Psychoanalytic Psychology, Vol 42(3), Jul 2025, 149-158; doi:10.1037/pap0000542
Female patients in mental health care services with extensive experiences of deliberate self-harm were invited to personal interviews about what was happening in their body and in their mind when they cut their skin. A series of 12 cases revealed the symbolic potential of skin cutting as a “staged” event, where each step—from cutting and bleeding to the formation of the wound, scab, and scar—represented emotional and embodied experiences that could not otherwise be expressed. In this article, we have explored this potential and the qualities the skin offered to the women who severely harmed themselves. We identified three main themes in the personal histories of these women: Their self-harming activities had a source in their personal histories of being exposed to boundary violations; cutting was an activity that gave them an experience of a “leaking” self; and cutting represented intense and unbearable emotions. The findings are discussed in the context of Joyce McDougall’s use of the theater as a metaphor for psychic reality as well as the psychoanalytic theories of trauma and second skin formation. Finally, we argue that psychological dramas related to shame may fit the “skin stage” particularly well. (PsycInfo Database Record (c) 2025 APA, all rights reserved)