Book reviewIntegrated Media and Book Review Editor:

Dr Francis C. Biley

Submissions address:

IHCS, Bournemouth University, 1st Floor Royal LondonHouse, Christchurch Road, Bournemouth, Dorset BH13LT

The Tender Cut: Inside the HiddenWorld of Self-Injury

Patricia A. Adler & Peter AdlerNew York University Press, New York2011, 252 pages, £15.99 (PB)ISBN 978-0-8147-0506-3

This book aims to examine ‘the sociological natureof self-injury’ (p. 22) in two ways. Firstly, theauthors state that they wish to perform a sociologi-cal analysis on their wealth of collected data, thus‘expanding the understanding of self-injury beyondthe way it has traditionally been conceptualized bythe psycho-medical establishment’ (p. 22). Sec-ondly, they aim to demonstrate how the ‘populationof self-injurers has spread from a narrow, clinicallyconceptualized base into the broader reaches of themainstream’ (p. 22). I approached this book keen toexplore experiences of self-harm from a differentperspective, sociological rather than psychological.And while there is much to be praised about thislargely compassionate and insightful book, not leastin the sheer breadth of Adler and Adler’s research,and in some of the insights they provide into thecyber-social world of self-harm, there were also ele-ments of the book that I found slightly less usefulfrom a clinical perspective.

To begin with the positives however. Firstly, thisbook provides a useful sociological perspective onself-injury that has not previously been exploredthoroughly. In terms of their chapter on the phe-nomenology of self-harm, the authors do much tobring about the voices of the ‘hidden’, non-clinicalpopulation of people who hurt themselves to thefore. This is useful when much other literature onthe topic pathologises self-harm as always indica-tive of a mental health issue of some form. Thisdominant, pathological view of self-harm stands incontrast to the wealth of personal narrative in thisbook which highlights the fact that many individu-als function highly in their personal and profes-

sional lives while their self-harming remainsshrouded in secrecy. Adler and Adler provide muchcommentary and thought on the online or cyberworld of self-harm, in particular providing a usefulcomparison of this and the online ‘pro-anorexia’communities. Examining, qualitatively, notions ofsupport, community and recovery through an arrayof online message boards and chat rooms, amongother online arenas, Adler and Adler give light to anarea that has previously been under-researched,and their arguments here are detailed and wellconsidered.

There were some areas of the book that werepresented somewhat uncritically – in particular, theassociation of Goth or Heavy Metal music andself-harm. This is an area that on occasion is pre-sented as a factual interrelationship through a fewbrief words from individuals, and this area wouldhave benefitted from a more detailed representa-tion. There were two other issues that I have withthis book, both of which jarred with me and led tomy leaving the book alone for a week or so. Thefirst of these came in the language used to describesome of the individuals who contributed to thisbook. For example, ‘Barb, the Swiss-army-knifecutter’ (p. 98). It may be personal preference, but Idisliked this kind of naming, though I can see howthey aimed to guide the reader through the myriadof personal contributions. Secondly, while I under-stand that the sociological formulation of deviantbehaviour involves, and I apologize for my verycrude understanding here, examining differentgroupings or subcultures for commonalities, theirexploration of ‘deviance’ of self-harm did at timesuse unhelpful comparisons. One example talks of‘loner deviance’ and compares people who self-harm with ‘other deviants such as embezzlers,rapists, physician and pharmacist drug addicts,paranoids, suicides, sexual asphyxiates, andbulimics and anorexics’ (p. 95). While I can appre-ciate that the sociological behavioural formulationof ‘loner deviance’ may be the same for these

Journal of Psychiatric and Mental Health Nursing, 2012, 19, e4–e5

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groups, I personally struggled to see the need for thecomparison, both here and on several other occa-sions in the book. Perhaps it seemed to me to riskstigmatizing self-harm in the same way as rape andcriminality.

Overall however, I do feel that this book is auseful addition to the literature on self-harm, whichwould be a beneficial read to students and cliniciansalike.

CHARLEY BAKER BA MA

Lecturer in Mental HealthSchool of Nursing

Midwifery and PhysiotherapyUniversity of Nottingham

NottinghamUK

E-mail: charlotte.l.baker@nottingham.ac.uk

Book review

© 2012 Blackwell Publishing e5