Shame and Medicine Exeter
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Shame and Self-harm: Association and Avoidance

In Imogen Tyler’s recent monograph, Stigma: The Machine of Inequality, she opens the introduction with a vignette describing her conversation with Stephanie, a woman who talked about her experience of joblessness, poverty, and housing and unemployment benefits. The vignette is powerful, and serves as an apt introduction to Tyler’s deft and vital exploration of austerity, race, and stigma’s function as a strategy of government. Yet I was struck by the role which self-harm played in Stephanie’s story and experience; Tyler tells of the “stigma words” which she cut into her body, a literalisation of the shame and dehumanisation society and the welfare system had enacted upon her.  (15/354) While Tyler goes on to think in some depth about the historic association of stigma with bodily markings she does not return to the topic of self-harm: yet its presence at the opening of her work did not seem incidental to me. Rather it seemed to confirm something that I already half-suspected; that self-harm’s association with shame and stigma is so self-evident as to need no explanation, no discussion.

This is not a conclusion which I came to easily or enthusiastically; when I began my doctoral work exploring fictional representations of self-harm and their interpretation by people who have self-harmed I didn’t assume that shame would be at the centre of the project. Rather I was keen to jettison it as an organising construct, to refuse to take it for granted that self-harm either was shameful or was straightforwardly a response to shame. And certainly I can comfort myself with the fact that it’s good scholarly practice to try not to take things for granted, but in this case I’m not certain that my main motivation for caution around the concept of shame was academic rigour. Instead, if I’m honest I think that it was something a little more personal: I think it was my own shame, and my discomfort with it.

I think I spent a lot of time in my own life hoping that if I simply believed, very hard, that self-harm was not inherently shameful then I could avoid being ashamed. I didn’t want to treat each act of self-harm as a failure, as a relapse: I didn’t need another thing to beat myself up about, and I certainly didn’t need anything else to be ashamed of. And this worked, a bit – but instead of working to eradicate shame I think it worked to ringfence shame, to contain it, to avoid it, to perhaps make it smaller but simultaneously to make it take deeper root.

I didn’t see this until I started conducting interviews with people as part of my project, talking to them about the representations of self-harm they’d come across, what they’d thought of them, how they’d made them feel. I soon realised that, no matter what my starting point, there was no avoiding shame: it was everywhere, sometimes explicitly and sometimes implicitly. People talked about feeling shame when watching characters self-harm, whether simply because something that felt private was being brought more explicitly into the social sphere, or because the representation felt inaccurate and hackneyed. Alternatively other people talked about shame at failing to live up to what representations suggested was the most acceptable form or trajectory of self-harm. People talked about feeling shame in watching a character who self-harmed being treated as a frustrating problem who simply caused trouble for those around them. And people talked about feeling that texts explicitly portrayed self-harm as something shameful, something associated with brokenness and failure, and that such representations made them more desperate to keep their own self-harm secret. Most importantly, perhaps, in each of these discussions I felt, in an embodied, almost non-cognitive way, the potency of shame: its power and its pain.

I think these experiences might contain some insights into shame, some directions for thinking and working. First, they might encourage us to think of shame as something which moves, something which “circulates”, to use Sara Ahmed’s frame (2004), but not only between bodies: rather here we see shame circulating through literature, films, and TV, through both the text itself and its reception. We might consider not just how shame is represented in texts but how it arises within or is transmitted through them, how reading or viewing might become a shameful experience even without shame being explicitly depicted. Second, these accounts might encourage us to think of shame as something which multiplies: over and over it seemed like there was a doubling movement, in which shame within a textual space became shame outside of it, in which a character’s shame became a person’s shame. Third, taking these two previous avenues of thought into account, we might consider shame as something uncertain, something which is hard to pin down, particularly in the context of self-harm. As all the different experiences outlined above might suggest there was not just one way that shame was experienced, not just one sort of representation which engendered shame, and not just one aspect of self-harm which was understood to give rise to shame. For all that the association of shame with self-harm might, from a distance, seem self-evident, upon closer examination there were myriad ways in which shame interacted with self-harm both in lives and in texts.

Which returns me, perhaps, to my starting point: how to address the significance of shame in relation to self-harm without simply re-inscribing, over and over, self-harm as something which is rightfully shameful. One of the moments within the interviews that I have returned to most is a comment made by Margaret, a heterosexual white, Jewish woman in her 60s, who had come from a working class background. Towards the end of our discussion I asked what she’d like to see in depictions of self-harm, and she referenced a video she’d watched of a short talk I gave at a public event, and said this:

“I think I would like, and actually this is kind of a new way of looking at things for me, since hearing you talk. I have never seen self-harm as anything except some dreadful, shameful, hideous thing to do that you hide from other people. But actually, when you talked about it being a means of coping with pain, I thought, well yeah, you know, bloody obvious really. […] So I think it would be good if there were stories, if there were fictions of, of self-harm, which showed it as a, as a tool, rather than as a sin.”

I think a lot about the experience of living for many years with the feeling that self-harm is dreadful, shameful, hideous. I think about how desperately important it feels to find other ways of talking about and understanding self-harm. And I think about how hard it might be to strike a balance between paying attention to these huge, vital experiences of shame and its cruel influence, and the need to find other ways of living that don’t start with shame. I know for certain that such a balance can’t be found through avoidance: instead perhaps it might start with space, space for shame and space for its absence in our thinking, our writing, our lives.


Veronica Heney, University of Exeter


Works referenced:

Tyler, I., 2020. Stigma: The machinery of inequality. Zed Books Ltd.

Ahmed, S., 2004. Cultural politics of emotion. Edinburgh University Press.














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