject matter. She feels that a set of findings and a conclusion and list of recommendations would be an inappropriate response to a deeply personal and individual issue. Using the narratives, Inckle demonstrates that each incident of self-harm is different and should not be codified or ‘treated’ in a proscribed manner. She quotes a member of the UK-based Bristol Crisis Service who states: ‘It’s about where that person is at a certain time. It is not fixed, directional.’ (p. 214). There is no predictable prognosis and this book shows that it would be futile to expect one.
The use of creative writing allows for an emotional response to the research, which Inckle argues will add impetus to a desire for greater understanding and for a change in approach and attitude to those who harm themselves. The stories are beautifully written. They are compelling, but never heavy handed; there are no lengthy descriptions to slow the pace. Although the characters are almost sketches, the reader empathizes with them. In the first story, ‘Faggot’, the main character’s parents are understood by their response to their son and his suffering. His mother is tearful, her face ‘like a skin treatment gone wrong’ (p. 22) is contrasted with her husband who is bulky and masculine and out of his depth. As he works towards a healing process, Connor uses painting and the description of the paint mirrors the description of the blood seeping from his pale skin. Later he learns to slash and cut the paint onto the canvas. Reading this piece made me cry. The pain inflicted on Connor, the physicality of the attack, the numbness and lack of power and his overwhelming desire to retreat into a space in which he could no longer feel anything, is deeply disturbing and distressing. The description of him cutting his flesh is alarming because, in this context, it makes sense. This is one of the reasons for the warning in the introduction to the book. Connor eventually finds that painting is an alternate means of expression and also a means of recreating his sense of identity. A brush replaces a knife or a pair of scissors; but this is not a complacent conclusion. The first incident in the story makes it clear that Connor is still fragile.
The stories feature a range of subjects, male and female, gay and straight, from a variety of backgrounds. They are set in Ireland and sometimes one wonders if the reactions of the characters are uniquely Irish. Unfortunately, one concludes they are probably not. The attitude of health professionals to the self-harmers especially in ‘Normal’ was puzzling. It was not unbelievable; but it appears to be almost callous. It is a strength of this book that the reader is able to penetrate the official viewpoint on self-harmers and to empathize with them. However, as mentioned previously, there is a potential danger in too close an empathy. Inckle does not condemn those who harm themselves, but it is implicit in the book that this is not desirable behaviour. It is generally born out of pain and it is the cause of the pain that should be addressed, slowly and with sympathetic and informed help.
One possible criticism of the book is that it is almost too well written. It is possible to slip into the comfort zone of a practised reader of good fiction. It is necessary to remember that this work is not about well-constructed sentences, impressive metaphors and powerful imagery. One wonders if some readers would question the truthfulness of the stories, they are fiction after all. Perhaps for some readers, there is an escape from the searing realism of the narratives by dismissing them as fictional? Some fiction is read for the thrill of it, safe in the knowledge that when the book is closed, the horrors are contained within the pages. This book does not set out to entertain and the fact that it is so readable is a distinct advantage as the subject matter is so challenging. Any criticism of the methodology is far outweighed by the effectiveness of the material covered. The stories allow outsiders to glimpse the mindset of people who resort to harming themselves. It is to be hoped that self-harmers may benefit from reading the experiences of others and knowing that they are not alone.
This book is professional, caring, non-judgemental, informative, haunting and disturbing. It makes a huge contribution to the subject area. It is also a superb example of the use of ethnographic fiction as a means of conveying the personal and often hidden narratives of vulnerable people. This book exposes hidden suffering and opens the area for further discussion and understanding.