Skin as ‘Mother’

In our role as analysts/therapists, we often face behaviors that defy simple explanation. That they can appear regularly in certain kinds of patients can lull us into thinking that we understand phenomena that remain puzzling and intriguing theoretically. I am thinking specifically of the frequent practice of self-cutting that occurs with borderline and other more impulsive patients. When asked about this behavior many of these patients offer a similar explanation: namely that seeing the blood causes a diminution in anxiety and that pain, which we would think might be present, is not experienced in the moment at all. Certainly there is an obvious connection to the extreme masochism these patients exhibit; but the peculiar choice of self-punishment requires further explanation. The general focus on “skin eroticism” has certainly been discussed and would fit nicely with sado-masochistic expressions that combine sexual excitement with sadistic punishment. It is my view that there is a close relationship between “mother” and the skin itself. In its grossest manner, skin is the first boundary; it is also the way “mother” as she begins to emerge from part-object is appreciated both as a giver of pleasure (soothing/stroking) and pain (rough handling/being left cold or wet). These early defining interactions with the first object make the skin in some sense, where mother can be found and further, where mother can be attacked. In our more symptomatic patients, who have had extraordinarily frustrating relationships with their mother, cutting must also be thought of as a way of expressing the less overt sadism of our patients who can do no more than impotently slash at the earliest remnants of that often very problematic relationship. I would be interested if there are other clinical situations that may support this supposition.