ABSTRACT
Self- destructiveness. a common feature of mental illness, may afflict the psychological self, the bodily self, or both. In psychological self-destructiveness, motivations of varying psychodynamic complexity are discernible, often involving guilt regarding internal objects and deriving from destructive and reparative desires. Bodily self-destructiveness takes various forms, of which the most common is self-poisoning with prescribed or other drugs. Of all forms of self-harm, burning by fire is the most dramatic and rare, and it is one of the most difficult to understand. An investigation undertaken with colleagues at the Maudsley Hospital approached the subject in the following way:
Acts of self-poisoning, cutting, jumping and hanging are often explicable in terms of depressive or destructive motivations, the choice of methods being determined by what is available, occasionally with imitative or symbolic significance. Minor self-mutilation, which includes selfcutting and less often small burns with cigarettes is encountered frequently, particularly in female adolescents 48and young adults with personality disorders or in association with anorexia nervosa. It is usually repetitive, causes little harm and is not a suicidal act. Although studies of self-cutting are highly informative regarding clinical and motivational correlates, they do not explain the psychopathology or clinical features of major self-mutilation (amputation, castration, blinding, tooth avulsion) which appears to be both a rare and more psychotic act. Fatal or potentially fatal self-burning is an extreme form of self-mutilation and needs to be distinguished in its clinical and psychosocial aspects from minor self-burning and from other violent self-harm. Although death may ensue, suicide may not necessarily be the conscious intent. [Jacobson, Jackson, & Berelowitz, 1986]
