In this comprehensive and insightful work, Dr. Sharon K. Farber provides an invaluable resource for the mental health professional who is struggling to understand self-harm and its origins. Using attachment theory to explain how addictive connections to pain and suffering develop, she discusses various kinds and functions of self-harm behavior. From eating disorders to body modifications such as tattooing, Dr. Farber explores the language of self-harm, and the translation of that language and its psychic functions in the therapeutic setting. She tells us, 'When the body weeps tears of blood, we need to wonder what terrible sorrows cannot be spoken.' Brilliantly illustrated with rich clinical material, this book offers a practical approach to the diagnosis, assessment, and treatment of the increasing number of patients whose emotions are expressed through bodily harm. The challenges of working with patients who tend to view the world of relationships in terms of predator and prey are clearly explicated and the stormy countertransference responses that threaten to destroy the treatment are given a full hearing. Finally, she shows how the attachment relationship formed in treatment can repair the traumatic attachment in mind, body, psyche, and soul, and can serve as the cornerstone of therapeutic change. A Jason Aronson Book
Sharon Klayman Farber, Ph.D., is a Board Certified Diplomate in clinical social work practice in Hastings-on-Hudson, New York. Dr. Farber earned her Ph.D. in clinical social work from New York University, and trained at the Institute for the Study of Psychotherapy and privately in psychoanalysis and child treatment. She is the founder of Mothertalk, a parent guidance group, and Westchester Eating Disorders Consultation Services. In addition to teaching, writing, and supervising, she maintains a general practice with specializations in child and adolescent treatment and treatment of people with eating and other psychosomatic disorders.
Table of Contents
Part 1 The Borderland of Self-Harm Chapter 2 The Mystery of Self-Harm: Concepts and Paradoxes Chapter 3 How Common Is Self-Harm? Chapter 4 Not Wanting to Know about Self-Harm: Trauma, Violence, and Chronic Mental Illness Part 5 Neglect, Violence, and Traumatic Attachments Chapter 6 Suffering and Self-Harm: Treating Oneself as the Other Dehumanization of the Other and Violent Suffering Chapter 7 How Attachments Go Haywire Chapter 8 The Psyche-Soma and Traumatic Attachments to Pain and Suffering Chapter 9 Survival and Sacrifice: When the Prey Becomes the Predator Chapter 10 Trauma, Duality, and the Transformation from Prey to Predator Part 11 The Body Speaks Chapter 12 The Body Speaks That Which Cannot Be Spoken Chapter 13 Self-Harm, Gender, and Perversion Chapter 14 The Addiction to Wanting: "Do Not Want What You Cannot Have" Part 15 Clinical Implications Chapter 16 The Attachment Paradigm Chapter 17 Diagnosis, Assessment, and Core Features Chapter 18 Using Attachment Theory in Therapy of Self-Harm Patients Chapter 19 Transference, Countertransference, and Enactments Chapter 20 From Self-Harm to Self-Reflection
Edward J. Khantzian, M.D.Clinical Professor of Psychiatry, Harvard Medical School Using clear and incisive language, Dr. Farber elegantly and empathically cuts to the core of the extreme suffering that our patients who repeatedly harm themselves endure. She provides an exhaustive, scholarly review of the underpinnings of self-mutilation and related behaviors in this beautifully written book. She then goes on to present one of the most sophisticated theoretical and clinical explanations to date showing why these behaviors have become so pervasive, how we can understand them, and what we can do to alleviate the suffering that is at the root of such disorders.
Martin S. Bergmann
Martin S. Bergmann Clinical Professor of Psychology, New York University Post-doctoral Program in Psychoanalysis and Psychotherapy Few patients evoke in their therapists the kind of dread that those who continue to mutilate themselves during treatment do. Dr. Sharon Klayman Farber earns our gratitude for venturing deeply into this difficult domain. Every therapist treating these patients will learn a great deal from this book, but beyond the immediate, all those who are puzzled by the nature of human aggression will appreciate the many insights the author has assembled.
David W. Krueger
David W. Krueger, M.D., F.A.P.A.Clinical Professor of Psychiatry, Baylor College of MedicineTraining and Supervising Analyst, Houston-Galveston Psychoanalytic Institute When the Body Is the Target integrates and transcends psychodynamic and developmental theories applied clinically to our most difficult-to-understand self-destructive patients, whom we have nicknamed borderline, narcissistic, sadomasochistic. In a brilliant and unique work, Dr. Farber helps us to see the genius and hope of the symptoms of those who articulate self-harm in the lexicon of their bodies, to understand the creative attempt to reveal and conceal that which is inchoate and unformulated, and to listen to how the body speaks. "With rich case material using the prototypes of eating disorders and self-mutilating behaviors, this is a definitive and comprehensive theoretical, developmental, and clinical reference work, eminently readable.
