Armando Favazza, MD, author of the seminal book Bodies Under Siege: Self-Mutilation and Body Modification in Culture and Psychiatry wrote this letter in 1998 as a response to the bill of rights for those who self-injure. He went on to collaborate with Deb Martinson on an article for the July 99 Psychiatric Times about the importance of this document.
Again, I am most impressed by your work in trying to raise self-harm into public consciousness and in establishing a NSIAD. Ok, for now I won't use self-mutilation: it's hard to know what to call "it" because of the broad spectrum of related behaviors. My use of "self-mutilation" is really neutral but I can see why people "hate"the term. I'm not so sure that SM speaks to intent any more than other terms do. Do people really want to harm or injure or destroy themselves? We agree that it is a coping mechanism (I refer to it as a morbid form of self-help) that does result in primary gain (the reduction of "symptoms") but it also can be a form of manipulation (secondary gain) especially in institutions such as prisons or mental hospitals. [...]
Here is a statement from me that you might want to use to help promote NSIAD:
"Self-injury is a public health problem that has been neglected too long. The Bill of Rights for self-injurers is a significant and important first step in bringing this problem into public consciousness and in addressing therapeutic considerations. The Bill of Rights is a unique document that deserves widespread attention. I wholeheartedly support it."
You should send a copy to the American Psychiatric and to the American Psychological Associations for inclusion in their newsletter/bulletin publications. Media types probably will want to talk with someone (they are impulsive!). They won't take the time to write for more information. I will be happy to field "professional" questions but you ( or a small committee of peers) should probably be available to handle questions about the bill and about NSIAD.
Armando R. Favazza, MD