The DSM-5 proposes that self-harm be recognized as a diagnostic category of mental disease, compared to its previous definition as a behavioral symptom. Based on fieldwork in London, I challenge this proposal by exploring the life-history of a homeless sex-worker and substance-user who practices self-cutting. By bringing phenomenological anthropology into conversation with psychoanalytic theory, this article provisionally re-conceptualizes self-harm as an ethics of self-reparation and existential affirmation in the face of extreme precarity. Approached as an agentive practice through which human beings reclaim “somethingness” by altering their bodily conditions, we can conceive self-harm in a way that is attentive to the situational conditions that shape existential pain, instead of reaching straight for the diagnostic toolkit. In taking self-harm as simultaneously a reaction to and a reflection on existential crisis—rather than a sui generis disorder—this paper situates such practices as a pluralized condition-of-world rather than a bounded pathology-of-mind.

在DSM-5建议将自我伤害视为一种精神疾病的诊断类别，而不是之前将其定义为行为症状。基于在伦敦的实地考察，我通过探索一名无家可归的性工作者和吸毒者的生活史来挑战这个提议，他们练习自我切割。通过将现象学人类学与精神分析理论进行对话，本文暂时将自我伤害重新概念化为一种面对极端不稳定的自我修复和存在肯定的伦理。作为一种代理实践，人类通过改变他们的身体状况来重新获得“某种东西”，我们可以以一种关注塑造存在痛苦的情境条件的方式来设想自我伤害，而不是直接去寻找诊断工具包。自成一格的障碍——本文将这种实践定位为一种多元化的世界状况，而不是一种有限的心理病态。