Book Review: Bodily Harm

By: Michael Clarkson-Hendrix, MSW

Conterio, K., and Lader, W., with Jennifer Kingson Bloom. (1998). Bodily Harm: The Breakthrough Healing Program for Self-Injurers. New York: Hyperion. 317 pages, $16.00 U.S., $22.00 Canada.

Bodily Harm: The Breakthrough Healing Program for Self-Injurers is a self-help book written by the program director and clinical director of the SAFE (Self Abuse Finally Ends) Alternatives program, with the help of a former New York Times reporter. The book is divided into two parts. The first part begins with a description of self-injurious behavior seen in female young adults and female adults. The authors argue the roles of biology and environment in the onset and maintenance of this behavior, and talk about the connections between self-injurious behavior and other impulse control disorders, especially eating disorders. There is a focus on the role of trauma and its influence on the development of self-injurious behavior. A chapter is included on self-injury in adult males.

The second part explains some of the intervention tools developed by the SAFE Alternatives program. The SAFE Alternatives program’s philosophy is for the self-injurer to use the “window of opportunity” between the thought to self-injure and the self-injurious action to make safe alternative choices instead of injuring himself or herself. Examples of some of the intervention tools created by the program are the Impulse Control Log, the No-Harm Contract, and the SAFE Journaling Assignments.

Throughout the book, the authors provide vignettes from people who were participants in the SAFE Alternatives program. These vignettes provide real-world information and feedback on the authors’ points.

The target readers for this book are social work clients and social work practitioners. For social work clients, there is a questionnaire to help them identify if they are self-injurers. The book includes information on how to help self-injurers access services and what to look for in a treatment program. It explains why people self-injure and how they can stop. For self-injurers who are referred to the SAFE Alternatives program, this would be a helpful book to explain to them the program philosophy and program expectations.

This book expands the boundaries of social work practitioners’ knowledgebase of this behavior. It includes a discussion about whether plastic surgery, compulsive exercise, and body piercing are self-injurious. Some of the SAFE Alternatives program’s more controversial viewpoints are the unhelpfulness of cathartic approaches to self-injury and how they implement the idea of personal responsibility through their program. They believe self-injurers make a choice when injuring themselves, and that they can make choices to support themselves in other ways instead. They advise practitioners to counsel self-injurers to consider the consequences of their behavior, but will leave the responsibility of remaining safe to the self-injurer.

This book would be most helpful to social work students considering careers in psychotherapeutic direct practice with adults, especially women. For social work educators, this book may be helpful to recommend in consultations with students who would like more information about the issue of self-injury, but it is not intended to offer the diversity of this human behavior observed in the social environment necessary for its use as a textbook.

Reviewed by Michael Clarkson-Hendrix, MSW, Master of Science (School Psychology), LMSW, Certified School Psychologist.