Starting off, we firstly would like to congratulate and thank the many non-self-abusers and intellectually underdeveloped overpriced psychiatrists, for really screwing us up and blaming it on our parents.

Secondly, we would like to thank our parents, thanks (a lot, we really mean it).

Shit, whereto now?

The Scar Report

In 1872,a mental-asylum patient in Utica, New York, stuck 300 needles into her body. Her form of self-torture was common enough that doctors had a name for those who practised it: ''needle girls.'' Diagnosed at the time as hysterics, needle girls sometimes pounded and rubbed shards of metal until they submerged under the skin and even punctured organs. The psychiatrist and author Armando Favazza has speculated that needle girls may have been inspired by ''human pincushion'' vaudeville acts. Or maybe they were simply acting out the way corsets and girdles pinched their bodies, and Victorian morality punished their souls.

In the 1987 publication Bodies Under Siege: Self-Mutilation and Body Modification in Culture and Psychiatry, Dr. Favazza offers a cross-cultural and historical view of various self-mutilating acts. From Christian mortification of the flesh, to tattooing and piercing, to self-castration and eye enucliation, to the contemporary behaviour Marilee Strong focuses on in A Bright Red Scream: cutting. Strong's book is in many ways a pop-psyche take on Favazza's work, as she's quick to admit. Favazza wrote Scream's foreword, and Strong, a journalist who's not afraid of research, repeatedly cites him and others who have worked with and studied cutters for years. She embraces Favazza's view that self-injuries are evidence of a life wish, not a death wish--that people who slash and burn their skin are trying to heal themselves by expressing pain or anger. Like Favazza, Strong also says cutting should not be understood simply as the act of psychotic individuals: ''their activity tells us something about ourselves as a society.''

It's rare that self-mutilation gets such enlightened treatment. Usually cutting is understood as an attention-getting stunt that backfires by distancing people. Cutters may also have trouble being taken seriously because the majority of them are women. Of the estimated 2 million cutters in America, the average one is a white woman in her late twenties who began hurting herself when she was 14. Strong interviewed more than 50 self-injurers for Scream, and their testimonies punctuate the book, putting faces to statistics.

We meet the 30-year-old born-again schoolteacher who hides her cuts behind her wristwatch; the college freshman who burned her hand 48 times with a hot iron; and the 53-year-old Jewish mother who describes her scar-covered arms as ''patchwork quilts''--sometimes she uses her blood to draw Stars of David and swastikas.

The publisher's marketing geniuses are positioning Bright Red Scream as similar to Reviving Ophelia and other books about girls in peril. Suddenly cutting is a trendy subject: this is the second book this year on it (Steven Levenkron's Cutting: Understanding and Overcoming Self-Mutilation is more self-helpy), and The New York Times Magazine ran an insightful cover story on self-mutilators last year. Many observers have compared the emergent public focus on cutting to the attention paid to eating disorders 10 years ago. The connection is direct: An estimated 35 to 80 percent of self-injurers are or have been anorexic or bulimic. In 1995, Princess Diana confessed to having purposely cut herself several times, as well as to being bulimic. Like many friends and relatives of cutters, Prince Charles responded by turning away.

It's crucial not to follow Charles's footsteps as the girls--and boys, and men and women--tell their often-gruesome stories in A Bright Red Scream. But it's also crucial to be sceptical when a long-extant phenomenon is suddenly hyped as ''epidemic'' (as Levenkron has labelled it) and, therefore, has the makings of a best seller. When blood and sex figure so prominently in the subject, our sensationalism radar's should go on red alert. And sure enough Strong undermines her own argument for empathy by focusing on extreme practitioners of self-mutilation and reductively dragging out their abuse pasts.

Favazza's research indicates that 50 to 60 percent of cutters were sexually victimised as children, and Strong is at her impassioned best synthesising and explaining the data--and lack of data--on abuse, disassociation, post-traumatic stress disorder, and serotonin. While cynics may feel like they've been culturally inundated with these topics, Strong argues that in fact research institutions have been reluctant to fund studies of abused children. ''There is little public support for a 'war on child abuse' like there is for cancer and other health problems,'' she writes. ''Researchers . . . who are bringing the light of hard scientific inquiry to the problem can only hope that their work will help put child abuse on the national agenda.''

But what about the 1 million cutters who weren't abused? Clearly moved by her interviewees' harrowing tales, Strong makes the mistake of searching for an evil stepparent in everyone's past--even when her own research tells her to do otherwise. Like Favazza and others, she connects the apparent (but undocumented) rise in self-injury to the current mania for tattoos and piercing. Does that mean everyone with a nose ring has an abuse past? What are we then, a society of molesters and molested?

In a way, yes. But Strong misses the more nuanced strains of abuse in our culture. Too busy digging up sordid family trees, Strong ignores the forest of ambient sexual harassment. In the same way needle girls were a Victorian phenomenon, cutters are reacting to what's been called today's neo-Victorianism, wherein bodies are presented as corseted items that give their owners no pleasure. Self-injurers express the confusion of an era that clings to Puritan values while slobbering over breast implants, that tells women to be sexy then calls them sluts, that loves Madonna and hates Madonna. Women start injuring themselves at 14 because that's the age they become sex objects, cutting is a way of punishing the flesh and regaining control of it. As Favazza predicted, cutters tell us what's wrong with the society at large--that we hate our bodies.

Strong also veers off course when she recommends that drugs play a major role in self-injurers' treatment. While anything that keeps a woman from singeing her arm black with oven-cleaning chemicals is fair game in the short term, it's dangerous to think we can narcotise our problems away--that if we fill women up with Prozac, we'll all feel better. Strong titled her book A Bright Red Scream because she believes self-injuries are cries of distress, not failed suicides. If we mute those cries, how will we know there's a problem?

In many cultures, shedding blood is integral to healing. Strong shines a bright light on why people harm themselves, but even she misses one of the obvious reasons: In an information-overloaded, machine-driven, alienating world, cutters draw the blood that connects us all and shows we're alive. Cutters aren't heroic, but they are an index of what's wrong, not just with themselves, but with culture as a whole.

Evelyn McDonnell writes for Interview, Swing, and Rolling Stone.