The Aesthetics of Self-Harm: The Visual Rhetoric of Online Self-Harm Communities 9781138638310, 9781315637853

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The Aesthetics of Self-Harm

The Aesthetics of Self-Harm presents a new approach to understanding parasuicidal behaviour, based on an examination of online communities that promote performances of self-harm in the pursuit of an idealised beauty. The book considers how online communities provide a significant level of support for self-harmers and focuses on relevant case studies to establish a new model for the comprehension of the online supportive community. To do so, Alderton explores discussions of self-harm and disordered eating on social networks. She examines aesthetic trends that contextualise harmful behaviour and help people to perform feelings of sadness and vulnerability online. Alderton argues that the traditional understanding of self-violence through medical discourse is important but that it misses vital elements of human group activity and the motivating forces of visual imagery. Covering psychiatry and psychology, rhetoric and sociology, this book provides essential reading for psychologists, sociologists and anthropologists exploring group dynamics and ritual, and rhetoricians who are concerned with the communicative powers of images. It should also be of great interest to medical professionals dealing with self-harming patients. Zoe Alderton is a lecturer in the School of Economics at the University of Sydney.

The Aesthetics of Self-Harm

The Visual Rhetoric of Online Self-Harm Communities

Zoe Alderton

First published 2018 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2018 Zoe Alderton The right of Zoe Alderton to be identified as author of this work has been asserted by her in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Names: Alderton, Zoe, author. Title: The aesthetics of self-harm : the visual rhetoric of online communities / Zoe Alderton. Description: Abingdon, Oxon ; New York, NY : Routledge, 2018. Identifiers: LCCN 2018004345 (print) | LCCN 2018002014 (ebook) | ISBN 9781138638310 (hardback) | ISBN 9781315637853 Subjects: LCSH: Self-injurious behavior. | Parasuicide. | Online social networks—Psychological aspects. | Internet and youth— Psychological aspects. Classification: LCC RC569.5.S48 A435 2018 (ebook) | LCC RC569.5.S48 (print) | DDC 616.85/8200285—dc23 LC record available at https://lccn.loc.gov/2018004345 ISBN: 978-1-138-63831-0 (hbk) ISBN: 978-1-315-63785-3 (ebk) Typeset in Bembo by Apex CoVantage, LLC

In memory of Izzy, my best boy.

Contents

ContentsContents

List of platesviii Prefaceix Acknowledgementsxix Introductionxx 1 Self-harm on social networks: understanding online eating disorder and self-harm communities

1

2 The aesthetics of self-harm: visual rhetoric as a key to understanding online activities

61

3 Sad Girls: the internet and the performance of mood

95

4 Suggestions for clinical practitioners: developing tools for managing visually oriented self-harmers

116

5 Healing through aesthetics: how images can guide behaviour and health

163

Index185

Plates

List of figuresList of figures

All images selected are available under Creative Commons 2.0 license unless otherwise indicated. 1 2 3 4 5 6 7 8 9 10 1 1 12 13 14 15 16 1 7 1 8 19 20

Jess McPhee, Self-Harm, photography, 2012. Rosa Menkman, BLINX3, glitch art, 2011. Freestocks.org, Skin and Bones, photography, 2016. Daniela Brown, veins, photography, 2013. Carolyn, Eczema and Bruising, photography 2008. Ruby Victoria, Untitled, photography, 2010. Ruby Victoria, Untitled, photography, 2010. Ruby Victoria, i have sold my soul, traded it for hollow gold, photography, 2010. Ruby Victoria, Untitled, photography, 2012. Julián D. Gaitán, Bulimia, photography, 2010. Andrés Nieto Porras, Pain, photography, 2016. Daniel Pasikov, Scar, photography, 2014. Tuan Le, Untitled, photography, 2015. Stills from Christina Enrico, Sad Girl Theory (Inspired by Audrey Wollen), video, 2016. linspiration01, V.2, photography, 2014. Screenshot from iPhone 8 showing Tumblr, Instagram, and Facebook Messenger push notifications, author’s own. Kristina Sohappy, Earth Crisis, photography, 2010. Gordon Tarpley, Untitled, photography, 2013. Richard Heaven, Edge Owl, T-shirt design, 2011. Kevin Cortopassi, Shirt idea, T-shirt design, 2009.

Preface

PrefacePreface

Self-harm remains something of a mystery. It can revolt us, frighten us, and anger us in a manner that few other disorders are able to do. As Lehman argues, violence is hard to understand; violence willingly committed against the self even more so (2013, p. 1). In this book, I offer an ‘insider’s perspective’ on self-harm as the starting point for an alternate sociological view of a problematic issue that is predominantly addressed through a clinical paradigm. There is a great deal of research concerning self-harm behaviour, but there are few sociological investigations that focus on how online community formation and identity may encourage and valorise this behaviour. Online communities provide significant support for self-harmers and can be a place in which they retreat from negative social environments and express themselves in an authentic and meaningful manner. This book examines the cultural logic behind the valorisation of gore and the deeply communal essence of self-harm that lies within these groups. Soft Gore, Soft Grunge, and other Sad Aesthetics have created a world where the beauty of injuries is foregrounded. Soft focus, pale flesh, flowers, and bruises abound.This combines the gentle with the grotesque, providing a space in which one can explore beauty within fresh wounds and broken skin.

Why ‘self-harm’? Admittedly, I have named my book after a phrase that is seen as imprecise and relatively unpopular within the medical community. Nevertheless, it is a term that has a great deal of value and meaning for those who use it. The specific terminology I have chosen for this volume is important, and self-harm is the most appropriate choice of description for the kind of behaviour I am exploring. To show how actual self-harm communities perceive their actions, here are the revealing words of Tumblr1 user ‘Brittney’: Self harm doesn’t always happen when a blade touches skin. It’s skipping meals because you don’t feel like you deserve to eat today.

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It’s having sex because you want to be used or abused or defiled. It’s drinking recklessly because you might have the ‘courage’ do something stupid. . . . (Brittney 2016) This might not adhere to the formal diagnostic condition of Non-Suicidal Self-Injury (NSSI), but it shows well the kind of behaviour this book examines. For many, self-harm is about mutilating the body, but it is also about taking risks, overdosing, and general lapses in self-care. Self-harm is the favoured term of those who feature in my unique case studies, and it describes my broad take on this topic more accurately than other word choices. Of course, I use it with some caution. The term Non-Suicidal Self-Injury is the preferred medical descriptor for self-inflicted bodily damage, which is thought of as more precise than the range of other terms that have been employed (Power et al. 2013, p. 192). There is also a long-standing preference for the term self-mutilation, largely in the wake of Favazza’s seminal Bodies Under Siege (1987). Nock and Favazza note that there is a slippage of meaning when terms like deliberate self-harm are used to mean both Non-Suicidal Self-Injury and suicide attempts (2009, p. 10). I do not wish to be unclear, but I do wish to use a term that opens the possibility for an action to be ambiguous. For Favazza, mutilation has very specific meanings. Under the category of self-mutilation, he places “deliberate, direct destruction or alteration of body tissue without conscious suicidal intent”. Thus, self-mutilation cannot be an accidental injury caused through general negligence. He also uses this as a way of distinguishing self-mutilation from more indirect methods of causing harm including starvation, alcohol abuse, overdosing, swallowing foreign objects, or medically counterintuitive decisions such as terminating dialysis (Favazza 1998).2 He also believes that risky behaviour, including dangerous hobbies such as skydiving and dangerous jobs such as firefighting, are instances of putting oneself in harm’s way, but they are not self-injury (2011, p. 197). Conversely, this book includes many of the behaviours that Favazza purposefully excludes. Rodham and Hawton believe that imprecise terminology hampers the epidemiological study of NSSI and prevents fair comparisons being made between studies (2009, p. 38). When it comes to the precise statistics that epidemiology relies on, this is very true. But this book is not a work of strict epidemiology; rather, it puts forward a new syncretic approach to understanding of the field. This is the best way of understanding what people are doing in online communities, how they understand themselves and their behaviour, and what they are trying to achieve by it. Because self-harm is such an important emic descriptor, and an appropriately flexible term, I have selected it as the best for my study. Medically diagnosable NSSI is a part of self-harm. But self-harm is so much more than tissue damage.

Preface xi

Why visual rhetoric? A major methodological grounding for this book is the field of visual rhetoric. It is vital that we examine the aesthetic impact of self-harm in order to understand its very complex and diverse place in different subcultures. Rhetoric has always been a broad and flexible discipline, designed from the start to analyse the output of authors. A basic premise of rhetoric is “observing the means of persuasion on almost any subject presented to us” (Aristotle 2014, p. 2155).This type of classical Aristotelian rhetoric remains the cornerstone of the discipline and has been updated from time to time in order to reflect changing patterns of communication. Visual rhetoric is the result of a later ‘pictorial turn’ in the discipline, pioneered by scholars like Foss, who queries why discourse must be the prime focus of the discipline. She argues that visual symbols are neither insignificant nor inferior within human communication (2004, p. 303). Foss’s complex take on the rhetorical situation also values rhetors, leaving space for the audience members to make up their own minds and respond to a text in a personalised way without undue force (Leiter and Dowd 2010, p. 36). She looks more to the function of an image (what it does for its audience) rather than the purpose of an image (why it was created) in order to value the power of reception (Foss 2005, p. 146). Within her schema, the function that a visual artefact has on its audience is as important as what its initial purpose may have been (Foss 2004, p. 308). This is important when analysing the present state of the online community, the Web 2.0 self, and the unusual rhetorical circumstance of images online. For an artefact to be considered as a piece of visual rhetoric that can be approached by the discipline of the same name, it needs to “be symbolic, involve human intervention, and be presented to an audience for the purpose of communicating” (Foss 2004, pp. 304–305). The images presented in this volume meet all these criteria. They are purposefully created by self-harmers in order to symbolise their behaviour and convey their emotional life. They also have a profound persuasive power. A series of conventions in pictorial representation emerge across self-harm communities. Noting this, we must keep Foss’s seminal question always in mind. She asks us to consider why people find certain images attractive and interesting (1993, p. 210). This should be more important than the question of whether we personally like the way something looks. In Foss’s schema of visual rhetoric, the only negative critique that can be given is the idea that a visual artefact communicates its function badly or that its function is illegitimate or unsound (1994, p. 221). Saying that something is ugly, or juvenile, or mass-produced is not an acceptable way of decrying it. This methodology is the most suitable to address the great changes in visual digital communication that have recently revolutionised communications methods, especially amongst the young. Importantly, Foss distinguishes between ‘aesthetics’ and ‘rhetoric’. An aesthetic experience is one where a viewer enjoys

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the beauty of an image via colour, form, or texture without necessarily aiming for anything beyond a pleasant visual experience. A rhetorical experience involves attributing meaning to the symbolic dimensions of the imagery and receiving some form of communication (Foss 2005, p. 145). An approach that relies only on an aesthetic evaluation of images can be unnecessarily limiting and is too indebted to the idea of good taste and the guidance of the connoisseur (Foss 1994, pp. 213–214). The theme of this book is the aesthetics of selfharm because those who hurt themselves often ascribe a great transformative beauty to their behaviour. This beauty will be studied in detail. As scholars, we need the tools of visual rhetoric in order to decode the meaning of selfharmer’s actions beyond a discussion of whether their output shows technical refinement. Scholars of rhetoric have been somewhat hesitant to embrace this new form of the discipline, feeling better trained to study discourse without visual imagery (Foss 2005, p. 142). So, too, has there been a delay in the health sciences, where those experiencing or at risk of mental illness are frequently surveyed en masse or added to case notes individually without much ever being said about their artistic output. Scholars need new methodologies to keep up to date with the development of new tools for digital visual communication. Digital technologies are a big part of the way in which self-harm is seen as an embodied practice and are often absent from scholarship on this topic (Johansson 2014, p. 17). Lindgren et al. argue that online communication modalities are becoming commonplace whilst the immediacy, constant accessibility, and availability of online spaces have integrated our cultural understandings of communication. We are now facing a world where the divide between online and offline is difficult to find (2014, p. 1). Older methodologies for understanding online communication are being outpaced as the virtual world becomes increasingly central to our mainstream understandings of what it is to be human and to speak to other humans. When studying the aesthetic dimensions of self-harm online, it is important to understand that ‘online’ and ‘offline’ are not the divided spheres that they once were. The human body can exist powerfully in both realms and can communicate ideas that rapidly spread and morph. To account for this, we need contemporary ways of dealing with profound changes to the online/offline divide and contemporary ways of discussing visual communication in this very new modality. To address this, Lindgren’s ‘media hybridity’ becomes useful. It refers to the coming together of online and offline spaces, leading to processes of transference and intertwinement between the two (2014, p. 2). If we spend too much time considering the differences between online and offline modalities, we miss the more important fact of how the two are increasingly merged. The online world is no longer a shallow and inauthentic zone, detached from reality (Lindgren 2014, p. 140). One area in which online and offline worlds are notably different is in the way that visual communication occurs. To explain this, Jenkins explores the importance of visual rhetoric online via his discussion of the digital circulation

Preface xiii

of online memes. Rather than exploring the traditional ‘rhetorical situation’ of image and text within a set context, Jenkins suggests that some forms of online imagery require a shift in focus because of their highly mutable context. He argues that analysing memes requires us to move into a virtual mode of analysis where we look at “the capacities for affect and affection structuring an encounter” rather than the more traditional questions of ‘What is this text?’ and ‘What is its context?’ Jenkins states that memes and other online, shared imagery are made recognisable and can be circulated via “a shared, virtual mode structuring all subsequent actualizations” (2014, p. 442). When providing an analysis of rapidly shared online imagery, we should look to this virtual mode for guidance as to why texts are constructed and how an audience is likely to read them or feel persuaded by them. This is also a practical way of dealing with the speed and scale of the reproduction of images online. In practical terms, this means that a traditional rhetorical analysis of an artwork hung in a gallery will not work as well for an image of bruises shared online. The gallery work has a known author, date, and medium. These factors remain static and create a reasonably consistent context where the main variable is the gaze of an individual audience member. Even this viewer may be reasonably predicted because of the fairly consistent demographics of those who enter art galleries and the structured viewing experience created within them. Thus, classical Aristotelian rhetoric works well for this kind of visual rhetorical analysis. The same cannot be said for an online image – which is duplicated, shared, and re-interpreted by a myriad of viewers. If an image of bruises is shared online, it is likely that details of ownership and date will soon be lost in a schema of unethical reblogging habits that fail to give credit to the original creator. Rather than being displayed in a single museum space (and perhaps reproduced in select art books), the bruise image will travel far and wide. Sometimes it will appear on a Soft Grunge Tumblr page. Sometimes it will resurface on WeHeartIt. Sometimes it will be used to celebrate self-harm, and sometimes it will be used as a stern warning to parents of the dangers lurking online.There will also be numerous comparable texts from other authors that go through a similar journey and contribute to a shared sense of aesthetics, or a shared moral panic. For this reason, it is useful to consider the broader aspects of a communication genre in addition to the specifics of any given image. That is, we should look at the broader phenomenon of self-harm and the common ways this is expressed and shared online rather than focusing on just one image of a bruise. This will allow us to understand emergent communal phenomena such as selfharm nodes in the virtual sphere. This kind of content is also likely to be spread and contextualised using practices of ‘folksonomy’. A folksonomy is a system of classification that allows members of the public to index or tag pieces of information so that this information can be connected to a particular topic or theme. This term was developed by Vander Wal between 2004 and 2007 and reflects a change in the authorial ownership of context.Vander Wal first considered ad hoc labelling and

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tagging in 1990 when he saw one of his co-workers adding tags to documents and programs on his computer. In the early 2000s, social bookmarking sites like del.icio.us allowed users to tag online content in a similar way. Not long after, image-driven sites like Flickr organised themselves around the tagging of photographs by theme. Folksonomy started as a “personal free tagging of information and objects (anything with a URL) for one’s own retrieval” and soon became a social project where people use their own vocabulary and perspectives to add in new explicit meaning to an item (Vander Wal 2007). Folksonomic practices can radically reframe an image, thus having a methodology that can deal with this is important. For example, a misty landscape photograph may have initially been captured because the photographer liked the way the scenery around her looked, or wished to capture a personal memory of place and time. For that author, her photograph represents certain categories like ‘holiday’ or ‘winter’ or ‘magical’. In a more traditional rhetorical situation, she would be able to communicate these to her audience, perhaps through some static paratext like a caption on the back of the printed image or viewer information in an art gallery. In the complex rhetorical situation of online visual content, viewers can add in folksonomic tags when sharing her photograph. These tags might overlay her initial intentions and reclassify the content of her image as something new. Other viewers might have a different emotional reaction and classify the misty photograph in more melancholic terms with tags like #sadness, #depression, or #lonely. This folksonomy is powerful and may completely alter the emotional reception of a text. While these interpretations may not be ‘correct’ in the eyes of a photographer who wished to share an enchanted scene with her friends, the photograph has left her hands and is now grasped by the immense power of the internet. It is at the mercy of mass folk consensus and will become whatever online taggers think it should be. This has sympathy with Foss’s focus on the importance of the function of a visual artefact as opposed to its purpose as designated by the original rhetor (1994, p. 215). In this system, it is the audience who determine what claims an image is making (Chryslee et al. 1996, p. 9). The original creator of an image is often so distanced from its multiple online manifestations that his or her intentions are lost and, for many consumers of the image, meaningless. For these reasons, Jenkins warns us that online visual content should not always be read “as the representation of specific rhetors” (2014, p. 442); instead, we need to have a more complex formula for addressing broader modes of social communication that have adapted and adopted certain images, aesthetics, memes, and visual gags. Jenkins provides this formula with his notion of ‘modes’: collective visual phenomena “that express the circulating energies of contemporary existence” rather than providing a specific focus on an individual rhetor (2014, p. 443). As Lindgren et al. explain, the internet has now led us to a world where material space, physical bodies, and geographical locations have all altered from that which we were previously accustomed to (2014, p. 1). It is time for our methodologies to change too. The author is dead, but the tag lives on!

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Research methodologies for new times This also leads into the question of how information can be gathered pertaining to a specific community of self-harmers when they are so geographically diverse. In order to gather research for this project, I undertook a process of online ethnography. This is still an emerging field in which boundaries remain unclear and methods vary. In part, this is due to the fuzzy time and space boundaries of the online sphere, which provide a challenge for more traditional methods of community engagement and information gathering. Online, there is no single geographic location with which to define one’s research (Tunçalp and Lê 2014, p. 59). Since the turn of the century, researchers have been promoting the importance of a transition from traditional place-based ethnography towards new methodologies that are more suitable for the manner in which adolescents use the internet and integrate their online and offline lives. Leander and McKim summarise these new methods as tracing the flow of objects, bodies, and ideas; exploring boundary construction around texts; and considering the multiple contexts of online texts (2003, p. 211). Fortunately, these coalesce well with the methodologies of visual communication online as mentioned earlier. New ethnographic approaches also support the fact that our online and offline lives are becoming increasingly unified. I agree with the notion, raised by several scholars of online ethnography, that we need to move away from a strict binary of online versus offline or virtual versus real (Leander and McKim 2003, p. 224). When theories of internet ethnography were initially developed, online spaces were often peripheral to everyday life. In this present decade, they have become central and have transformed the way people conduct their daily lives and communicate with others.The internet is now the locus of workplace communications, business transactions, friendly communication, news and information gathering, and political organisation. This needs to be understood in order to appreciate the significant overlap between the internet and everyday life in contemporary society (Hallett and Barber 2014, p. 307). It is especially important to appreciate this when exploring youth cultures online, as it is clear that the cultural knowledge acquired by young people online informs the way in which they interpret the world around them. This knowledge can challenge that which is acquired offline, such as knowledge gained from formal education (Wilson 2006, p. 309). Because of this convergence, Hallett and Barber warn that ignoring online spaces can lead to a failure to capture the interactions and communicative style of the communities they study. They argue that the divide between online and offline no longer exists, as individuals “present and construct themselves in multiple, overlapping spaces”, which include face-to-face interactions and interactions online (2014, p. 323). The collection and processing of data generated within computer-mediated discussion are somethings that require careful consideration, especially since there are fewer models for this kind of process than there are for the use of

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more traditional data gathered from face-to-face observations or interviews. Tunçalp and Lê’s study of internet ethnography explores some of the different ways that data can be gathered. One way is to focus on a single site as a bounded location where activities can be observed. Another is a multisite study, where different locations are examined but the finite boundaries of each are respected. Finally, they note “flow approaches” in which researchers follow thematic or community connections across different sites without being limited by strict frontiers (2014, p. 63). Flow in this sense describes a network structure and the performance of individuals within this structure (Leander and McKim 2003, p. 226). Cultural flows can move through online and offline settings and through global and local contexts (Wilson 2006, p. 315). It is this flow approach that I have favoured for this project, as it allows for a focus on the expression of themes that are not bound to particular websites or platforms. Instead, gathering data through a flow approach prioritises factors such as linguistic, narrative, and behavioural patterns in communities that do not bind themselves to a single site. In order to achieve a strong reading of rhetorical modes and cultural flows,Wilson recommends the use of textual analysis. He argues that this methodology allows us to unveil the meaning of a website for its audience and to consider the goals of the content producers.Wilson suggests that this be integrated into more traditional ethnographic work such as interviews with participants. Through this, the ways in which, for example, youth resist dominant social hegemonies online can be better understood (2006, p. 312). A weakness of this online flow-seeking method is that it becomes difficult to verify the authenticity of the stories or images presented by those who discuss their self-harm in anonymised spaces. Identity is a slippery category when it comes to discussing who we are studying and writing about.This becomes even trickier when the internet is involved, as this medium provides an opportunity to formulate an identity that is separate from one’s everyday presentation of self. The anonymity of the internet does mean that a researcher has to trust claims about demographics such as race, class, or gender. People are often known to lie about these details, and some like to use the internet as a performative space where they can be someone different from who they are offline. Nevertheless, this anonymity often inspires people to divulge sensitive information about themselves – including genuine mental health struggles that they may not be comfortable sharing offline.While some data are corrupted by falsehood, much of them are extremely valuable. We also need to remember that the construction of different versions of one’s self and persona frequently happen in the offline world, meaning that this is not a problem unique to the internet (Garcia et al. 2009, pp. 68–70). Hammersley and Treseder outline many of the problems associated with identity of subjects, concluding that none of the existing models for understanding identity are flawless. Usefully, their core case study is identity in proana websites. As is shown in this volume, participants in these websites often see their disordered eating as an affirming life choice rather than as a medical disease. This is reflected in the language they select to describe themselves

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and their starvation. Hammersley and Treseder query if researchers in this field should favour medical perspectives and describe these participants as ‘suffering’ from anorexia or if we should use their own identity terms and call them ‘pro-ana’. Hammersley and Treseder also bring up the aforementioned problem of impersonation. They conclude that deception on this level is not a huge problem in pro–eating disorder, or pro-ED, sites. Nevertheless, they warn that researchers should be aware of natural ambiguities in language. For some, proana is a full lifestyle commitment that defines their self-conception. For others, ana is simply an opportunity for quick weight loss. It is not always immediately apparent what aim an individual has. Users will also present themselves in keeping with their perceived audience and context, which means that rhetorical choices also need to be considered when examining identity choices (Hammersley and Treseder 2007, p. 294). Overall, Hammersley and Treseder conclude that there is no flawless method for understanding or representing the identity of subjects studied online. Instead, they recommend that a researcher should be considerate of their own goals and the limitations of their choices. For example, if a researcher wishes to document the experiences of those who discuss their disordered eating online, then it is beneficial to get a sense of the way these people represent themselves and describe their behaviour – a core aim of this book. Hammersley and Treseder note that this particular method can put a little too much faith in the honesty and reliability of people’s presentation of self online but that it comes with the benefit of giving authority to subjects and trusting them to represent themselves in a meaningful manner that reflects something genuine about their lives and selves (2007, p. 296). Because the sensitive data released by participants in such studies are likely to be both accurate and very private, this does raise the questions of how much can be shared in a publication and to what degree should those who divulge their deepest feelings be anonymised for privacy. When including information gathered through interviews I conducted on Tumblr messenger, Facebook, and email, among others, I was able to simply ask my informants how much personal information they were comfortable with me publishing. Their responses varied from a wish to be known by their online username only to those who wanted their ideas and creations credited and contextualised with their full names and geographical location. Importantly, a large portion of the information presented in this book has been made fully available to the public prior to my reproduction of it. None of the information I have gathered is from password-protected sites or secret forums. While I have occasionally had to rely on archives, these are also fully accessible resources. This has been my response to the ongoing conversation about whether a researcher should be a ‘lurker’ on internet forums. The anonymity of this medium does allow for invisibility, which is highly unusual in an ethnographic study and challenges the traditional elements of researchers interacting with, and participating in, the communities they study (Leander and McKim 2003, p. 216). Online, a researcher has the opportunity to take part in unobtrusive

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observation and can have a totally undetectable presence. As such, there are debates as to whether or not lurking is an ethically viable method. Garcia et al. note that a lack of physical presence in the research sphere means the ethnographer must carefully manage their own identity and self-presentation. Even more ethical delicacy is required in the management of private and confidential data, which can be confusing when lines between public and private are blurred. Ethnographers are, of course, still required to protect their subjects – but the relative sensitivity of information is not always as clear in the online research environment as it is in a traditional face-to-face context (2009, p. 53). Many ethnographers have decided that it is inappropriate to collect data without announcing oneself. Nevertheless, Garcia et al. conclude that different methods suit different situations. If an internet researcher is focusing on a forum where all members are expected to contribute to a conversation and announce their presence, then a researcher should do the same and endeavour to experience the site in the same way as a regular participant does. If, however, a group already involves or allows silent lurkers, then lurking is a valid way of experiencing group dynamics (Garcia et al. 2009, pp. 58–60). The communities discussed in this book are not older-style forums or chatrooms where members are known and expected to contribute. Rather, they tend to manifest on microblogging platforms – more akin to a public diary where one confesses thoughts to anyone who knows how to find them (generally through shared folksonomies).While I doubt that the primary-source authors cited here would be thrilled to have their thoughts shared with their offline friends or family members under their full legal name, none of these data have been told to me, specifically, as a secret. Nor have any of them been protected by passwords or other locks. Because the majority of the data I used are public, I was able to avoid some of the more difficult ethical dilemmas of a digital ethnographer. The question of anonymity is also an important one. As explained earlier, I have maintained the level of anonymity that each person discussed herein has created for him- or herself. Some people who discuss their self-harm online use untraceable pseudonyms with no connection to their legal identity (such as ñiñi❀ or BORN TO DIE). Others have pen names that may have some connection to their legal names but nothing clear enough to trace (like Mandi Faux or Ruby Victoria). I have retained these names, as they protect the subject from any unwanted attention but also allow them to retain due credit for the writing, curation, or images they have created. Others who discuss their mental health online wish to have their full names and identities associated with this material. To anonymise someone like Audrey Wollen or Lora Mathis (who are known by their full, legal names) would be to strip them of due credit for their philosophical and creative works. While some degree of anonymisation is necessary to protect privacy, full anonymity is often undesirable for those who create content online. As with all the earlier debates and concerns pertaining to new internet methodologies, the safest approach is that which is negotiated thoughtfully on a case-by-case basis.

Acknowledgements

AcknowledgementsAcknowledgements

Thank you to Breann Fallon, Cassandra Hastie, Jessica M. Kirk, Dr Elizabeth Miller, Eleftheria Prodromou, and Tara Smith for your comments on my chapters. Your guidance and suggestions have been a big part of this book turning from a sketchy dream to a completed piece of work. I would like to give special thanks to Sally James and Alicia Jones, who were generous enough to give advice for multiple chapters. But thanks most of all to my often-sleepy partner Dr Christopher Hartney, whose critique turned the book on its head and forced me to articulate what it was that I needed to say. Thank you so much for your time and your dedication to helping me with this mammoth project and all the emotions that came with it.

Introduction

IntroductionIntroduction

In recent years, the internet has spawned the ‘Sad Girl’: a young woman who is unashamed of her emotional life and who fearlessly acts out her pain for others to see: sad girl chases the moon, touches the stars, fights the sun to burn through the ache in her chest. sad girl paints pictures on her body of the darkness, of the pain. sad girl drives fast and doesn’t scream. . . . (Grimaldi 2016) So who is the Sad Girl (or the Sad Boy) who feels emotional torment, carves her pain onto her arms, and shares the fresh bleeding images with the entirety of the internet? To answer this question, this book explores how self-harm manifests on the internet – often in the form of explicit and graphic imagery. The visual rhetoric of such communities is extraordinarily powerful. Understanding the aesthetic dimensions of self-harm is key to understanding why these online spaces are so compelling, complex, meaningful, and addictive. Fortunately, aesthetics is also a key to overcoming a reliance on self-harm as a communicative device. There are other ways to be sad and show frustration that can be beautiful and satisfying for the participant. There are also ways to heal and show strength and resistance that may not be immediately obvious to those suffering from acute distress and residing within mono-methodical online spaces.The final part of this book introduces a range of visual techniques and performances that members of vulnerable demographics have used to heal from trauma, childhood rejection, heartbreak, and other life pains – and to form together in communities of solidarity and healing.

Self-harm on social networks: understanding online eating disorder and self-harm communities This book opens with a specific exploration of what happens in online selfharm groups and where they can be found. I start with a history of pro-selfharm content online, dating back to the early 1990s. A major part of this is

Introduction xxi

the existence of pro–eating disorder communities. These groups are often embroiled in exclusive spiritual discourses, which personify eating disorders as deities and lead to strict rules for inclusion. I also examine different contemporary social media and information exchange sites where users are able to generate and share their own self-harm content such as graphic images or explicit instructions for causing tissue damage. Most websites now have a policy for deleting or censoring self-harm content. But, I argue, these are knee-jerk reactions that arise from a paternalistic approach to young people and their self-expression. The deletion of self-harm material has achieved very little and shows a misunderstanding of online relationships, community, and the power of aesthetics.

The aesthetics of self-harm: visual rhetoric as a key to understanding online activities This eponymous chapter provides a new take on why self-harm communities are so compelling and addictive. This is the information that needs to be understood in order to realise why these online spaces are powerful, and what users gain from engagement with aesthetic objects. To understand the most pervasive contemporary example of emotive expression, I explore the ‘Online Aesthetic’, encompassing the Soft Grunge/Soft Gore genre, the Tumblr Teen Girl Aesthetic, and the Sad Girl Aesthetic – all redolent with explorations of self-harm and visible performances of sadness. These aesthetics vivify communities and bond participants in a manner that needs to be acknowledged. They allow people to explore their bodies and present themselves in a way that often critiques mainstream society. This opens a space where groups of people can express their feelings, rebel against discourses like patriarchal beauty standards or psychiatric models of health and wellness, and gain support from an international conglomeration of like-minded people or fans.

Sad Girls: the internet and the performance of mood In this chapter, I dig deeper into the character of the Sad Girl.This figure – halfcomic, half-tragic – is represented in the fine arts, apparel, websites and social media streams, and philosophy and through the work of iconic Sad Celebrities like Lana Del Rey. By being visibly unhappy and celebrating the importance of negative moods, young women are showcasing a profound need to annunciate their sadness, frustrations, and the failure of the modern world to deliver the promises of true female emancipation.The Sad Girl is a new digital übermädchen who acts out the internal lives and struggles of young people online. Importantly, the Sad Girl Aesthetic encourages cathartic acts like crying and the use of sadness to protest inequity. But this aesthetic does not foster self-harm or other dangerous behaviours. Instead, this aesthetic shows us that emotions can be

xxii Introduction

performed online in a genuine and therapeutic fashion, which leads to liberation and self-expression rather than self-hatred, disease, or death.

Suggestions for clinical practitioners: developing tools for managing visually oriented self-harmers There have been many efforts to shift self-harm treatment and information online so that people can discover it through their home computers and take the first steps to recovery. I am by no means the first person to propose that the internet be used for treating self-harm. There is evidence of self-harm sites dating back to the earliest days of the internet.3 But, at present, there exists a staunch divide between self-harm resource and recovery sites and pro-selfharm material.The latter is, unfortunately, far more popular and persuasive.This warrants deeper investigation, as the community that people locate themselves within can have a significant impact on how likely they are to harm themselves. In this chapter, I look at some of the strengths and weaknesses of online communities relating to self-harm. Pro-self-harm can have some benefits for users. They tend to be friendly and accepting spaces where participants feel wanted and valued. They also provide on-the-spot counselling and support. Of course, the problem here is that peer-led guidance can be unhealthy or dangerous. Anti-self-harm sites tend to have a better grounding in mental health practice and are often run by professionals in this field. While the information and support they provide are safer and more accurate, they are often presented in a way that feels too ‘happy’ for many people who are in the midst of a painful mental health crisis. Sites with professional content also tend to have less advanced media hybridity and weaker user of the Web 2.0 modality. Healing online is a very real possibility but needs to be managed in a more media-savvy manner in order to provide a viable alternative to pro-self-harm communities.

Healing through aesthetics: how images can guide behaviour and health Finally, I end with some suggestions for online, aesthetic-based solutions. Drawing on the influential visual strategies used by participants in pro-self-harm groups, I explain why they are so deeply compelling and how they foster cathartic self-expression. Telling people to stop being sad and start being happy, healthy, and productive is bound to fail. To work effectively, health and wellness need to be enchanted concepts that are supported by a strong aesthetic and a sense of community.This is already present in a variety of alternative communities that do not value self-harm but do value a strong aesthetic identity. These include the health and social movements Straight Edge and Fitblr. I also present alternative conceptual standpoints available online, such as the Radical Softness philosophy that values recovery and allows people to express themes of sadness

Introduction xxiii

and frustration without being shamed. All these ideologies offer something very powerful, and only that degree of influence and meaning can offer as much as the self-harm aesthetic.

Notes 1 For more information about specific social networking websites and their logistics, please consult the chapter ‘Self-Harm on Social Networks’. 2 A main reason given for this decision is that self-injury should be evident to others and relatively predictable and direct from the perspective of the harmer. Swallowing objects or overdosing is invisible and not as directly predictable as lacerating the skin or similar (Favazza 2011, p. 199). While I agree that these acts do have different degrees of visibility, the impact of poisoning is quite clear when a person is discovered unconscious by his or her family or when presented to an emergency department.This is often the desired effect. It should also be noted that since his 1998 publication, Favazza decided that mutilation was a little too misleading as it suggested that self-inflicted injuries needed to cause a dramatic bodily change. He and Nock now prefer NSSI (2009, p. 13). 3 I could not find a precise, dated list, but there is agreement that the now-defunct ‘Secret Shame’ site (http://users.palace.net/~llama/selfinjury) is one of the earliest and existed for certain in 1996. It hosted the foundational Bodies Under Siege mailing list and links to a variety of other self-harm pages that were hosted on university servers and commercial sites such as Geocities and Angelfire.

References Aristotle, 2014. The complete works of Aristotle:The revised Oxford translation. Princeton: Princeton University Press. Brittney, 2016. Self harm [online]. Tumblr. Available from: http://brittneyy-00.tumblr.com/ post/146732634491/self-harm [Accessed 7 July 2016]. Chryslee, G.J., Foss, S.K., and Ranney, A.L., 1996. The Construction of Claims in Visual Argumentation: An Exploration. Visual Communication Quarterly, 3, 9–13. Favazza, A.R., 1998. The Coming of Age of Self-Mutilation. Journal of Nervous & Mental Disease, 186 (5), 259–268. Favazza, A.R., 2011. Bodies under siege: self-mutilation, nonsuicidal self-injury, and body modification in culture and psychiatry. 3rd ed. Baltimore: Johns Hopkins University Press. Foss, S.K., 1993. The Construction of Appeal in Visual Images: A Hypothesis. In: D. Zarefsky and L.M. Griffin, eds. Rhetorical movement: essays in honor of Leland M. Griffin. Evanston, IL: Northwestern University Press, 210–258. Foss, S.K., 1994. A Rhetorical Schema for the Evaluation of Visual Imagery. Communication Studies, 45, 213–224. Foss, S.K., 2004. Framing the Study of Visual Rhetoric: Toward a Transformation of Rhetorical Theory. In: C.A. Hill and M.H. Helmers, eds. Defining visual rhetorics. Mahwah, NJ: Lawrence Erlbaum, 303–313. Foss, S.K., 2005.Theory of Visual Rhetoric. In: K. Smith, ed. Handbook of visual communication research:Theory, methods, and media. Mahwah, NJ: L. Erlbaum, 141–152. Garcia, A.C., Standlee, A.I., Bechkoff, J., and Yan Cui, 2009. Ethnographic Approaches to the Internet and Computer-Mediated Communication. Journal of Contemporary Ethnography, 38 (1), 52–84.

xxiv Introduction Grimaldi, J., 2016. Scarred conversations. Available from: http://scarredconversations.tumblr. com/post/144889650924/sad-girl-chases-her-feelings-with-a-handle-of [Accessed 10 July 2016]. Hallett, R.E. and Barber, K., 2014. Ethnographic Research in a Cyber Era. Journal of Contemporary Ethnography, 43 (3), 306–330. Hammersley, M. and Treseder, P., 2007. Identity as an Analytic Problem: Who’s Who in ‘proana’ Websites? Qualitative Research, 7 (3), 283–300. Jenkins, E.S., 2014. The Modes of Visual Rhetoric: Circulating Memes as Expressions. Quarterly Journal of Speech, 100 (4), 442–466. Johansson, A., 2014. Hybrid Embodiment: Doing Respectable Bodies on YouTube. In: S. Lindgren, ed. Hybrid media culture: Sensing place in a world of flows. London: Routledge, 16–33. Leander, K.M. and McKim, K.K., 2003. Tracing the Everyday ‘Sitings’ of Adolescents on the Internet: A Strategic Adaptation of Ethnography Across Online and Offline Spaces. Education, Communication & Information, 3 (2), 211–240. Lehman, K.M., 2013. Assuaging the Dark Gods: Non-Suicidal Self-Injury and the Symbolism of Sacrifice and Redemption. Master of Arts in Counseling Psychology. Pacifica Graduate Institute. Leiter, D. and Dowd, J., 2010. Textual Expectations, (Dis) Embodiment, and Social Presence in CMC. In: J. Park and E. Abels, eds. Interpersonal relations and social patterns in communication technologies: Discourse norms, language structures and cultural variables. Hershey, PA: IGI Global, 32–47. Lindgren, S., 2014. Towards a Heterotopology: Unlayering the Reality of Hybrid Media Culture. In: S. Lindgren, ed. Hybrid media culture: Sensing place in a world of flows. London: Routledge, 139–148. Lindgren, S., Dahlberg-Grundberg, M., and Johansson, A., 2014. Hybrid Media Culture: An Introduction. In: S. Lindgren, ed. Hybrid media culture: Sensing place in a world of flows. London: Routledge, 1–15. Nock, M.K. and Favazza, A.R., 2009. Nonsuicidal Self-Injury: Definition and Classification. In: M.K. Nock, ed. Understanding nonsuicidal self-injury: Origins, assessment, and treatment. Washington, DC: American Psychological Association, 9–18. Power, J., Brown, S.L., and Usher, A.M., 2013. Non-Suicidal Self-Injury in Women Offenders: Motivations, Emotions, and Precipitating Events. International Journal of Forensic Mental Health, 12 (3), 192–204. Rodham, K. and Hawton, K., 2009. Epidemiology and Phenomenology of Nonsuicidal Self-injury. In: M.K. Nock, ed. Understanding nonsuicidal self-injury: Origins, assessment, and treatment. Washington, DC: American Psychological Association, 37–62. Tunçalp, D. and Lê, P.L., 2014. (Re)Locating Boundaries: A Systematic Review of Online Ethnography. Journal of Organizational Ethnography, 3 (1), 59–79. Vander Wal, T., 2007. Folksonomy Coinage and Definition [online]. vanderwal.net. Available from: www.vanderwal.net/folksonomy.html [Accessed 27 June 2016]. Wilson, B., 2006. Ethnography, the Internet, and Youth Culture: Strategies for Examining Social Resistance and ‘Online-Offline’ Relationships. Canadian Journal of Education/Revue canadienne de l’éducation, 29 (1), 307.

Chapter 1

Self-harm on social networks

Self-harm on social networksSelf-harm on social networks

Understanding online eating disorder and self-harm communities

We use the internet to share stories about ourselves, our desires, and who we want to be. For some people, these stories and desires are centred on a bleeding body, a thin body, or a body that is somehow changed to demonstrate how we feel or what we want from life. The author of Dehungerize, a personal weightloss blog, shared this vision with her followers, titled ‘Skinny Aesthetic’: Imagine yourself lounging on the couch at your boyfriend’s parent’s house on NYE. . . . Everything about you is dainty from your thin ankles up to your thin wrists. Your boyfriend’s sister glares at you jealously from across the room, eyes like wildfire. All you feel is emptiness and pure bliss. (Dehungerize 2016) Over a one-day period, this aesthetic vignette was shared and favourited 135 times. It tells a story of the deep satisfaction that one can gain from starvation. A starved girl can feel beautiful, dainty, and free of the overwhelming burden of a ‘fat’ body. She can also ‘win’ the patriarchal struggle for dominance amongst her female peers who will be unable to compete with her unearthly svelte figure. Psychologically, a thin body is the key to moksha; it is the release from suffering and the entry point to bliss. As the internet becomes an essential part of daily life, it is imperative that we learn how to deal with this kind of problematic content in a sensible and productive manner. Developing a functional response will take new knowledge and approaches, some of which are provided in this book. We have known for some time that modern media (film, television, etc.) is able to have an impact on suicidal and self-harm behaviour, with particular texts leading to the formation of clusters or contagions. At the turn of the century, Pirkis and Blood raised a concern that very little had been done to study the role that the internet might play in encouraging this sort of harmful behaviour (2001, p. 167). Sixteen years later, this concern has been addressed to some degree. We know that the internet is a potential danger zone, and many websites (especially social media websites) are developing ways of addressing user-generated content with concerning themes, which run the risk of encouraging others to hurt themselves.

2  Self-harm on social networks

Nevertheless, most of the reactions we presently witness are based on a sense of anxiety and are overshadowed by a paternalistic approach to protecting the vulnerable via complete censorship. They also hinge on a misunderstanding of the way relationships and communication work online.

Where did online self-harm communities come from? The internet did not invent depressed teenagers. Rather, it brought them together. An older self-harmer writes, “In my day we did not run in packs. We sniffed the air when we spotted another one and eyed each other warily, like tigers breaching each other’s territory” (Zimmerman 2014). Before the rise of online self-harm groups, those who hurt themselves on purpose were often isolated loners who had no one to share deviance with or with whom they could discuss deviant thoughts in an empathetic way. They were also more likely to define themselves – via a medicalised understanding of self-harm – as mentally ill, suicidal, or dangerous. They tended to think of actions like cutting as weird, abnormal, and something that should be concealed from others – even if they had already decided that it was personally beneficial and helped them to function better in society (Adler and Adler 2011, pp. 94–96). Although some self-harmers decided to stay isolated and reject emerging online communities, the rise of home internet allowed many loners to find and connect with other sufferers (2011, p. 108). They were no longer alone. Early websites included general information about self-harm, often compiled by lay experts.These sites did not engender participation and were designed for people to read and learn from in a more passive manner.They also tended to be from a medical standpoint and highlight the pathological aspects of self-harm, recommending medical assistance. Most websites run by medical or psychiatric associations have this as their heritage. Self-harmers could express themselves via the creation of personal websites where they journaled their feelings and shared art and poetry. Pro-self-harm content also existed in this very early era, with several sites showing graphic images of self-harm and giving rationalisations for why the behaviour was justifiable. Some of the early internet users interviewed by the Adlers even stumbled across proto–social media sites like Usenet – a very early news-sharing group with threads divided by topic, which debuted in 1980. These sites were more interactive than online journals, which did not garner much attention at the time. Message boards, and later semi-private groups, provided a space where selfharmers could communicate with each other directly and chat as friends (Adler and Adler 2011, pp. 109–112).The Adlers noted several of these communicationbased sites emerging during the late 1990s.While some were forums, they were hosted on privately owned and unmoderated websites. Many also hosted image galleries with names like ‘bleed me’ and ‘bioetchings’. They functioned as a place where self-harmers could find support from like-minded individuals for

Self-harm on social networks 3

the first time and thus quickly took on a powerfully pro-self-harm philosophy (2011, pp. 44–49). A major website that emerged during this era was psyke.org, launched in 2001, which contained a gallery filled with graphic images of selfharm and text explaining the experiences of the person in each photograph (Duggan et al. 2012, p. 61). The picture gallery is still available and contains a warning that it is not designed to be used as a triggering stimulus and that no one is allowed to behave in a competitive way with other contributors (Warning 2016). Aside from this, the material is free, uncensored, and accessible to all. Pro-ED sites date their ‘first wave’ to the turn of the century. Many were hosted on early social network sites such as Yahoo! and MSN. This date also coincides with companies like Yahoo! realising that this content was a possible legal liability. In 2001, Yahoo! instigated a significant purge of pro-ED material from its servers. This meant that any obvious communities encouraging eating disorders were deleted. Users labelled the censorship of these sites as efforts by “watchdog nazis” to hamper free speech, with experienced moderators suggesting that pro-ED material be hidden away under subjects like ‘coin collecting’ and that suspicious words be written in l337 cypher. For example, a word such as skinny could be replaced with its l337 version – ‘sk1nny’ (Narscissa 2001a). It is believed that these censorship efforts were a result of two major pressure groups. The National Association of Anorexia Nervosa and Associated Disorders, an American advocacy group for diagnosis and recovery, is said to have been involved. So, too, was an episode of The Oprah Winfrey Show featuring an interview with Holly Hoff – director of programmes at the US National Eating Disorders Association. Hoff discussed pro-ED communities, which made their existence known to the average American for the first time (Singler 2011, p. 19). In the mid-2000s, the Adlers noticed that many previously public message boards were being locked up and were admissible only by formal application in order to evade deletion. They also became fragmented into specialised themes, such as groups for older self-harmers (2011, pp. 44–49). In a 2006 study, most message boards were found to have either a ‘medium’ moderation level, where triggering posts are labelled, or a ‘low’ moderation level, where sensitive material is neither noted nor blocked.Very few show ‘high’ moderation, where problematic material is blocked entirely (Whitlock et al. 2006, p. 410). Message boards have a history of being made and run by self-harmers for the benefit of other self-harmers and thus have always had a very ambivalent message about recovery and a fairly open attitude towards content that is generally classified as deviant (such as images of scars and wounds). Since the purges at the turn of the century, these sites have also developed a strong belief in freedom of speech and the right to express alternative lifestyles without censorship (Singler 2011, p. 20). Now, the majority of content has shifted to even more dynamic spaces such as Tumblr. The social dimensions of the internet continue to develop, and new generations of self-harm groups continue to grow in step with the latest

4  Self-harm on social networks

technologies. My particular focus in this chapter is on communities that are fully immersed in the newer Web 2.0 modality, that is, websites where anyone can create and share content and in which discussions about this content are encouraged. Web 2.0 is a dynamic space where confessions can be made, creative works can be shared, and community can be found. In more complex spaces for user engagement, such as Tumblr, the original producers of content are able to articulate their ideas and struggles, provide a wealth of content rather than a single image, and, most important, speak back to those who comment on or share their work. Seko and Lewis call this “contentbased interaction”, facilitated through functions such as reblogging and liking appealing content (2016, p. 3). Thus, this conversation is lively and connective, often strung together by tags rather than the older and stricter style of groups with single moderators. It can also spiral out of the control of content moderators who might aim to stop the discussion of suicidal ideation or the glamourisation of mental illness. Without this kind of moderation and the careful contextualisation of material pertaining to suicide and self-harm, the site might not be as powerful in terms of encouraging recovery and positivity.

How do online self-harm communities work? Since the very beginning, individual self-harm communities have had different aims and methods. Some encourage a self-harm lifestyle, others are focused on recovery, and most lie somewhere in between. Nevertheless, there are some functions that most of them share. On the most basic level, these communities form because people who share interests come together. After converging, specific communities develop particular norms that govern behavioural patterns, hierarchies, and shared beliefs or aims. These norms will often shape offline behaviour – even though community members may never meet in person (Whitlock et al. 2009, p. 150). For example, a group of people who all wish to recover from self-harm might find each other through a tag like ‘#recovery tips’. They may then decide that their primary focus is to guide each other and give unconditional support. They might engage in behaviours like covering scars with make-up and might frown on content that could trigger a relapse. In contrast, a very different group of people might gather using a tag like ‘#prosi’ and form a community dedicated to celebrating and developing self-harm lifestyles. This group might seek out and share triggering content as a way of supporting each other and upholding a group goal. The outcomes might be very different, but the essential processes are the same. Because groups coalesce around powerful shared interests, social relationships can progress at a rapid speed. Adler and Adler note the immediacy of intimacy in online spaces. Correspondence on the internet can move very quickly, with posters of content receiving a flood of responses over a short period. Because of shared values, there is less pressure to change or censor the language used to discuss socially contentious themes such as self-harm.This gives a sense of honesty

Self-harm on social networks 5

that might be missing in many offline relationships where deviant behaviours tend to be censored. Relationships can also be just as quickly abandoned, meaning there is less fear of long-term judgement if things turn sour – unlike discussions with real-life friends and family who are perceived as more judgemental and harder to avoid. Pragmatically speaking, internet relationships are also easier to terminate and escape from than their ‘real-life’ counterparts if they become too stressful or boring (Adler and Adler 2011, pp. 144–145). This lack of faceto-face contact is often seen in positive terms. The downside is that emotive reactions can become confused online. Thus, it is fairly easy for the absence of vocal tone to make people mistake sarcastic jokes for actual cruelty. But it is equally easy for people to feel relieved by a world in which they are spared from negative cues like sneers when discussing sensitive information (Leiter and Dowd 2010, p. 35). Many community members find themselves confessing things to near strangers that they could never say to their closest offline friends. Nevertheless, the internet is really not so powerfully different from the rest of people’s existences. It is replete with the same stereotypes, privileges, and disadvantages afforded to people in their offline lives. It is not necessarily an escape from one’s class or race or gender. Indeed, it is often a venue in which people can gather to discuss issues they face because of their offline identities like racial stereotyping, disability access, or sexuality. Rather than hiding marginalised identities, the internet is increasingly a place where people emphasise what makes them different so that they can connect with others who can empathise and share a sense of solidarity. As such, the internet can be a space to annunciate new or hidden narratives about the self, identify with different groups, and disclose information that might be private from offline friends and family. It is hard to shake off the kind of identity and social position that we radiate from our typed words and performances, but this is not necessarily an impediment to honest and engaging communication. The internet allows for an appealing flexibility in terms of revealing different aspirations or aspects of the self that may be hidden in offline relationships (Leiter and Dowd 2010, pp. 40–41). With this in mind, can internet groups actually inspire pathological behaviour? Or can they cause people to act in unpredictable ways? It is unlikely that the internet can create problems out of nowhere, but it can bring together people at risk and allow them to disseminate deviant ideas and behaviour. Whitlock et al. argue that humans can learn from media presented to them. We can develop new behaviours by engaging with sources that normalise novel or unusual activities, and by receiving ‘scripts’ that prime us to act in ways we would not have done otherwise. For example, media messages have been known to make children act out in violent ways, and suggestions of suicide in the press lead to actual increase in suicide figures (2009, p. 143). Nevertheless, before people can receive these scripts, they do need to actively search for problematic content. In the late 2000s, the popular press started to criticise pro-anorexia websites for luring in vulnerable young girls with the promise of friendship. These websites were seen as recruiting grounds for the disease and became a

6  Self-harm on social networks

site of moral panic (Boero and Pascoe 2012, p. 28).Yet there is no evidence that people without disordered eating tendencies were ever searching for, or engaging with, these very specific and highly demanding communities. The biggest dangers occur when individuals already have dangerous ideas or unhealthy tendencies and use the internet to seek out others who might empathise. In my opinion, the most ‘dangerous’ function of intensive online groups – in terms of how likely they are to cause pathological behaviours – is their ability to transmute individual suffering into group suffering. One of Adler and Adler’s self-harm community users explained, “When one of us hurts, we all hurt. If one of us have a good day, we all have a better day” (2011, p. 118). In his favourite group, someone having a good day was seen as positive and to be encouraged, whereas some groups like to cultivate this sense of mass sadness. In the examples of real, present-day communities that follow, we will see both of these variants emerging. Sternudd and Johannsen agree that the kind of suffering depicted in online communities differs from its typical manifestations because it often collapses together individual suffering and collective group suffering. In the case of self-harm, the barrier between mental and physical suffering is also eroded (2015, p. 342). This is a substantial threat to individualistic Western culture, where emotions are seen as subjective and personal. Collectivist self-harm groups can provide a deep challenge to the idea that healing an individual is possible.

Pro-ana and pro-mia: an introduction to harmful content online One of the earliest themes to emerge in user-generated problematic content is the veneration of anorexia and bulimia in the lifestyles known as pro-ana and pro-mia1 (also described collectively as pro-ED [eating disorder]).2 The normalisation of eating disorders as a lifestyle choice remains common in online circles and is a good starting point for understanding how groups of this nature function. Participants in pro-ED groups often view anorexia or bulimia as a legitimate alternative to normal eating patterns, as opposed to a dangerous illness (Lyons et al. 2006, p. 253).3 Indeed, some take what Hammersley and Treseder dub a “human rights stance” in order to argue that emaciation is a valid life choice for those who are strong enough to earn it (2007, p. 291). Often, users have an ambivalent stance towards anorexia and will express a desire to maintain anorexic behaviours whilst also wishing to recover or seek treatment for them (Williams and Reid 2010, p. 554). Pro-ED websites tend to discuss the philosophy of starvation or thinness, provide tips for extreme weight loss and ways to trick the body, provide tips for hiding starvation from parents and friends, and give inspiration from other members or photographs of emaciated bodies (known as ‘thinspiration’). Although these sites started in the Anglosphere and have English-based terminology, they have since spread around the world. Common languages for pro-ED sites include Spanish, French, German,

Self-harm on social networks 7

and Dutch (Casilli et al. 2013, p. 94). Interestingly, the internet is not a notable influence on eating disorders in Hong Kong (Tam et al. 2007, p. 815), suggesting that their impact is not completely international. The first pro-ED sites appeared in the Web 1.0 modality and featured early examples of chat rooms and forums. Now, pro-ED culture has spread to Web 2.0 and is a recurrent theme of user-generated content and social networking.4 Encouraging or celebrating eating disorders contravenes many websites’ codes of conduct, and thus, communities are frequently deleted (or obscured/hidden by the owners in anticipation of deletion). Communities can most easily be found via tagging and often exist on sites that allow for this folksonomy, such as Tumblr. Popular pro-ED tags include #pro ana, #pro mia, #pro ed, #thinspo, #meanspo, #bonespo, and #collarbones. Some of these tags relate to a philosophical stance like pro-anorexia, while others relate to popular content like images of protruding collarbones on slender women. The demographic with the highest risk is fairly predictable.Yeshua-Katz and Martins’s survey of pro-ED bloggers found that the typical user had been living with an eating disorder for an average of 6.8 years, was in high school or college, and tended to be White and living in the US. As well as those who defined their eating disorder as a lifestyle, many also described it as a mental illness or a coping mechanism (2013, p. 502).The Tong et al. study has tallied bloggers ranging from 17 to 29, with an equal majority from the UK and the US (2013, p. 414). Fox et al. have found users ranging from 14 to 42 years of age but note that the majority are in the 17–20 bracket and engaged in full-time study. The majority of the users they surveyed come from the UK, US, Australia, and New Zealand (2005, p. 954). While most users are youths and young adults, participants in their 40s, 50s, and 60s are also present in smaller numbers (Gavin et al. 2008, p. 326). The preceding surveys have also found that the vast majority of owners and moderators of these sites are female, as are the majority of users (Fox et al. 2005, p. 954, Juarascio et al. 2010, p. 398, Tong et al. 2013, p. 414). Wooldridge et al. are suspicious of the figures that show only female participants, as at least 20% of those with anorexia nervosa are thought to be male. By specifically adding in the keywords ‘male’, ‘guy’, and ‘boy’ to their search, they located several male participants in pro-ED spaces. Although they are not present in as large a number as their female counterparts, male pro-ED users are certainly present and active in the community. Male users tend to show an awareness of physiological differences such as men being ‘permitted’ a lower body-fat percentage and needing to eat more calories than their female counterparts. Many also express substantial appreciation for the support provided by their female friends online, which seems to be lacking in their offline worlds. Overall, males in pro-ED communities report high levels of isolation and loneliness and are likely to have had alienating experiences as a child such as weight-related teasing (Wooldridge et al. 2014, pp. 98–101, 106). Pro-ED websites tend to contain clear and unique rhetorical strategies. Nearly half the pro-ED blogs located in the Tong et al. study had the author’s

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current and/or ideal future weight included as a major detail (2013, p. 414). This is usually expressed in a formula such as “sw: 165 • cw: 120 • gw: 105” (Slim Thintetions 2016).These abbreviations stand for ‘starting weight’, ‘current weight’, and ‘goal weight’. Some users have a series of goal weights including a UGW, or ‘ultimate goal weight’, and some also include height and body mass index. Goal weights tend to be firmly in the underweight category. The Lyons survey of pro- versus anti-anorexia rhetoric reveals a deep fixation with numbers and an ambivalence towards any consequence of weight loss aside from the development of an emaciated physique. One participant they found confessed, “I am 5’4 and 51 pounds. Clinically dying; and if that’s what gets me the thinnest, thinner than every other anorexic, then so be it” (cited in Lyons et al. 2006, p. 254) Her remarks are a good reflection of the standard values and modes of expression for this online group. This kind of statement also reflects the general trend of ambivalence towards recovery noted in sufferers of anorexia (Williams and Reid 2010, p. 551). Despite these fundamental similarities, there is variety in pro-ED sites, users, and community spirits. For example, some groups thrive on a sense of competition and an obsession with meeting difficult goals. Patients with eating disorders tend to have high levels of interpersonal anxiety and high levels of perfectionism (von Lojewski and Abraham 2014, p. 106), which is clear in many of these activities. For example, some sites hold competitions to see who can have the smallest body measurements or eat the fewest calories over a given period. Shared food and exercise logs are common and are often harshly judged. Another growing trend in these communities is ‘meanspo’, meaning ‘mean inspiration’. Meanspo encourages users to be cruel about each other’s bodies in order to provide motivation for difficult tasks like long fasts. Users will specifically ask their friends for meanspo, which is a gift rather than a curse. There is even a Tumblr blog called Meanspo, which amalgamates nasty comments to share with interested followers. A recent post reads, “You fill your tubby hands with oily food, stuff it into your disgusting gob while completely grossing out what little amount of friends you have. No one wants to be friends with the fat girl” (meanspo-for-me 2016). This is a discourse that purposefully borrows from the words of schoolyard bullies in order to motivate via negative reinforcement. In contrast, many users enter a pro-ED milieu because they are looking for support rather than the anger, confusion, or derision that often results when an eating disorder is disclosed to friends and family members – especially if a person does not feel and express a wish to recover. A major feature of these pro-ED sites is the social support and interaction they provide, which is the most common thematic tallied by researchers logging content of such groups (Juarascio et al. 2010, p. 397, Wooldridge et al. 2014, p. 100). Many blogs run by individuals contain an email address where the owner can be contacted (Tong et al. 2013, p. 418) or encourage those needing help and friendship to send them a private message through the site on which their material is hosted. The

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Juarascio et al. study shows that many pro-ED groups are primarily devoted to providing social support and a place to share negative emotions. These groups tend to emphasise that they are a safe place for people who feel lonely and misunderstood. They provide interaction, friendship, and a place to ask advice about relationships (2010, pp. 398–399). These communities are a place where people with low self-esteem can safely ‘vent’ their feelings and apologise for bothering everyone with the weakness and their emotions – a typical linguistic pattern in pro-ED groups (Gavin et al. 2008, p. 329). They also allow for selfdisclosure of personal thoughts and feelings that a blogger may not wish to communicate with those outside of this network (Tong et al. 2013, p. 410). Of course, advice given is not always in agreement with that given by medical professionals. Participants are rewarded for secrecy and helped in their avoidance of doctors’ visits or hospitalisation (Curry and Ray 2010, p. 362). All in all, they are places where people can safely celebrate a deviant identity together. “More than thin”

Most pro-ED communities are safe, relatively anonymous places where stigmatised illnesses can be discussed and successful starvation can be celebrated. Users can find people who share their anxieties and frustrations, thus making their eating disorders more bearable (Yeshua-Katz and Martins 2013, pp. 499, 501). For this reason, many users engage with these sites and tags in a fairly mundane and prosaic way. But this is not true for all communities. I think the most fascinating, and perhaps dangerous, manifestation of pro-ED groups is those which aim for a deep spiritual and physical transformation. Many ana devotees see themselves as abnormal and everyone else as standard. They often describe themselves as ‘nuts’ or ‘having issues’ (Gavin et al. 2008, p. 328). This is not, however, pejorative. It is a way of showing that they have rejected social norms in order to go on a different journey through life – the journey of being thin. For such users, ‘thin’ is a not just a desired body type. Rather, it is a fetishised, enchanted, inspired state of freedom and perfection. In 2016, ‘whiteskeletons’, a Tumblr user, posted the following discussion of thinspo on her blog, titled ‘thinspo is more than “thin” ’: [I]t’s a skinny girl on a beach wearing her favorite bikini, laughing and having fun, not worrying if she looks too fat . . . it’s people looking back at you when you walk past them and still thinking about how great you looked hours later. (whiteskeletons 2016) Her blog deals with thinspo and fitspo, focusing on her dream of getting smaller. This dream is clearly and evocatively articulated here.Thinspiration is part of an imaginative, emotive journey in which people (generally female) are invited to imagine themselves in a new, better body, which frees them from their present

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concerns and insecurities. They are encouraged to see themselves in a “skinny little body” – inspiring envy and living a life where all concerns over being fat have abated. This is a place of happiness and possibility. Thinspo sells a dream. The way in which this dream is articulated can be quite religious, as can the rules for group membership and the prohibitions placed upon members. Approximately 20% of pro-ED sites contain ana-based religious content (Abbate Daga et al. 2006, p. e67). The oldest incarnation of pro-ED religious devotion seems to be the cult of AnaMadim, who is described as “Guardian Servitor of the Anorectic Praxis”. Her name is also occasionally shortened to ‘Ana/ana’ (ana’s underground grotto 2001a). This cult was created and/or supported by the website ‘ana’s underground grotto’, which appears to have been active from 2001 to 2006.5 Run by a woman known as Narcissa, this site promoted a philosophy of “There are No Victims Here”, meaning that members should see themselves as practitioners of “[v]olitional, proactive anorexia” rather than an eating disorder or sickness that causes suffering. This site was one of the first to declare that pro-anorexia lifestyles are a process of profound internal and external transformation through strength and the willpower to refuse consumption (ana’s underground grotto 2001b). AnaMadim is a spirit belonging to the first wave of pro-ana sites (Faux 2006a). There is debate as to whether AnaMadim was created to fulfil a need, or whether the spiritually gifted Narcissa contacted the pre-existing AnaMadim using her telepathic skills. Project Shapeshift implies that AnaMadim was invented by Narcissa to help the community members focus their religious energy on their anorexia, but her friend Moriah claims that Narcissa actually used Goetic, Enochian, and Thelemic ceremonial magick to summon a goddess who was already in existence. Narcissa was believed by some in her circle to be an initiate of Western Occultic orders (Singler 2011, p. 25). The oldest references to a temple for AnaMadim date back to July 28, 2001, when the Project Shapeshift forum appeared, connected to the Grotto. This forum described itself as an “AnaMadim Temple” containing “[t]ips, tricks, techniques, spells and sigils for shapeshifting”. The only information that remains are links to scientific media articles about possible benefits of calorie restriction and pharmaceuticals for weight loss. A connected forum contained the “Pro-Ana Consciousness Raising Temple”,6 which is now completely lost to time. Fortunately, what remains of the Grotto contains revealing instructions on how to summon AnaMadim using occult magick. AnaMadim can be summoned by performing a ritual outlined by the grotto at “1:47 a.m. upon the New Moon”, as her sacred number is 147. The ritual instructions call for isolation. The practitioner should set up an altar facing the east, and surround it with candles and incense. The scent should be something that “you ‘feel’ represents ana-energy”.The altar can also be adorned with ‘antiofferings’ of unhealthy food such as sugar, bread, or cookies. To give a gift to AnaMadim, thermogenic weight-loss tablets can be dissolved in a goblet of water to make a libation. To start the ritual, the practitioner should perform

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the Lesser Banishing Ritual of the Pentagram from the Golden Dawn or a similar piece of ceremonial magick. They should then align themselves with their inner centre and “iron will”, visualising glowing circles around their head in a sequence that adds or multiplies to 147. The glowing circles should then be drawn into a triplicate rose and brought into the core of the practitioners, radiating throughout their body. Now AnaMadim can appear. Practitioners are encouraged to write their own invocation but can also use one supplied by the site. This provided invocation contains phrases such as Shapeshift me to the image which forms the essence of desire and success; empower me to embrace and endure the necessary deprivations and disciplines . . . tighten the fibers of my being, and make light the vessel wherein I sojourn upon this earth. (ana’s underground grotto 2001a) Now that AnaMadim is present, she can ‘speak’ to the practitioner through trains of thought, sudden insights, or memories coming to the surface of their mind. If practitioners are quiet and open-minded, AnaMadim will eventually give them guidance, either immediately or in the days to come. This point in the ceremony is also an opportunity for making a pact with AnaMadim. In exchange for doing something useful, such as making a new website or defending AnaMadim against her critics, she will help her devotees to show more willpower and give them the strength to fast or exercise every day. Ideally, the pact should be signed off in blood. As the ritual is closed, it is important to thank her then make a return to the material world. It is recommended that practitioners quickly record their thoughts and feelings so as to keep track of progress and signs. Once the ritual is over, any anti-offerings should either be treated as “bad juju” and either thrown into the bin or buried in the garden. Libations may be consumed by the practitioner during a time of need (ana’s underground grotto 2001a). There is evidence of this ritual being performed by practitioners. One of the remaining Tripod sites of this era reproduces and endorses the summoning procedure, stating, “I have used this rite to great success” (ana-gracilis n.d.). Abbate Daga et al. also found evidence of a cult to AnaMadim, a “sculptor, whittler of the flesh, shameless burner of the fat of babes!” who was invoked to gain more strength and resolve and who can enter human bodies that are offered in tribute. She is described as the “hidden mystical martial force of Venus” who can help a girl reach a desirable form that will “cause the phalluses of men to throb with unrequited and unquenchable desire”. She offers the “ecstasy of emptiness” for those who devote themselves to her (2006, p. e70). This power was very real in the minds of many followers at the turn of the century. More recently, the terms ana and mia have been favoured. As explained earlier, these terms can simply be abbreviations for anorexia and bulimia. But to some, ana and mia are divine figures, comparable to the older AnaMadim.

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Boyd et al. describe contemporary pro-ED communities as replete with shared symbology, rituals, and rules for inclusion. Most striking is the personification of ana and mia as venerable, anthropomorphic gods (2011, p. 14). This feature is common enough that Sharpe et al. include a “list of commandments for the ana/mia ‘religion’ ” as one of the main identifying features of a pro-ED site (2011, p. 35). As Williams and Reid discovered, ana is thought to have her own emotions and perform her own actions. She can take control over individuals and enforce behaviours on them (2010, p. 560). She is also used as a figure who demands loyalty and respect. Adherents can threaten each other with her name; for example, “we have to be HONEST with you so you remain faithful to Ana” was a sentence used to justify negative comments about a community member’s perceived fatness and lax diet (Boero and Pascoe 2012, p. 43). The idea that anorexia might actually be some kind of character outside of the patient’s self seems to have come from the kind of therapy that eating disorder patients were receiving in the 1990s. Singler argues that “one therapeutic method in particular opened the door for the externalization of anorexia that allowed for the deification of Anamadim, and the creation of a religion – ‘Foucauldian Narrative Therapy’ ” (Singler 2011, pp. 28–30).This kind of therapeutic approach arose in the late 1980s as a way of emphasising that individuals with mental problems were not inherently problematic people. Instead, their problems (like anorexia) were seen as external forces. Part of the healing process involved encouraging patients to see their disorder as separate from their selfimage so that they can more easily contest compulsions brought on by it. In this kind of therapy, a disease like anorexia is discussed as a force that has intention and that can persuade people to act in dangerous, obsessive ways. Patients are also viewed as experts on their disorder due to their closeness with the voice of the disease. Singler believes that this therapeutic process made anorexia look like an external parasite that controls the mind of certain people. Indeed, there is evidence that Narscissa invented AnaMadim as an external deity while she was being treated for her disorder. She seems to have inverted the suggestion that anorexia was an external parasite that attacks a host into something more positive. She aimed to recolour this external anorexic force as a deity who could provide help (Singler 2011, pp. 52–54). As such, many eating disorder communities have fostered the idea that ana is an external figure who can possess a person’s body, and who can be placated through worship. A letter written from the perspective of ana explains, “[I] am there when you figure out the plan for the day: 400 calories, 2 hours exercise. I am the one figuring this out, because by now my thoughts and your thoughts are blurred together as one” (L. 2014). Many adherents share letters written to them by ana, which tend to be aggressive, domineering, and cruel and contain impossible demands. Blogger Ally describes the pro-ana spaces she joined as “a cult-like community, and for me, it was like a religion with Ana being the goddess. I worshipped my anorexia”. Part of her pattern of worship was to set calorie limits for each day, repent for any transgression with exercise and diet

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pills, and reprimand herself in keeping with the laws, commandments, and punishments of her pro-ED groups. Ana was only satisfied when it was obvious that she was losing weight and working hard to not gain any back (Ally 2013). Ally made her own thoughts and feelings secondary to those of ana. Keeping up with ana’s wishes and trying to avoid her disappointment are powerful motivations factors for many devotees. Even in the earliest days of the tradition, ana was seen as vengeful. She could be “a Saviour that enlightens and shows you the way” but was just as likely to manifest in her darker form as “a demoness that haunts and possesses you” (Narscissa 2001b). Summarising this complex emotional relationship, pro-ana participant Hayley confesses, “Ana is my friend, my foe, I love, yet hate her”. This is supported by Grace, who not only feels safe and loved because of her eating disorder but also has moments in which she fears its deadly control and compares it to a cancer. Jack agrees that anorexia is a guardian and a friend but laments that his disease has isolated him from his other friends, his parents, and his sisters. He explains, “It forces me into a relationship between just it and I”, which is as stressful and lonely as it is comforting (Williams and Reid 2010, p. 560). Ana is a real friend to many. Charlene describes her anorexia as “something that is there for you when no one else is!” while Grace sees her disease as a loving teacher: “It holds my hand when I need to feel safe. It sleeps next to me every night. It makes me feel safe and secure” (Williams and Reid 2010, p. 560). She is also seen as someone who guides people into the faith. One devotee recalls, “I met another beautiful girl. Her name is Ana. She said I should feel some sort of shame if I eat. That losing weight would be a much better treat than the cake I threw up yesterday” (ilunga-x 2016). Recalling her time in proED communities, Williams summarises: [A]norexia wasn’t a cold, clinical, mental illness. “Ana” was a wraith, and a friend, and a bully. Ana wanted the best for you. Ana wanted you all to herself. Ana reminded you of your failures. Ana kicked you while you were down. (Williams 2014) The impact of this complex relational pattern is summed up by L. – a current member of the lifestyle – who explains, I will devote myself to Ana. She will be with me where ever I go, keeping me in line. No one else matters; she is the only one who cares about me and who understands me. I will honor Her and make Her proud. (L. 2014) For many participants, this kind of spiritual and religious relationship with the external ana figure is something they need to actively train themselves for. Despite the intensity of her convictions and her ongoing guilt for eating, Ally

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describes her religious experiences as part of the human ability to “train the mind to believe in a god/goddess that doesn’t exist” (Ally 2013). A different mind game was played by one anonymous pro-ana blogger from a Roman Catholic family. During church services she would pray to ana instead of God, as both struck her as ‘Almighty Figures’. Discovering that the Catholic worldview was a good template for an ana theology, she then invented a whole pantheon of holy figures to help support her new faith and devotion. She explores martyrdom through ‘The Thins’ – people who died for anorexia – and the daughters of ana, similar to Jesus as the Son of God. On the opposite end of the spectrum are the ‘Fallen and Forgotten’ – people who died of obesity and their lack of control over food. These sinful figures become like demons. She describes calories as “the hell and devil of ana’s religion”, as calories both tempt and punish humans. To help both herself and others, she made ‘The Voice’ – a kind of earth apparition of ana who takes the form of any fashion model or inspirational blogger who appeals to you. Your particular Voice becomes a “ghost that only you can see” who stays by your side and corrects you if you want to eat something forbidden. She describes this as “a little like the Holy Spirit in [sic] Cathlocism” (Religion n.d.).7 She has shared these new spiritual figures online so that anyone else can use them if they needed help constructing an ana religion of their own. Ana and mia may not be seen by everyone as literal deities, but they are figurative representations of the very powerful and seductive nature of eating disorders, which are akin to having a controlling, beautiful friend who promises success if you do as she says. Many pro-ana participants describe their eating disorder as a way of feeling strong and successful and as a pathway to what they want in life. In this way, it becomes a solution – “thinness will fix everything” (Williams and Reid 2010, p. 558). Ana and mia will help you cross the threshold into the promised land of thinness where you will achieve all of your goals and receive recognition of a job well done. As one former user explains, “[t]he sites became really popular among adolescent girls, because of the detailed instructions to look the way that society tells us is beautiful” (Ally 2013). The term Ana has also been used to refer to eating disorder faiths as a whole. As Narscissa explained in the earlier days of the movement, Ana is a religion . . . a form of magickal craft, the modern form of the ancient spell of changing shape. Ana is a form of mysticism – seeking a particular state of mind and body through deliberate, calculated efforts and repeated rituals to get us there. (Narscissa 2001b) This can lead to confusion when studying pro-ED communities, as ana means the disease anorexia, a specific deity who is anorexia personified, anorexia personified in a more secular manner, and a broader belief system dedicated to

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the spirit and magical craft of starvation. As such, Singler argues that the “fluid boundary between disease, personification and deity” is part of a move towards an anorexia lifestyle where ana represents different modes of anorexic thought (2011, pp. 3–4). Sometimes ana is a goddess, sometimes a friend or a bully, and sometimes a way of viewing the world. This can sometimes be grammatically confusing, but it is a fair bet that someone who uses the word ana or mia is somehow invested in an eating disorder lifestyle. This is enough to demarcate the community and to gain an understanding of what behaviour is likely to result from engaging with it. Creeds, codes, and sacred texts

Like other faith systems, eating disorder communities have set beliefs and behaviours that govern moral action, and help create a sense of orthodoxy and orthopraxy. Many pro-ED groups have ‘Thin Commandments’ or ‘ana creeds’, usually based on the same text – sometimes with small personal alternations. One seminal creed includes the following lines: I believe in Control, the only force mighty enough to bring order to the chaos that is my world. I believe that I am the most vile, worthless and useless person ever to have existed on the planet, and that I am totally unworthy of anyone’s time and attention. (Abbate Daga et al. 2006, p. e70) The similarities to the Nicene Creed are fairly obvious, especially when the text is read in full.While this has led some people to dismiss the pro-ED version as a poor imitation, this is actually quite a typical strategy employed by young, developing religions. Many reuse existing religious elements as a point of inspiration and legitimacy (Hammer and Rothstein 2012, p. 7). By borrowing from creeds that always have religious value in society, eating disorder communities can create a more respectable and relatable body of sacred text. The content and structure of most ana creeds make them quite easy to recite and memorise. This is true of many of the adages attributed to ana and recited by her devotees. One recovering devotee explains that the phrases are still lodged in her head: “[W]hen I hear the word salvation, in my mind, I start repeating, ‘Salvation comes from starvation. Salvation comes from starvation. Salvation comes from starvation.’ Or the word perfection, in any context, triggers ‘Perfection exists and I must attain it’ ” (Ally 2013). Ana is also given as the source of catchy and popular adages like “skip dinner, wake up thinner”. In one such Tumblr post, ana’s ‘wise’ advice is celebrated with the tags #my best friend and #voice in my head, showing the role that she plays in the life of her devotees (Cute But Sad 2016).

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Some websites amalgamate different rules sets, like the Pro Ana Princess Club, which outlines some of the conduct expected in the ‘Thin Commandments’: 1 If you aren’t thin you aren’t attractive. 2 Being thin is more important than being healthy. 3 You must buy clothes, cut your hair, take laxatives, starve yourself, do anything to make yourself look thinner. 4 Thou shall not eat without feeling guilty . . . These are coupled with the ‘Ana Rules’ (to help uphold the commandments), including the recommendation that adherents look in the mirror every day, tell themselves that they are fat, and then look at pictures of skinny girls to become more like them. For additional shame-based motivation, it is recommended that adherents try on clothes that are two sizes too small (Pro Ana Princess 2011). This site has a fairly metaphysical view of anorexia, explaining that “[a]n imperfect body reflects an imperfect soul” (Pro Ana Princess 2011).These rules, commandments, and creeds outline the pathway to a virtuous life under the guidance of ana. Following them shows goodness and strength, while failing is a transgression worthy of punishment. As one participant explains, “[b]eing thin and not eating are signs of true will power and succes” therefore “[t]hou shall not eat fattening food withoud punishing afterwards” (L. 2014). To help with the amount of devotion and community spirit required for such pursuits, there are also many songs and poems devoted to ana – some even released as mainstream music. Ally explains that, within these texts, “ ‘Ana’s voice’ is often mentioned, because ‘Ana’ really becomes her own voice” in the kind of her devotees (Ally 2013). One of the most popular songs to ana is Silverchair’s 1999 hit “Ana’s Song (Open Fire)”. Written by lead singer Daniel Johns to express his struggle with anorexia, the tune sounds like a love song. Even though he opens with his wish for ana to die, Johns still proclaims “And you’re my obsession / I love you to the bones”. Some songs are more traditionally religious and exist only within the pro-ana community itself. As with creeds, ana has psalms created for her – borrowing from the Judeo-Christian style. One psalm dedicated to strict diets is a rewrite of The Lord is my Shepherd with lines including the following: Before me is a table set with green beens and lettuce I filleth my stomach with liquids Surely calorie and weight charts will follow me, all days of my life And I will dwell in the fear of the scales forever. (L. 2014) Interestingly, some of these seminal texts were actually created as anti-anorexia tools to help sufferers come to terms with their disordered thought processes and reject them as both damaging and fallacious. The Thin Commandments,

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for example, were written by an eating disorder therapist who devised them after interviewing patients with warped attitudes towards food. These commandments were initially meant to be talking points for patients who needed to confront some of their cognitive distortions (Costin 2000). Faux believes that most of the pro-ana texts are totally made up as part of a con from mental health professionals but that their plans misfired. Instead of helping recovery, “those who are anorexic and wanting to go further into it, seen these messages as motivation instead of the reverse that it was intended to be” (Faux 2006b). For that reason, they were taken from therapists like Costin and posted as genuine motivational and spiritual aids. Media misrepresentation of pro-ED circles has also been blamed for introducing the figure of ana as a real, venerable goddess. In her history of the movement, Faux argues that the media and other anti-ED sources accidentally created the goddess ana by spreading lies about what community members believed. She explains, “Ana in the religious conotation actually is the full name Anamadim, and not some goddess named anorexia”. Faux states that ana the goddess is a later pollution in the movement who was invented because of a misunderstanding of the true spiritual core of the early devotional rites. She also specifies that only a select minority of pro-ED community members ever engaged with this early AnaMadim cult, which is completely different to present-day ana creeds, commandments, and letters that are commonplace and adhered to by many (Faux 2006b). But despite these questionable origins, most members of the community remain untroubled and are happy to replicate texts like the Thin Commandments on their blogs. Posting these texts is a way of showing membership in an exclusive community. Singer argues that copying and pasting devotional material is a way of speaking the texts ‘aloud’ and cocreating them – sharing language within a community and allowing a conversation to develop around core statements of belief (2011, p. 41). Their origins are not nearly so important as their shared recitation across a plethora of pages. Wannarexia

Another common theme in pro-ana circles is the threat of the ‘wannarexic’ – a ‘wannabe’ anorexic who treats eating disorders like a fad and who fails to show the required dedication to genuinely starve. This kind of person threatens the core of the movement and irritates those who have truly devoted their lives to ana. There is even some debate over whether praying to ana or mia shows real devotion or, rather, is a smokescreen to hide a lack of willpower and the inability to adhere to a strict lifestyle (Boero and Pascoe 2012, p. 40). As Rouleau and von Ranson note, pro-ED websites often require an initiation rite to show dedication to the group and to determine if a candidate has suitable commitment and the right views to gel with the other members. This often takes the form of writing an extensive response to questions about ED philosophies and life aims in light of the disease. People are more likely to be accepted if they are

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in sympathy with the philosophies of established members. Emotional support is only provided to those who deeply engage with the group and communicate with the other members (2011, p. 526).This is one way of keeping frauds at bay and locking out the wannarexics. It is also a way of reminding adherents that their community is as devoted to orthopraxy as they are to orthodoxy. Although group members are unlikely to ever see each other offline, this is not an excuse to boast about eating disorders without living the real eating disorder lifestyle. Boero and Pascoe argue that pro-ED communities are fraught with struggles over authenticity because their prime discussions are about bodily things like limb measurements and hunger. Because these discussions take place in a disembodied space, users seek ways to make their bodies more apparent online. They believe that these rituals of obsessive verification to identify those who are genuinely ‘ana’ is part of this struggle (2012, pp. 29–30). Rituals for the ongoing verification of true anorexia can include activities like group weigh-ins where members need to show believable progress and the sharing of photographs that depict bodily changes. The kind of physical changes that come from starvation are seen as good signs of proper devotion. For example, lanugo hair growing in new places and the loss of head hair are categorised as positive changes within these groups. Gavin et al. found one user who described these hair changes as “just another ana phase that lets you know you’re doing it right!! Awesome girl, keep it up” (2008, p. 328). By noting bodily changes that are consistent with long-term starvation, members can prove that they are long-term devotees to the cause. Although it has fallen out of popular parlance, Martin notes the use of the terms anorexics versus rexies, which was popular circa 2004. The subjects she studied referred to anorexia as something you have if you want a disease and sympathy. Conversely, rexies are proud of their accomplishments and see anorexia as a badge of honour and success, not something that should be pitied. Alarmingly, one rexie ‘call to arms’ specifies that “we will never die” (Martin 2005, p. 156). On one level, this seems to be a way of emphasising the perceived difference between rexies who maintain starvation in the long term versus anorexics who are sick and pass away. It also reads as a promise that the elite rexie movement will endure forever. While this term is now archaic, the debate between different factions of anorexia endures. A wannarexic can threaten levels of overall group authenticity by using anorexia as inspiration for a short-term crash diet rather than committing to a full lifestyle shift (Boero and Pascoe 2012, p. 39). This anxiety is felt very deeply by the original pro-ana community. A member of one of the first wave (which she dates to 1999–2001) described these seminal groups as a place where adult women could come together and seek empowerment by challenging the label of eating disorders as mental illness. These women also found a sense of community that helped to prevent their deaths by suicide. They are irritated by teenagers without eating disorders who use pro-ana material to look cool and

Self-harm on social networks 19

lose weight when these resources were initially designed to give a sense of hope to those who were already struck down by the disease (AnaxSlavex 2012). Wannarexics cause irritation because of their misunderstanding of the struggles, loneliness, and secrecy of true anorexia.They are more likely to tell people about how little they have eaten and publicly describe themselves as fat. This is in contrast to a ‘true’ anorexic who would keep these details private (Courtney Jean 2013). Thus, the main difference between a real ana devotee and a wannarexic is the difference between a gruelling lifestyle and a crash diet. Boero and Pascoe found that many users were accused of wannarexia on MySpace if they showed a lack of commitment, control, or dedication (2012, p. 39). On Tumblr, the process is similar despite fewer formal groups and more focus on folksonomic tagging. AnaxSlavex, who laments the presence of newer and less authentic pro-ED discourse, feels that many younger people enter pro-ED spaces to find “tips and tricks to ‘lose 10 pounds before prom’ ”, which she sees as “by definition, completely insulting” (AnaxSlavex 2012). These newer users will decide they have an eating disorder when it suits, then “they’ll ‘recover’ or just forget, as soon as they’ve lost the 5 or 10 pounds before prom” (Courtney Jean 2013). Thus, participants are encouraged to show a long-term commitment to starvation before they can claim that their decreased caloric intake is anything other than a crash diet. As such, many health practitioners and policymakers have worried that wannarexics might intensify their unhealthy eating behaviours in order to gain acceptance as ‘true’ sufferers of an eating disorder (Casilli et al. 2012, p. 121). Wannarexics are also criticised for failing to understand the true darkness of the movement and the seriousness of the disease.Those who are deeply afflicted by anorexia tend to simultaneously hate and celebrate their illness. Users who are deeply involved in pro-ED websites are actually quite likely to recognise their affliction as a disease or a disorder with serious negative health effects, including death. They tend to describe themselves as consumed by anorexia – in so deep that they cannot escape (Williams and Reid 2010, p. 561). Those who are committed to this level are often frustrated by attempts to glamourise a disease that leads to death and suffering (Yeshua-Katz and Martins 2013, p. 504). Such people are also likely to reject any kind of proselytising or any kind of community structure that might encourage people to cross the line into a painful and dangerous disease. As one member explains, “if these people asking for ‘e.d’ buddies had a real disorder they would not be encouraging anyone to go through the same mental and physical torture they are” (chewingguns 2012). Another agrees: “[I]f they truly knew how dark and lonely having anorexia is, they wouldn’t wish it upon their worst enemies” (Courtney Jean 2013). A major way of testing for wannarexia is to see who is genuinely familiar with the processes or starving or purging because of long-term personal experience. Boero and Pascoe located a very long discussion on MySpace where users compared the kind of soap they consumed to induce vomiting.When one

20  Self-harm on social networks

participant claimed that this idea was new to her and that she had only relied on using her fingers to gag, she was met with the response: “You NEVER heard of eating soap? Ummmmmmm.You must not really have bulimia, then”. Other participants then went on to compare their favourite soap flavours and methods for sneaking soap into food to ensure that it is ejected from the body. This discussion was peppered with occasional mentions of being in the hospital and having supervised showers in order to show just how serious their treatment has been (2012, pp. 40–43). Juarascio et al. also came across similar judgements when group members asked for tips or suggested that they were struggling to starve or purge without assistance. In one such case, an angry respondent refused to give purging tips, stating, “[I]t’s not cool that you are even asking for this kind of advice”, and finished off with the accusation, “It sounds like you don’t even really have an eating disorder” (2010, p. 400). There is a recurrent implication that those who are genuine ED suffers have an inherent disposition to the disorder and are called to the lifestyle out of necessity, as opposed to wannarexics who try to cultivate the disease by asking for tips and tricks. By depriving other people of a real pro-ana identity, those who are seen as genuine anorexics can strengthen their position and dismiss others as wannarexics. This creates an authoritarian structure in a group and helps in the policing of boundaries and norms (Boero and Pascoe 2012, p. 31). This process is not unique to eating disorder groups and can be seen at all levels of pro-selfharm discourse. For example, ‘wannabe depressed’ is occasionally employed as a descriptor for those who engage with self-harm and sad quotes on their Tumblr accounts but are not serious or devoted enough to meet diagnostic criteria for depression (Bine 2013). As Boero and Pascoe note, this policing and exclusion of outsiders contravene the idea that these kinds of online groups function as recruiting grounds for new members. Instead, new members are actually harshly limited so as to maintain group authenticity and ensure that standards are not dropped (2012, p. 42). This need for extreme devotion may also be a way of managing the common ambivalence and confusion people feel towards their anorexia, as noted by Williams and Reid. Their studies into anorexic teenagers online show that many have polarised responses to the illness – often seeing it as a technique for controlling their world and as something out of control that disrupts their lives. Many showed a wavering commitment, with one participant explaining that “one day you can’t see life without Ana, the next day, you just want to be normal” (2010, p. 558). Similarly, Gradin Franzén and Gottzén found that online self-harm communities show a tension between discourse that normalises the behaviour and discourse that pathologises it. Those who are seen as the most authentic participants are those who can juggle both of these discourses in order to negotiate contradictory world views (2011, p. 279). By elevating anorexia to an extreme position in a person’s life, it is easier to discuss the good and bad sides of the illness without losing focus on one’s complete devotion to the cause.Those who lack total devotion and who only wish for a lifestyle they

Self-harm on social networks 21

have not yet ‘earned’ are a threat to this powerful identity and may denude the resolve of those who wish to remain anorexic, even during days when they also yearn for freedom. A high-demand group

Members who achieve this highest level of devotion are made sacred and special through the power of ana: Ana sets us distinctly – and irrevocably – apart from, and above, the herd. Though they have called us shallow, sick and self-absorbed; shameful, false, empty, these words shall be like blood in their mouths, and dust thereafter. Say it loud and say it proud: a bone above any other! (Narscissa 2001b) There is an interesting congruence between the behaviour in extremist pro– eating disorder groups and the behaviours and social pressures that lead individuals to join extremist religions and new charismatic groups. According to Bhugra’s model, extremist groups often appeal to people suffering from a psychosis or experiencing severe social disempowerment such as from racism or economic discrimination. These problems can make a person predisposed to desire acceptance, or to wish for an improved self. This vulnerability makes them more likely to gravitate towards charismatic leaders who can aid in selfdetermination and redemption. As such, vulnerable individuals are able to gain a sense of power and control. This often involves reframing their perceptions of the world into a more personally acceptable or appealing vision. Whilst in this state of reframing, individuals often report feeling psychologically transformed or healed. They tend to seek out others with a similar outlook and foster solidarity with these sympathetic people. This is also a point at which people are likely to feel under threat and to take part in acts that control their own emotions or the actions of others around them (Bhugra 2002, p. 241). Anorexics in high-demand internet groups control their own bodies in order to take part in a profound and holistic transformation of the self, ignoring the reality of their health. This also allows them to feel closely connected to others who have a similar world view and transformative aims. However, this support comes with a series of stringent rules. Participants must adhere to strict group norms and be active participants at all times in order to be fully accepted and recognised by the group (Rouleau and von Ranson 2011, p. 526). For example, VICE reporter Nadja Brenneisen went undercover in a pro-ED community that ran daily group check-ins via the messaging service WhatsApp. Brenneisen was forced to give full details of her height and weight and was told to count every calorie she consumed. Every week, she and the other participants were expected to share full-body pictures plus photographs of their scales to prove that their anorexia was progressing. The group was eventually shut down by

22  Self-harm on social networks

the moderator’s mother, but Brenneisen was troubled by how religious their devotion to ana was and how much it reflected a teenager desire to belong what whatever cost (Brenneisen 2015). As the Gavin et al. study notes, many of the powerful pro-ana groups normalise their eating disorder identities by creating a strong sense of group togetherness. Within the group, having anorexia is a fundamental requirement, and anorexic behaviours are presented as typical and expected. In order to make these socially stigmatised and marginalised behaviours seem typical, successful groups develop a strong sense of a secret group identity and an ‘us against the world’ mentality.This secret group identity means that participants are very unlikely to disclose group secrets to outsiders, such as their friends and family (2008, p. 325). It also helps the process of taking marginal identities and activities and making them the everyday reality of a follower. Working off Bates’s observatiorxn that pro-ana forums position anorexia as a conceptual space, which a true devotee may inhabit and where they truly ‘belong’ (2015, p. 194), we can see how these kinds of maximalist identities form online. In his study of fundamentalist religions, Lincoln uses maximalism to describe groups that see their religious identity as their core identity to which all others are secondary. Ethics, aesthetics, and cultural practices are all defined by this engulfing world view of one’s faith (2006, p. 59). ED websites form both a conceptual space and a virtual space where strict identities can be aligned and where individuals can connect with those who share their beliefs, ambitions, and rituals.When eating disorders are thought of as a space in which people can reside, they gain the power to become a maximalist and engulfing world view. This is especially likely if members see their illness as something with a supernatural element, or if they see it as a way of defining themselves as separate and set apart from the mainstream. A powerful way in which this separation occurs is via a system of rigid secrecy and suspicion. Intense, guarded behaviours are normal in the pro-ED sphere. Members are told that outsiders will not understand them or may even try to sabotage their weight loss attempts. There is a strong focus on fooling both family members and doctors. For example, Juarascio et al. located a poster who received test results showing that her liver enzymes were elevated. She asked other community members for help in understanding her bloodwork and advice for receiving normal results without eating. Her hope was not to get better but to fool her doctor so as to evade detection (2010, p. 401). Many users are adamant that disclosure to people in ‘real life’ will backfire. Boyfriends and best friends are considered people who will love you too much to accept starvation, meaning that they cannot be told for fear of interference or relationship breakdown. A big fear is that a close companion will try to ‘fix’ one’s ED behaviour and force unwanted recovery behaviours (Gavin et al. 2008, p. 330). As such, there is also a pervasive anxiety that blogs and other safe online spaces will be discovered by family, friends, or partners. Many of the bloggers interviewed by Yeshua-Katz and Martins (2013) expressed this concern, with

Self-harm on social networks 23

one calling her blog “a skeleton in my closet”. Another blogger was discovered because she shared a computer with her boyfriend. His discovery of her blog led to so many fights that she made it private so he could no longer read the content. Users often talk about the inability of other people in their life to understand their need to starve or their happiness when they can achieve long-term fasting goals, extreme exercise targets, or weight loss. Online groups provide this missing affirmation and provide a place where stigmatised behaviours such as these can be expressed and validated without judgement (Yeshua-Katz and Martins 2013, p. 503). Again, this is not so different from the relationship between the world at large and other developing sects. Often, a young religion will be looked at with distance and distrust by mainstream society. In return, members of the group will see the society around them as misguided and be encouraged to uphold a distinctive lifestyle and pattern of behaviour to emphasise their difference from the norm (Hammer and Rothstein 2012, p. 4). Under this rubric, it is easy to dismiss doctors and loved ones as people who are simply unable to comprehend one’s new lifestyle because of profound cultural differences. This is also a process by which the self is redefined as an agent of the pro-ED sphere, not the mainstream world. Bates notes that “self as space” is a popular metaphorical language for pro-ED users. Many refer to their selfhood as a place and space that they occupy in the world. Under this social schema, all individuals fully own their ‘space’ in the world and have the right (or even obligation) to make improvements to this space as they see fit (Bates 2015, p. 193). This focus on space also allows users to categorise themselves as a ‘waste of space’ in order to engage with the self-deprecating discourse required within the pro-ED movement. Many describe themselves as ‘taking up space’ (Bates 2015, p. 194). Both of these perspectives encourage people to become smaller and consume less by making them feel that they are less deserving of resources. Nevertheless, this sense of complete bodily autonomy also encourages individuals to value self-transformation and morally resent outside imposition into the private sphere of their bodies. Many hard-line pro-ED groups are known to be aggressive towards perceived threats. These threats include lax members, wavering devotion, and outsiders who have a standard medical perception of anorexia as an illness. Such groups encourage suspicion towards health sciences and conventional nutrition. Singler argues that the pro-ana community is often “based on a hermeneutic of suspicion and paranoia”, with members encouraged to doubt that government-run health projects are correct in their conclusions about disordered eating. Members are often taught to rely on personal investigation instead. In ana’s underground grotto, for example, readers were encouraged to educate themselves and to do their own experimentation with their bodies. This often resulted in unscientific conclusions such as the idea that all calories, fats, and carbohydrates are bad and dangerous to consume. While this obviously goes against the conventional understanding of the body’s daily needs, it

24  Self-harm on social networks

encouraged members to trust only themselves and to reject mainstream beliefs (Singler 2011, p. 23). Casilli et al. hypothesise that “pro-ana and pro-mia subcultures might be engaged in a series of rituals aimed at resisting the cultural hegemony represented by the biomedical establishment” (2012, p. 126). I think that this hypothesis is correct and that much of their rejection manifests as anger and intense suspicion. Again, this kind of behaviour is not unusual in other young, high-demand communities.Terman observes that fundamentalist groups tend to “react with a kind of collective rage” when threatened (2010, p. 17). They also have the ability to make victims into martyrs.Whether members are attacking outsiders and their ideologies or lamenting attacks against the pro-ED lifestyle, these communities give users an opportunity to frame themselves as “heroic sufferers” for the cause (Casilli et al. 2013, p. 94). Boero and Pascoe agree that aggression is often a major part of boundary-policing in pro-ED movements. Aggression is not just against wannarexics but also against the self. If people show good self-aggression, they are seen as motivated and dedicated.They can also indicate that they are suffering and not enjoying themselves; thus, they are less likely to be seen as a wannabe (2012, p. 46). Self-aggression can also be beneficial if a new community member wishes to show that they understand their subaltern status as a pledge. This means they are more likely to be included later on due to showing proper deference. For example, many users will note that they are unworthy of an eating disorder by saying thing like “I’m too much of a wimp to purge!” and lamenting this as a personal failure (Gavin et al. 2008, p. 329). More experienced members can then step in and give approved advice. The practice of meanspo is also a response to this desperate need to find motivation by putting oneself down. By placing themselves in a position of unworthiness, often including an apology to ana, people can then mark themselves as in need of transformation. Some meanspo comes from the individual, some comes from their friends, and others are composed in the voice of ana. This kind of hyper-aggressive diatribe has similarities with Shaw’s observation of traumatic narcissism in high-demand groups. Often, group members will be led to believe that only perfection is good enough.This allows leaders to berate followers for their inevitable failure to be utterly good and devout at all times (2013, p. 49). Through meanspo, the voice of ana taunts and abuses those who purge, bloat, or place food above her. She often wants her devotees to hurt themselves as penance. In a popular letter, the deity writes, [P]erhaps I just make you hurt yourself, bang your head into the wall until you receive a throbbing headache. Cutting is also effective. I want you to see your blood . . . fall down your arm, and in that split second you will realize you deserve whatever pain I give you. (L. 2014) Such communities provide not only a clear ideal for the body but also a set of moral ideals intrinsically connected to extreme thinness. To be morally good

Self-harm on social networks 25

and repent, people must punish themselves for being too large, greedy, or uncontrolled. This punishment is something that happens frequently, not always involving meanspo. Self-punishment is a popular way of achieving control. A pro-ED member explains, “Thin is about control. Total control over your body. Your feelings. Your desires” (Juarascio et al. 2010, p. 403). This also leads into one of Shaw’s other observations on this kind of group dynamic: Inner deviance must be eradicated (2013, p. 50). Because total control can never be achieved, especially considering the powerful impulse of hunger, members keep succumbing to food, and thus punishment must be repeatedly doled out. Even when they succeed in restricting, members are not encouraged to be smug. Victories are often phrased with a tone of defeat. For example, “[p]eople say ‘you are what you eat’ and maybe it’s true that I am nothing” (angelic body hellish mind 2016). Here, the author has succeeded in avoiding food, but she still ensures that she and her group members view her in an appropriately diminutive manner. As unpleasant as these attitudes may seem, they all lead towards the end goal: transformative thinness and the unveiling of one’s ‘true’ body. Bates notes that many pro-ED users describe their thin self as their true self – often in opposition to the larger body that they presently inhabit (2015, p. 195). This makes an eating disorder a search for veracity and a transformation back to one’s true and real form. Concurrently, pro-ED social networks are often described as a different reality where users can be their true and authentic selves. This is in opposition to their offline lives, where many users describe themselves as playing a role or hiding the truth. Others also maintain this charade online by having multiple blogs. Some describe running decoy ‘healthy’ blogs that their friends follow to assuage suspicion and carry on a normative social performance (Yeshua-Katz and Martins 2013, pp. 503, 505). But these charades are all false personas, which are stripped away in the safe spaces of pro-ED communities. Here, users are able to seek out their ‘real’ bodies to reflect their ‘real’ internal world. As in many world-denying religious movements, many ED suffers refer to their bodies as shells or containers – often implying that the true self is trapped inside and needs to be released from a flawed vessel. Bates quotes one user who writes, I feel savagely surrounded by myself on all sides. I feel the substance sticking to my alabaster bones in contempt; you can rid of me so easily!; says the flesh, holding and sticking every bite to the pure frame that truly is the heart of me. (Anon. in Bates 2015, p. 195) An ultimate aim for many participants is to become so weightless as to disappear, or even to die, as a means of finally obtaining bodily perfection. The perfect body is one that is erased and de-materialised (Bates 2015, p. 197). In the meantime, punishments help devotees to cope with the deviant body they inhabit. By obsessing over an eating disorder, the entire world of the devotee is seen through the lens of food restriction. Bhugra writes of the

26  Self-harm on social networks

“role-engulfment” that occurs when one aspect of the self, even a perceived deviant aspect, becomes the most important aspect of selfhood under which all other aspects are subsumed. For example, a person’s mental illness may become his or her primary aspect of self, which trumps other important aspects such as occupation or ethnicity (2002, p. 244).This is comparable to the aforementioned maximalist model of religious affiliation proposed by Lincoln, who argues that individuals in this category see their religious identity as their primary identity that overshadows and influences all other areas of their lives, in opposition to the minimalist model in which religious identity is one of many identities held (2006, pp. 4–5). Exemplifying this,Williams and Reid quote pro-ana participant ‘Maria’, who explains, “Everything I do or think, I relate it to anorexia in some way”. ‘Jack’ agrees: “My anorexia is my life. It is who I am” (2010, pp. 558–560). It seems as though participants who become obsessed with their disordered eating to a religious degree are the least likely to recover and would be the most resilient to alternative discourses about health and well-being. They also have the ability to make an argument that their beliefs and practices are as valid as anyone else’s within a pluralistic culture that grants religious freedom. But, despite these barriers, Bates believes that the best path to recovery may well be the creation of a multifaceted self in order to deflect a monomaniacal focus on an ED identity (2015, p. 199). Conversion into a group is also worth considering when looking at processes of leaving. Joining another community to replace a high-demand group may appeal as a way of regaining a lost sense of belonging and self-esteem. These groups can be religious groups divorced from mainstream society as explored by Bhugra, or they may also be intensive online communities that allow people to exist in a manner not defined by their offline self. Bhugra explains that belonging and self-esteem can be eroded by the onset of mental illness, often starting in the early teenage years. Finding a new setting where they are unknown can help a mentally ill person to find acceptance and support without the baggage of his or her prior deviant behaviour. These new settings often result in a person changing their external appearance and their internal belief structure (Bhugra 2002, p. 247).While this process often results in people adopting a religious approach to their eating disorder, shifting groups again may help them to escape. For example, many recovering ED sufferers can be found in the immersive Tumblr ‘Fitblr’ community, which values transformation of the body through healthy eating choices and the development of lean muscle. This is explored more in the final chapters of this volume. I think that encouragement towards appealing, healthy groups that require less deadly changes to the body are likely to be far more successful than attempts at censorship.

Self-harm on specific social networks To understand how self-harm manifests online, it is important to understand the different media sharing and social networking sites in which this behaviour

Self-harm on social networks 27

is celebrated. The nature of each site is slightly different. Aima provides a good taxonomy of the major types. She notes that more traditional social networks were based on blogging – a form of commentary. They have since moved into microblogging – a practice more akin to curation. Within microblogging, we have the purely textual world of Twitter, plus the more visual worlds of Instagram, Tumblr, and Pinterest (Aima 2012). All these sites involve folksonomy through the process of tagging.The kind of tags selected show the clear overlap between pro-self-harm and pro-ED content. For example, self-harm communities are often cross-listed with the topics of ‘depression’ and ‘eating disorders’ (Whitlock et al. 2006, p. 411). Tagging content makes it easy for people who identify with these topics to find each other, form communities, and share information that reinforces their choices. As with pro-ED communities, the kind of beliefs and values promoted on pro-self-harm tags are not uniform.There is tension between the idea that selfharm is a symptom of defective brain chemistry or a physiological addiction and the idea that it is a choice and a lifestyle that can be opted into at will (Adler and Adler 2011, p. 136). Members of pro-self-harm groups rarely become entirely divorced from the morals and expectations of mainstream society. Instead, they often find themselves wavering between the knowledge that their behaviour is dangerous and repulsive to others and a feeling that they should discuss and praise this behaviour with their online friends. This conflict means that online spaces are not isolated safe havens but, rather, are places where participants show awareness of their deviant status (Gradin Franzén and Gottzén 2011, p. 280). As such, they usually contain quite an ambivalent message. Lewis and Baker found that a large portion of self-harm sites had a mixed purpose, not only making claims that self-harm cannot or should not be stopped but also arguing that it should never be started either (2011, p. 393). Finally, it is important to note the specific demographics of those who join self-harm communities online. Despite many studies indicating an even gender distribution of self-harmers, the Harris and Roberts’s study into online community usage shows some very different statistics. Of 329 respondents polled, 91.8% identified as female (2013, p. e285). Other surveys have come up with figures as high as 97% female participation (Peebles et al. 2012, p. s62). Images of female subjects are also the most common. Seko has noted a prevalence of female bodies in self-harm photographs on Flickr, where gender can be easily identified. For example, of 91 self-portraits, 88 had female subjects (2013, p. 12). Similarly, Lewis et al. (2011, p. 553) noted that 95 out of 100 popular self-harm YouTube videos they studied were uploaded by female creators. In terms of age, the Harris and Roberts study tallied an average figure of 23.06 years (2013, p. e285). In a survey of people who used pro-ana and pro-mia websites, the average age was 22 years (Peebles et al. 2012, p. s62). A similar survey came up with a younger average age of 17.3 years for pro-ana users and 21.1 years for sites dedicated to recovering anorexics (Lyons et al. 2006, p. 254). It is worth noting that not all self-harmers who use these sites are schoolchildren. The average

28  Self-harm on social networks

age noted by this survey means that many users would be old enough to have completed their tertiary education. Tumblr

Tumblr is a good place to start when it comes to understanding image-sharing social media sites today. It was created in 2007 by David Karp, who based his ideas on the emerging ‘tumblelog’ format (Alfonso 2015).8 Tumblelogs developed in response to the need for ‘microblogging’ – short posts about the self or an interest made frequently. Previously, traditional blogging had been focused on longer posts, which were often written in an essay style; provided a personal narrative like a diary; or advanced a specific argument. Microblogging can be equally powerful and persuasive but does not have the same length requirements. Many self-harmers have reported that they now use Tumblr (and Twitter) more than the traditional forums and websites (Harris and Roberts 2013, p. e285). This is in keeping with a general shift towards microblogging and the improved usability of websites that can be seamlessly accessed through smartphone and tablet apps. Tumblr is a community that can be ever present in the life of its users because of its strong integration with mobile technologies. Participants in the Hillman study described their engagement with Tumblr as “always on”. That is, Tumblr is a constantly in their thoughts, and a tab containing their Tumblr dashboard is always open in their browser (2014a, p. 288). Wearable technology such as the Apple Watch also supports the Tumblr app and thus fosters its ubiquity. One of the main appeals of Tumblr is the way users can curate a collection of appealing images, songs, quotations, and text posts. Microblogging has helped to advance the idea of ‘reblogging’ –reposting material by another author to widen its audience base and endorse the content. Fink and Miller note the archival impulses that drive participation in this site (2014, p. 613). Tumblr allows users to curate highly visual blogs with images, animations, songs, and short pieces of prose that match their interests. It is supported by an engaged user base who network through the reblogging of media. Each post on Tumblr can be liked or shared by others. People can also reach out to each other by leaving comments on posts that pique their interest. In sum, the site is comparable to a virtual scrapbook with the added bonus of community chat. Aima describes visual microblogging as the “spiritual heir” of a ’zine, made with text, image, and quotes. This is different to the unique creativity of a sole artisan, as it is more a process of bringing together objects, contextualising them, and playing the role of co-producer (Aima 2012). Another special factor that makes Tumblr a locus for deviant content is its inherent anonymity. As opposed to sites such as Facebook, users of Tumblr are less likely to follow and friend people whom they know in real life and are more likely to represent themselves using pseudonyms. This means they are more likely to be honest about their passions and deviant identities. Tumblr is

Self-harm on social networks 29

more distant from a user’s everyday relationships than Facebook tends to be. Users will add each other on Tumblr and form close relationships without ever having any offline relationship. It is also less likely to be a place where people have to consider the values of their family or employers. This allows for the presence of far more candid material, which is often in line with a user’s perceived authentic self. Hillman et al.’s survey of Tumblr communities revealed that participants feel a heightened sense of comfort and support, which allow them to be more expressive of elements of their personality or interests that they censor in other social situations. Conversely, many saw Facebook as superficial and less supportive (Hillman et al. 2014b, p. 781). Although Tumblr is generally pseudonymous, it is often the place where users are truest to themselves and most genuine about their feelings, needs, fears, and desires. Due to this peace and the freedom to be oneself, Tumblr is a zone in which many people feel entirely safe and honest. Popular Tumblr user Plastic Pony explains that Tumblr is different from a social network like Facebook, where you connect with people who you know in everyday life and who want updates on your activities. She sees this as a limited and limiting platform. Tumblr, on the other hand, is “a totally different thing”, which can be a blog, a personal website, and a project: You can become famous through it and it can change you. I know for sure that it changed me. It helped me in deciding to be strong and dye my hair, it helped my taste in fashion, art, photography change and evolve, it made me interested in feminism and social rights. (Eler and Durbin 2013) She is not alone in her advocacy of the magic of Tumblr. Several participants in the Hillman study describe their Tumblrs and Tumblr personas as a reflection of their genuine selves. One explains, “I would say it’s me. It’s the ‘real me’ I don’t get to be in my everyday life”. Another user states that his or her persona on Tumblr is a projection of an ideal real-life self. Tumblr provides an avenue for confidence and expression that is not always available in daily life (Hillman et al. 2014a, p. 288). A major cultural difference between Tumble and ‘real life’ is the way in which images of injury, pain, blood, and suffering are valued – as are those who create them. Mutilated bodies are generally unseen in mainstream Western visual culture. If they appear, they are the stuff of horror films or crime scenes. But within the unique visual communities of Tumblr, the grotesque and unpalatable can become things of elevated beauty. For users of Tumblr, Bell notes that there is currency in having a deviant identity of some form. For example, people might note that they are neuro-atypical, suffer from some kind of recurring illness like polycystic ovary syndrome (PCOS), or are a member of a disadvantaged group such as non-White or non-wealthy. Clearly irritated by this parade of labels, Bell argues that “power in this community lies with those who can play the

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most enticing victim” (2013, p. 36) Their negative experiences and emotions thus become commodified as cultural currency. The kind of help and support that people give within these communities can also be emotionally loaded. Zimmerman believes that Tumblr self-harm communities foster a culture where users help each other in order to put themselves down. Thus, “[e]ven the support is a kind of one-upsmanship  –  you’re not worthless, I’m worthless. You’re not crazy, I’m crazy. And if I encourage you to get better, I will be unchallenged as the craziest” (Zimmerman 2014). This is part of a broader battle for authenticity. As Gradin Franzén and Gottzén note, users will often show that they are authentic cutters by noting how bad and disgusting the process can be. This shows that they have genuine problems and cut to address them, rather than cutting because they want attention or to look impressive to others (2011, p. 290). This rhetorical strategy is a very important way of showing a true devotion to the lifestyle. Competitive activities like comparing the size of wounds is also a common reason why people access images of self-harm. Many feel that their own injuries need to be severe enough to measure up to those shown online, with several users expressing feelings of worthlessness if they have smaller and less impressive scars. These images act as trophies, which reflect the bravery and determination of those who can achieve the most dramatic results (Sternudd 2012, pp. 428, 430). Fink and Miller explain that “to thrive within Tumblr’s format, you need to labor and gain credibility according to particularly intense systems of distinction” (2014, p. 615). Within the self-harm community, this can mean that an individual’s notoriety and visibility within a community comes as a result of creating and/or sharing new, shocking images of bodily harm or intense emotional distress. The reblog system makes it quick and easy to share content – including graphic GIFs and videos showing the movement of extremely thin bodies, or people cutting themselves. Bine believes that “looped video of gifs makes selfhatred into practical bite-sized packages” (2013). Interestingly, cutting seems to be the main form of self-harm that is visually represented on Tumblr. In the Seko and Lewis study, 91.8% of the Tumblr images they found involved cutting or carving words and images into the skin (2016, p. 7). ‘Dark’ imagery is relatively popular on Tumblr and can lead to both followers who empathise and sympathy from concerned strangers. Reinecke warns that adolescents are vulnerable and seek recognition from others, even if this recognition comes from ‘bad’ behaviours. He is concerned that Tumblr promotes gaining followers through the creation of a beautiful, mysterious, and depressive persona (Reinecke in Bine 2013). This concern is not unfounded when we turn to the testimonies of those who have kept self-harm Tumblrs. Buzzfeed interviewed a 14-year-old girl who ran the now-defunct depressionand-disorders.tumblr.com. She publicly blogged about her self-harm, suicide plans, and eating disorder.This blog also provided a haven for other people with similar confessions or with questions to ask. Sharrock notes that the site had

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quite an ambivalent stance on self-harm. Sometimes readers were encouraged to get help from their parents or seek out a therapist, but other times they were given techniques for cutting coupled with a range of inspirational photographs showing razors and blood (Sharrock 2013). The anonymous curator of the site maintains that her words and images do not actively encourage anyone to selfharm. She explains: Other people usually think we’re freaks and they say it’s our own fault because we’re looking at those things, but that’s not true. It doesn’t start with looking at pictures.You start looking at pictures and stuff after you’re started with cutting or after you’ve developed an eating disorder. (Sharrock 2013) Nevertheless, she does confess that she finds the images she reblogs triggering and has often been encouraged to cut after looking at her own content. She has also wanted to starve herself after reblogging pictures of skinny girls (Sharrock 2013). This is a fairly common reaction, even for people who are no longer chronic self-harmers. Zimmerman confesses that seeing self-harm imagery on Tumblr can still make her feel anxious even though she has largely recovered. The imagery that she sees on Tumblr makes her feel bad for not injuring herself more deeply and bad for letting her scars fade (2014). In terms of recovery, the curator of depression-and-disorders seems unconvinced. She keeps her blogging private from everyone in her life and has repeatedly lied to her parents about the severity of her self-harm. At the time of the interview, she was being forced to see a psychologist once a week, which she did not enjoy. She planned to fake a recovery in order to stop the visits (Sharrock 2013). It is unclear what happened to her after this point. As with most social media sites, Tumblr has responded to self-harm content by banning any material that could be seen as ‘promotional’. Technically, Tumblr prohibits content that could be seen as promoting self-harm, eating disorders, or suicide. But most users have realised that they can post whatever content they like so long as they can claim that they are offering support for sufferers rather than encouragement. Several blog owners do this by including disclaimers that they do not promote dangerous behaviours, although many do not bother as enforcement is known to be lax (Sharrock 2013). While sites like Instagram have deleted entire problematic tags from their site, Tumblr tends to delete problematic content on a blog-by-blog basis (Seko and Lewis 2016, p. 2). On February 23, 2012,Tumblr proposed a policy to ban self-harm content such as blogs and posts that “glorify or promote anorexia, bulimia, and other eating disorders; self-mutilation; or suicide”. This ban was not intended as a way of stopping users from posting about these topics or using Tumblr as a way to start conversations with other people. Rather, they note “this prohibition is intended to reach only those blogs that cross the line into active promotion or glorification” (Tumblr Staff 2012).

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Tumblr Staff also proposed a system by which users searching self-harm tags would be greeted with an automatic message explaining the dangers of eating disorders and self-harm. This message would recommend a resource for help and recovery (Tumblr Staff 2012). Presently, the message recommends either National Eating Disorders Association (NEDA) or S.A.F.E. Alternatives and provides a link to the online crisis counselling chat service 7 Cups of Tea. Other tags that trigger a similar concerned response from Tumblr include #depression, #sadness, and any of the #pro ED folksonomy. Many blogs that use these tags will eventually be shut down. I assembled my own Tumblr account containing images relevant to the present study. It was eventually deleted by Tumblr without warning. I emailed their support account to ask why my research-based collection was erased. After nearly a month, I received a form response stating that my research “contributes to the growth of disordered eating and deliberate self injury as expressions of distress”. I was also encouraged to “seek professional help” for my mental problems from services including S.A.F.E. Alternatives (Tumblr Trust & Safety 2016). The fact that Tumblr took five years to implement this censorship policy was noted by many users, some of whom were disappointed because of Tumblr’s commitment to the freedom of ideas.Writing from the perspective of someone who has an ED blog on Tumblr, Dutton-Gillett thinks the site may have taken longer to implement content restrictions because the philosophy of the Tumblr is to give people space for self-expression in whatever form. After hearing of their 2012 proposal to limit harmful content, Dutton-Gillett became anxious and sad. She owns two Tumblr blogs – one ‘everyday’ public blog that she tells her friends about and one more secretive blog to promote her eating disorder. The pro-ED blog contains thinspiration pictures and reflections on the anorexia lifestyle. Dutton-Gillett describes herself as someone who eats “relatively normally now” and who realises that anorexia is unhealthy and leads to feelings of extreme weakness. She no longer posts updates on her ED progress. Nevertheless, she still collects ED pictures on Tumblr because she finds them “beautiful” and still wishes her body could look that way. Her pro-ED blog gives her a sense of comfort because she enjoys seeing “perfect girls” with thin bodies and likes feeling a sense of connection with other people suffering from anorexia. Tumblr’s threat to remove this kind of content left her with “a strong sense of loss” (Dutton-Gillett 2012). I discuss more about the broader project of selfharm censorship online towards the end of this chapter as the way it has been handled lacks the sophistication required when dealing with such a complex scenario as this. Other image-sharing social media

While Tumblr is the main site that I focus on and draw many of my case studies from, there are other popular image-sharing social networks online such as Instagram, Flickr, and WeHeartIt. Instagram and Flickr are generally used as

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portfolios for an individual person’s photographs of his or her own life. Some photographers use Flickr as portfolio for launching a professional career. Like Tumblr, WeHeartIt is more of a curatorial project, or a scrapbook of images from different creators. These visual social media sites are increasingly popular and important. The Pew Research Center has been tracking the rise of images as online social currency since 2012. Researchers have noted that this process involves a combination of creating original images and curating images by other authors. Of adult internet users, 46% have created new material, and 41% have been involved in some kind of curation. The rise of smartphones has made this process easier because phones generally have cameras to create new material and apps to process and share images. On a smartphone, people can record video for YouTube, take a picture and process it through Instagram, or sort through pictures and text on their Tumblr and Pinterest apps (Rainie et al. 2012, p. 2). Seko argues that Flickr’s Web 2.0 structure, in which users can easily share and group together images pertaining to a theme, has brought self-harm images out of a disorganised online underground and into more workable community structures (2013, p. 3). WeHeartIt has less flexibility and sense of community than Tumblr but is very useful for searching and cataloguing images by theme. For example, the user Rochy Quiroga has assembled a collection titled ‘Bruises’, which is currently followed by 218 people. Many of the bruises catalogued are self-inflicted or posted in a celebratory manner (Quiroga 2015). Instagram is perhaps the most popular image-sharing social media site, reaching 400 million users in 2015 (Instagram Blog 2015). Unfortunately, most of the prominent self-harm pages are private and thus difficult to assess and analyse. I suspect this is because of Instagram’s close connections with Facebook and emphasis on using one’s real name and connecting with family and colleagues. The most in-depth study into image-sharing social media (outside of Tumblr) is Seko’s exploration of self-harm photographs on Flickr. In her tabulations of the kinds of self-harm images present on Flickr, Seko describes the majority of photographs as “raw, candid digital snaps assumingly taken by lay photographers”. She makes it clear that not every self-harmer she located on Flickr is proud of his or her injuries or seeking to encourage or celebrate this behaviour. Many describe feelings of embarrassment of ugliness as a result of their wounds. Importantly, she observed that bodies are often presented with identifying features removed.This means that gender, age, race, and the cultural background of the wounded subject are commonly unclear. Seko explains that the effect of this is twofold. The self-injured body is deprived of “its context, depth and other attributes necessary for meaning making”, thus objectifying it and denuding communicative power. Nevertheless, this absence of context allows for the wounded body to gain a new ontological meaning that is broader than any individual creator. Thus, a generic harmed figure symbolises the “ubiquity of pain and suffering beyond the boundary of individual bodies” (Seko 2013). This allows individuals to feed into a broader project of symbolising shared

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pain. A site like Tumblr is even more complex because it allows more easily for curation and is not just a portfolio from a single artist. Arguably, this allows for an even more complex discussion on the shared or essential nature of pain. YouTube

YouTube is the internet’s pre-eminent video-sharing site, launched in 2005 with the slogan “Broadcast Yourself ”.YouTube combines professional broadcast material with user-generated content. Many YouTube videos on the topic of self-harm are designed to create awareness of the problem and offer advocacy to fellow suffers. A good example of self-harm culture on YouTube is Taylor Hansen’s vlog on her struggles with mental illness. In this 2013 vlog (which remains highly popular to this day), Hansen talks directly to the camera and films herself in black-and-white. She is on the verge of tears throughout and comes across as very fragile and damaged by her experiences. On some levels, she is the ‘typical’ self-harmer: young, blonde, beautiful, and sweet. She also details alcohol abuse, marijuana smoking, risky behaviour while drunk, and bad friendships with bullies who were cruel to her. She started to have anxiety attacks at school, obsessively picked at her skin, and was prescribed Zoloft. While feeling anxious, she started clawing her body and created scars all over her arms and elbows. She also started to cut and had to sleep in a room with her parents so that she could be supervised. Hansen was later put on, and taken off, a variety of antidepressants and sleep drugs. A big part of her eventual recovery was due to her new dog, Molly, who was rescued after going through difficult times herself. Hansen was also enrolled in an online school so that she could be safe from her bullies. She now describes herself as 100% happy. She now focuses on make-up and beauty vlogging. Her recovery occurred thanks to freedom from bullies, the profound love of a rescue animal, and her self-described faith in God’s plan (Hansen 2013). Post-recovery, her largest problems seem to be harsh judgement from those who watch her videos and criticise her for having harmed at all. The responses to her video vary.The majority of viewers empathise with her situation and look to her for guidance and support. Hansen and other viewers are quick to provide friendly and constructive comments for anyone who seems in distress, even many years after the video debuted. A few others have responded with negativity and misplaced concern. To explain her motivations, Hansen includes a disclaimer before her video starts, explaining that it was made as part of her “healing process”, not as a cry for pity or attention. She also makes it clear that she is aware of global struggles and knows that other people have harder lives than her own. She points out that sharing her story has been able to help thousands of people who are going through similar problems and asks why “some people think it is acceptable to ridicule me for posting this video and say that my problems and pain were/are not valid”. Her disclaimer concludes with the words: “We all find a way to deal with our pain and at this

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point in time of my life, that’s how I dealt with it. (Hansen 2013). While her video is very emotionally raw and contains distressing content, the overall message is one of hope and healing. Another interesting YouTube vlogger is Ana Cadence, who titles her channel ‘Howsenselessdeath Howpreciouslife’. She has more than 100,000 subscribers, and each individual video she has posted has views in six-figure numbers. Cadence has posted videos about her suicide attempt and her depression. She also posts about her experiences in the pro-self-harm community. In her 2015 video titled “☯Being in a Pro-Self harm Community | GRAPHIC☯”, Cadence cries as she tells of her experiences with this culture. She initially fell in with a small and intensive group of self-harmers on Instagram. Cadence explains that there were many groups she could have connected with, but Instagram is her favourite social media platform so she joined in there. She initially located online self-harmers when she realised that one of her favourite followers had a consistent set of self-harm hashtags and devoted friends who all discussed self-harm issues. This made Cadence feel as though there was a real community at play as opposed to disparate self-harmers telling their stories in an echo chamber. Cadence started a private account (without the knowledge of her friends) to use for “quotes that were sad”. She also shared pictures of herself being sad and her self-harm scars. This autobiographical material, showed by Cadence in her vlog, was part of the self-harm ‘black-and-white’ aesthetic. This blog was designed to be sectioned off from her happier persona and her primary blogs. She because very distressed when people from outside the community stumbled on it and could identify her. The friendship dynamics of the pro-harm group were very intense and unusual, which seems to have added to the need for secrecy. Cadence was friends with many of these community members for a long time, growing attached to them and their social mores. This attachment was very powerful due to the fact that users disappeared at any time without warning. Some were deleted by Instagram staff because their accounts were deemed to be too graphic, whilst others self-deleted so their images would not be found after their suicide. No one in the group could ever be certain if they were talking to a friend for the final time. In addition to this culture of secrecy and fear, members were required to loathe their bodies and their souls. Cadence describes the unwavering focus “the pro-hating yourself and the pro-hurting yourself ” material that was shared. Members used the same hashtags, cheered each other on, and encouraged each other to not eat for ‘just one more day’ or to cut deeper next time. Cadence believes that the group taught members to “felt loved for hurting yourself ”. She was personally very touched and elated when novices admired the depth of her cuts or her need for stitches.There was substantial group pressure to hate everything about oneself, including checklists for different aspects of the body like ‘eyes’ and ‘hair’. Anyone who did not successfully tick off that they hated each body part would be bullied with negative comments about the body part

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in question until they changed their minds. The group also circulated blank outlines of a body. Members were encouraged to draw on this outline show where they had cut or burned themselves. This helped to keep a tally of who was the most injured. Cadence felt forced to post every time she was sad and document what damage she did in response to her feelings. This added to the group’s reserves of depressive material. This obsession with sadness mandated a complete rejection of happiness. When things were going well in her life and Cadence was feeling good, she did not feel like posting or connecting with other peoples’ sadness. She also felt uncomfortable sharing happy thoughts or moments from her life because they did not match the tone of the community. When she retreated into her happier persona, community members would message her and call her back into the abyss. Cadence believes this was not because they were worried or missing her but because “they wanted to see you hurt”. She also noticed how members wanted to prove that they were more hurt than anyone else and to keep a sense of competition thriving. She feels that she was dragged back in to the community every time she tried to leave because her friends wanted to see her torn down and have her as witness to their own destruction. Anyone who wavered too much, had cuts that were too shallow, or lost too little weight was accused of not being true self-harmer or a true anorexic. Cadence is still traumatised by the ongoing accusations that she was not “anorexic enough” to meet group standards. Cadence eventually broke free from this high-demand group and has not returned since. This was not, however, a complete solution to her troubles. Although she no longer feels forced to document her moments of sadness for the enjoyment of the group, she still keeps notes of these feelings for her own reference. She also remains emotionally distant from her friends and associates who do not harm themselves. After being given the ultimatum “If you cut yourself again, we’re not friends”, she decided that the outside world was ignorant and did not appreciate how hard the life of a self-harmer is. Cadence still cuts and starves herself and hopes she can provide support to other people in the same situation. Although she does not want to encourage people to hurt themselves, she does believe that self-harm is a useful coping mechanism. She compares it to taking a sleeping pill to numb a bad trip on narcotics. It might not be healthy behaviour in the long run, but it is good for quickly relieving stress. Although Cadence stresses that she does not wish to promote self-harm, she is still accused of doing so. She explains, “I don’t react like I should”, when talking about self-harm. That is, she does not repent and make it clear that selfharm is wrong in all circumstances. As such, she receives numerous complaints from strangers who accuse her of encouraging self-harm rather than being someone who is merely empathetic to the complex role it plays in the life of many people. Cadence is clearly distressed by the feedback she has received from viewers of her videos and by the community she was once a member of.

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She describes herself as feeling scarred for life and finds it especially hard to talk about her eating disorder because of accusations of fakery. She is visibly stressed and angry while filming. She also hopes for a future in which she can see selfharm as something that is bad for her and to be discouraged at all times. This seems to be her intended way of escaping from both those who have encouraged her to self-harm and those who have subsequently criticised her for telling a story that does not completely demonise this behaviour and its emotional impact (Cadence 2015). As of 2017, Cadence is still posting about her mental illness, fashion, and life in Perth. Beyond such notable individuals are clear communities of vloggers and viewers who create and watch specific types of videos. Some are vlogs about personal experience such as those noted earlier. Others are montages of self-harm imagery, which are similar to a kind of animated Tumblr. Self-harm videos fall into general aesthetic typologies that show a powerful community undercurrent. In her survey of the site, Johansson found that cutting was the main form of self-harm that appeared on YouTube videos. She has located more than 70,000 videos about self-harm, which also have relevant commentary supplied by viewers. She notes that some videos are created by mental health services, some by broadcast media, and some by self-harmers themselves. Of the material created by self-harmers, some is by those who are active, and some is by those who have recovered. Some videos are vlogs including self-harmers speaking to the camera, and others are montages of images accompanied by music. The vlogs found by Johansson are primarily female cutters discussing topics such as covering scars, receiving medical treatment, or dealing with stressful relationships. Some of these vloggers are very popular and receive thousands of views and numerous comments from other YouTube users (2014, pp. 17–18). Animated montages are an older form of expression than vlogs and had an earlier heyday.Whitlock et al. described them as the most common type of selfharm content in 2007 (2007, p. 1137). Nevertheless, they are still made today and still receive large amounts of views and comments. These montages tend to contain slideshows of body parts with either wounds or healing scars, selfharm tools like razors, and sad young women. Most of these images are taken from other videos and websites rather than produced by the video’s creator. Sometimes these images will be interspersed with text slides that give facts about self-harm or tell the personal self-harm story of the person who created the slideshow (2014, pp. 17–18).The images selected are generally very graphic, showing deep cuts, acute scarification, and clear suicide attempts in the form of wrist slitting and overdoses (Duggan et al. 2012, p. 63).9 Researchers have noticed clear stylistic trends in such videos. Sternudd and Johannsen describe this material as highly stylised and gendered, leading participants to view and encode their suffering in specific, predictable ways (2015, p. 341). This has led to an aesthetic contagion. Lewis et al. mapped the likelihood of infectious self-harm behaviours as a result of user-generated content. They found that YouTube self-harm videos may exacerbate self-harm repetition

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within individuals via a “social-contagion effect.” This suggests that self-harm can be spread if a person sees, knows, or hears about other people injuring themselves (Lewis et al. 2011, p. 553). The contagious effect of seeing self-harm seems to be especially strong. Another Lewis et al. study into self-harm YouTube videos found that viewers connect most strongly to videos that contain a narrative. 38.43% of comments on self-harm videos were in reference to personal experiences shared by the creator of the clip. Interestingly, the second-most popular category of discussion was ‘admiration of video quality’, including aspects such as camera work, technical prowess, and other aesthetic considerations (2012, p. 383). Lewis et al. are concerned that the rich artistic expression in some self-harm YouTube clips may be especially damaging as it can help glamourise this act and turn aesthetic self-harmers into celebrities (Lewis et al. 2011, p. 555). The flaunting of wounds for online celebrity status is something that has been explored by Alder and Adler.They divide self-harmers online into a series of character types based on how much social interaction they have and who they reveal their injuries to. One such category, which is relevant to YouTube, is that of the ‘Flaunter’. A Flaunter is someone who is open about his or her selfinjury and scars, desiring to reveal these wounds and signs of damage to as many people as possible. Flaunters might wear clothes that expose cuts and scars or cover themselves in bright Band-Aids to bring attention to the number of cuts on their body. Flaunters are the rarest type of self-harmer and are often seen as attention-seekers (2011, p. 158). On YouTube, a Flaunter might video and broadcast his or her wounds and scars in order to reach an even larger audience. While many self-harmers find Flaunters distasteful, there is still a substantial audience for those who show the gory details of their injuries online. Because acts of self-harm are often presented in a glamourised context, Lewis et al. are worried that many YouTube videos give the message that it is normal or acceptable to self-harm rather than providing hopeful messages of recovery and change.10 This may cause viewers to feel as though recovery is not typical or achievable (Lewis, Heath, Sornberger, et al. 2012, p. 381). Because of this worrying message, Lewis et al. suggest that health-care professionals ask self-harming youths about their internet history as part of an examination of their case and their personal risk factors. They also recommend that websites display helpful mental health resources when search terms that may lead to pro-self-harm material are entered (2011, p. 556). This would help provide other perspectives on self-harm that challenge any kind of glamorous or fatalistic discourse uploaded by those who advocate this behaviour. The potential danger of wound flaunters is not just an issue discussed by doctors or YouTube staff. Self-harmers are quite polarised on this topic and often accuse others of being immodest exhibitionists who trivialise the behaviour or use it for their own gain. Johansson notes an interesting tension in terms of how bodies should be displayed, which she calls the ‘body battles’. This debate hinges on the question of whether self-harmers who display their wounds are

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‘showing’ their injuries, or ‘showing off’ their injuries. Many people on YouTube negotiate a fine line between being courageous and confident about their selfharming status without being labelled as ‘drama queens’ who cut for attention. While showing fresh or graphic wounds as part of a photo montage video seems to be accepted, attaching these wounds to a face and an identity in a vlog is seen as gauche and boastful (2014, pp. 22–23). The majority view is that a ‘good’ self-harmer’s body is one who tends to hide scars and show modesty. ‘Respectable’ members of the YouTube community are encouraged to limit the display of body parts that could earn them notoriety in an unsavoury way. For example, badly scarred arms traditionally represent a commitment to a selfharm lifestyle and an endurance of deep pain, so they should not be flaunted. Being a ‘good’ woman online means depicting oneself with a strong sense of modesty and moderation (Johansson 2014, p. 28). In the YouTube self-harm community, there is also a clear tension between those who are pro-cutting between those who are pro-recovery. People who fall into the latter category are often criticised for being triggering or trying to glorify an illness (Johansson 2014, p. 25). There is genuine cause for concern over the possibility of triggering content. Even though most videos are actually in opposition to self-harm and promote recovery, they often contain very graphic and potentially triggering imagery (Duggan et al. 2012, p. 63). Many self-harmers use images of self-inflicted injuries to “provoke the right mood” for an effective self-harm session (Sternudd 2012, p. 428). Purposefully seeking out content that will trigger a relapse is a fairly common technique amongst community-connected self-harmers.YouTube helps to support this by allowing for graphic videos of fresh wounds or deep scars, even if the narrative connected to these images has a more ambivalent stance on the health or validity of cutting. Many popular self-harm vloggers overtly refuse to advocate their own behaviour and are opposed to giving tips that might help others to cause damage. A popular video style involves luring viewers in with titles like “How to Cut Deep (for Bigger Scars)”. Once a person clicks on this video, he or she is actually shown a clip of a former self-harmer then explaining that tips like this are dangerous and that the questions themselves are offensive. The video “How to Cut Deep (for Bigger Scars)” was uploaded by popular reformed self-harmer Laura Lejeune. Although she lures in viewers with the promise of triggering material and new ideas for wound-making, her bubbly and enjoyable videos are actually about her recovery from self-harm and advocacy for current harmers who deserve respect and healthy support networks (Lejeune 2011). Many recovered self-harmers also create videos overtly rejecting pro-selfharm mentalities. There are numerous vlogs with titles like “Stop Romanticizing Things That Hurt”. In this particular video, a young American lady named Amanda Henkel shares her frustration about expressions of sadness online. Henkel is upset by the pervasive romanticisation of sad feelings on YouTube. She is fine with the expression of dark thoughts when people genuinely sad

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but feels that many people falsely create sadness within themselves in order to impress others and appear more artistic or philosophical. Henkel complains that many people cultivate their depression “for the pure reason of wanting to make something artistic or beautiful out of it”. She believes that Tumblr is the “breeding ground for romantic ideation of depression”, which is used as a way of getting attention or as an excuse to write sad poetry (Henkel 2014). There are many other videos with similar sentiments. The YouTube self-harm community is certainly complex, and it is clear that there is no consensus amidst its members as to proper conduct. Some fully support YouTube’s efforts to censor any graphic or triggering material, while others devote their time to seeking it out or creating new ways to confound the censors. In this online world where fellow self-harmers are the most likely to flag pro-self-harm content or lampoon its style, it is vital to ask why individuals might make vlogs about their scars and wounds when they know that they risk social alienation or horrifying other people – including their peers. There are some answers to this. As Johansson discovered, many vloggers show their “marked bodies” online in order to come to terms with stigma rather than avoiding it. For some users, this means teaching other people how to hide scars or disguise them with make-up. For others, making videos and showing self-harm injuries is a way of processing the rejection and bullying they have endured in a cathartic way. Johansson describes these motivations as “partly therapeutic and partly political” – providing support to others, spreading awareness of self-harm, and trying to remove the social stigma against those who have wounds and scars as a result of mental illness. Through this procedure, creators of video content reject deviant identities and use YouTube as a way of creating new, embodied identities for themselves (2014, pp. 19–20). This form of expression is so needed and so valuable that it is worth of the risk of losing one’s account, being banned, or being attacked by other users. Twitter

Twitter is a popular text-based microblogging platform where users are able to ‘tweet’ a 140-character message. Founded in 2006,Twitter reached 313,000,000 monthly users within one decade (Twitter Usage/ Company Facts 2016).Twitter has also found itself in a difficult position when it comes to people using this platform to announce dangerous plans. As of 2015, Twitter allows users to “report possible threats of suicide or any other form of self-harm” on its site with the option to provide a URL to the offending Tweet so it can be dealt with swiftly. They also provide guides for recognising possible symptoms of mental illness and resources for those currently suffering.11 Individual users of Twitter (who are not endorsed by the company) have also taken it upon themselves to help others with mental health crises. For example, Beaumont’s popular ‘Stop Self Harm’Twitter was launched in 2010 and is now a non-profit organisation dedicated to tips for dealing with self-harm impulses, generally

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delivered on attractive but melancholy images like misty mountains or sunsets over the ocean. He also presents facts about the real possibility of stopping selfharm forever. Currently, more than 24,000 people follow this account (Beaumont 2017). Nevertheless, there are also many popular and prominent users who use Twitter as motivation for self-harm and starvation, or as a place to share their darkest thoughts. A simple hashtag search reveals users such as BrutallyThin who is 5’7” and aiming for a weight of 97 lb. Her Tweets catalogue her mental health struggles, such as visits to the psych ward and feelings of loneliness and abandonment. She writes evocative messages, such as “The only thing that matters to me right now is being thin” and “My eyes are red and swollen from crying so hard” (BrutallyThin 2017). A popular Twitter feed dedicated to laxative abuse chronicles a journey of recovery and relapse (Lax Abuse 2016). The AESFATlC Twitter account is primarily devoted to regrets about having eaten, including “i hate myself so much why did i eat why did i let myself get so fat” and “FATASS I SHOULDNT HAVE EATEN FATASS WHY WHY WHY”. With a touch of sarcasm, the owner’s profile reads, “thanks for the tragedy i need it for my art” (AESFATlC 2017). All these users have header images in keeping with the Soft Grunge aesthetic. So too does the Thintoxicating Twitter run by ‘h.’, who explains that “[a]n ordinary girl, an ordinary waist but ordinary just not good enough today”. She is vehemently opposed to the glamourisation or promotion of eating disorders but still uses her feed as a way of expressing her own desires such as “My goal for 2017 is to get back to my skinniest and become skinnier” (h. 2017). Other New Year’s goals or ruminations shared on connected accounts also reveal a great deal of pain and a very deep desire to be skinny. They include “i hope i die during 2017” (Jade 2017), “new years resolution: RESTRICT LIKE A BITCH” (THlNB0NES 2016), “2017: get thin” (trying 2017), and “I wasn’t supposed to be alive long enough to see 2017 and I don’t want to be” (Sucker for Pain 2017). Despite profound self-hatred, the pro-ED Twitter community is actually quite kind and supportive. All these posts were met with kind and timely replies, where friends gave support and vowed not to let their companions die. Importantly, these pseudonymous Twitter friendship networks allow users to purge the pain and say things that they cannot say to their families and ‘reallife’ friends. They are a space where people are encouraged to enunciate their genuine pain. One user explains, “Its okay to be sad because if you sad and you act happy you aren’t being yourself ” (/bye/ 2016). Many people who fall into these circles are already feeling sadness, already have an eating disorder, and already cut themselves. Rather than using Twitter to become sick, many people pride themselves on using it to reflect a sickness that was already there. This is summed up well by the user ‘fatty’, whose profile picture is a bottle of bleach. fatty explains that they no longer feel close enough to their offline friends to be honest about their feelings. The description of this blog clarifies: “i don’t

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promote ed or self harm and i’m not pro anything, just a vent account”. A pinned Tweet at the top of the page reads, “[T]his account isn’t by any means meant to glorify mental illnesses or self destructive behavior if triggered easily, please leave immediately” (fatty 2017). Many other users are similarly opposed to the idea that someone might be using their expressions of sadness to make their own behaviour worse.

Do we need to censor self-harm on social media? These are just a few of the ways in which self-harm content has been used and spread on social media sites. Most popular sites are aware that threats of suicide and self-harm will appear amongst their user-generated content. The common response is to delete offending material and ban people who produce it. There have been long-term efforts to shut down self-harm websites and stop their content from spreading. Some of the earliest censorship took place in 2001–2002 when AOL and Yahoo! started to take down problematic content from their servers (Casilli et al. 2013, p. 94). Governments have also tried to ban harmful content. Australia was the first nation to criminalise the use of carriage services for the dissemination of material that incites suicide. The Suicide Related Material Offences Act was passed in 2005 and came into force in 2006 (Pirkis et al. 2009, p. 191).12 Because this legal code specifically deals with pro-suicide material, it is unclear if pro-self-harm sites could be penalised. Subsequently, France and the UK have both passed legislation to restrict sites that encourage dangerous behaviours (Casilli et al. 2013, p. 94). There has not, to date, been a case against such a website brought to trial. Instead, offending material is censored by removing it from servers on the basis of service violations. In terms of the legal side of these communities, Martin has explored whether a pro-ED website can be held responsible for the deaths of people who used its content to mould their willpower, refuse their food, and purge their stomachs. She believes that a court case attempting to blame pro-ED or pro-selfharm material for a bodily harm would be difficult, as damage is self-inflicted by the victim. This contributory negligence means that it is very difficult to solely blame website for harming its users (2005, p. 152). She believes there may be a case for pro-bulimia websites inciting dangerous actions leading to death, as they contain exhaustive, explicit details for hiding fasting behaviours, lists of foods that can be vomitted up more easily, and instructions for inducing vomiting. There is solid evidence that visitors to the sites have used this information to intensify their bulimic behaviours and perform them more frequently or with greater success. Nevertheless, Martin concludes that it would be almost impossible for a case like this to stand up against a defence counsel asking for proof of a transient website’s liability in inciting a disease that can typically endure for over a decade. She also notes that incitement charges generally require active, vocal encouragement of dangerous or deadly

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activities – something that pro-ED and pro-self-harm sites tend not to do (2005, pp. 161–163).Thus, a strong case against such a site, its administrators, or its online host seems unlikely. Martin focuses on the US legal system, but it seems likely that the Australian Suicide Related Material Offences Act would also fail to apply to self-harm websites. Because these laws are domestic, they also have limited efficacy in the international world of the internet. For example, the Australian criminalisation of pro-suicide websites can only apply to offences occurring within Australian borders or by Australian citizens or entities incorporated under Australian law. This means that overseas websites are immune. There is very little prosuicide material hosted on Australian-owned servers (Pirkis et al. 2009, p. 192). In agreement with Martin, studies from other disciplines have shown that it would be very difficult to prove a connection between a site about eating disorders and the actual development of an eating disorder within an individual. From a public mental health perspective, the Sharpe study concluded that there is evidence proving the harmfulness of pro-eating disorder content but “no clear indication that such sites promote the development or maintenance of eating disorders”. As such, they recommend that servers should be allowed to remove problematic content but that an outright ban is both “inappropriate and unpractical” (2011, p. 34). Even if there was a stronger legal basis for the banning or persecution of these sites, their owners are unlikely to be deterred. The main reaction to site-run censorship has been constant stealth rather than self-censorship.There has always been a large turnover of pro-self-harm sites, which often shift between hosts or change their names and addresses to evade detection. For example, Boero and Pascoe surveyed 14 large pro-ED pages on MySpace for their research. Before their paper was published, all the groups they gathered data from had been deleted, had moved to other sites, or were privatised and renamed with less suspicious titles (2012, p. 37). Caselli et al. have mapped the development and interconnectivity of Francophone pro-ED sites and have noted that the number of offending sites has stayed constant (with a slight increase) despite French government legislation to restrict its availability. Although the sites they tracked had very high turnover rates – only 50% survived over a two-year period – those that vanished were quickly replaced in a powerful cycle of renewal (2013, p. 94). Self-harm groups are like a hydra – chop off one head and another two appear. This situation is unlikely to change due to the arrangement of pro-selfharm communities online. Most pro-self-harm material is part of a series of clusters, which are closely interconnected due to the sharing of links, content, and members. These clusters form around a few seminal hubs, which tend to be large repository websites that gather, organise, and share user-generated content.These hubs are surrounded by ephemeral blogs that change, disappear, and are quickly replaced. The tone of the community as a whole seems to be based on the hub sites, which act as gatekeepers and are able to restrict or promote the flow of ideas.This means that external information, such as public

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health campaigns, cannot successfully penetrate the pro-ED milieu unless the gatekeepers in the hubs see the information as worthy of passing on (Casilli et al. 2013, pp. 94–95). Hubs also mean that users can quickly move between satellite sites and receive new information about replacements for censored material. This is not much of an inconvenience and actually tends to suit the style of engagement reported by most members. Users are known to move between different communities at a fairly rapid rate. They often change their degree of involvement, in keeping with personal preferences and emotional condition, and detach from groups when they become too busy in other areas of their life. These same people might return to a whole new group of members after an extended hospital stay or other sabbatical and need to re-introduce themselves as though they were a stranger (Adler and Adler 2011, pp. 139–141). Those who are navigating self-harm content through folksonomy-like tags have an even more nebulous sense of group and community. If one piece of content, or even a whole account, is deleted, they can still find other material that is much the same. With this kind of mobility, the deletion or censorship of self-harm content might not even be noticed by those it is meant to target. Intra-community censorship

It is also important to realise that external efforts at censorship are actually in competition with a thriving and well-defined system of internal regulation. Participants are generally very conscious about the sensitive nature of the material they are discussing and are far less naïve and uncontrolled than advocates of censorship seem to anticipate. Many producers of questionable material selfcensor by removing content that they have shared soon after the fact. In their survey of Tumblr, Seko and Lewis noted that 10% to 15% of posts disappeared fewer than 24 hours after being posted (2016, p. 5). While some of these deletions may have been due to unusually rapid responses from Tumblr’s censorship team, most are deleted by their own creators who become embarrassed or somehow regretful about having shared sensitive images and information about themselves and their darker emotions. Many people who administer pro-self-harm and pro-ED communities are well aware of the academic literature on the topic of censoring their communities and are aware of plans that professionals have made to restrict or ban their online activities. As such, they have already developed counter-arguments to these plans. One such person is Tetyana, who runs the Science of Eating Disorders (SED) website – a place where she and others reflect on scholarly publications, often in a critical manner. SED aims to broaden communication between scholars and their subjects in order to expand what they see as primarily a “one-way dissemination of research”. Tetyana and her contributors aim to provide first-person perspectives from adults who have experienced eating disorders, asking them to reflect on emerging academic research in this field.

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Sometimes information is accepted as verifiable, and other times it is critiqued. SED reminds readers that published, peer-reviewed ideas are not perfect and should not be blindly accepted as fact (Science of Eating Disorders 2017). Based her reading of Casilli et al. (2013), Tetyana argues that external censorship of pro-ED blogs is impractical and dangerous as it results in communities locking down and being less receptive to external ideas. These ideas include awareness campaigns that can teach people more about their illness and information about new recovery services (Tetyana 2013a).13 This does not mean that members of pro-self-harm and pro-ed communities are lawless or lacking in standards. They generally realise that people benefit from classificatory systems that help them to decide what content to view and what to avoid. There is now a comprehensive culture of self-censorship where users will willingly tag triggering posts. This has happened despite the lessening presence of moderators in online communities as many groups are constructed through shared tags and interests rather than fixed message boards, as was the case a decade ago. In 2011, Lewis and Baker found that about 60% of sites had trigger warnings in play (2011, p. 394). Many users are very conscious that they can trigger either themselves or another vulnerable person if they do not engage in some degree of censorship. For example, many users in the proED community wish to keep out impressionable young girls who are looking for restrictive diet tips and prefer to limit their material to older people who have already developed a disorder (Yeshua-Katz and Martins 2013, p. 505). This helps them to feel that they are supporting restrictive eating without causing a healthy person to cultivate a mental illness. Tags also stop unwanted triggering episodes. On Tumblr, about a quarter of self-harm images contain a trigger warning tag to help vulnerable viewers avoid if necessary (Seko and Lewis 2016, p. 7). If people post about self-harm, suicide, eating disorders, or other sensitive topics, they will often be asked to tag this content because of the distress it can cause when proper warnings are not issued. People in recovery can be especially cautious with their tagging. For example, one young woman recovering from an eating disorder explains that she will not reblog any pictures of bodies or even post her own selfies without a tag that will help sensitive people to blacklist or avoid this content. She also suggests that other people use specific body part tags when posting selfies, such as #legs, so that sensitive viewers can look away (Amy 2015).This is a common technique and reveals the depth of sensitivity that many users have towards potential triggers. Why communities flourish despite the censors [Y]oung people, young women especially –  are hurting themselves and posting the evidence online. But they don’t hurt themselves because there’s a community there for them. The community exists because they are in pain. – Zimmerman (2014)

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Zimmerman’s astute observation is an important reason why censorship is ultimately a flawed pursuit. Pro-self-harm sites tend to appeal to people because they are already harming themselves in some way. There is strong evidence that websites showcasing self-harm are not the original cause of this behaviour. The Harris and Roberts study notes that a staggering 90.5% of website visitors first viewed these resources after harming themselves, not before; 98.5% of visitors had self-harmed at some point in their lives. Only 1.5% of visitors were using these sites without having hurt themselves in the past. While some of these visitors were looking for information and felt tempted to participate, others were seeking guidelines for preventing their urges, and some were looking at the material for work-related purposes. The majority of these visitors found online communities after harming in isolation for a year or longer (2013, p. e285). Self-harm, in the vast majority of cases, happens prior to the discovery of pro-self-harm websites – often by a substantial time. Additional proof can be found in the testimony of users themselves.Williams, a recovered anorexic, argues that thinspiration is no more likely to cause an eating disorder than cleaning tips cause obsessive compulsive disorder (OCD). Discussing ‘negative’ calorie foods and the body mass indexes (BMIs) of celebrities is the symptom of an illness – not its cause (Williams 2014). As such, empathetic researchers like Yeshua-Katz and Martins strongly advise against the censorship of pro-ED sites as they feel that kind of action this is usually the result of a moral panic in which young women tend to be blamed for sabotaging their own recovery when, in fact, they are suffering from a mental illness with no effective treatment (2013, p. 506). Indeed, many users describe being lonely and misunderstood. Some confess to being lonely because they cannot eat and drink in the same way as their friends do or need to fast for long periods in order to have a similar intake to their healthy friends on a night out (bo0youwhore 2016). Others are frustrated by doctors who misunderstand their condition and simply tell them to eat more food or who struggle to cope with the behavioural patterns of self-destructive people (Arnold 2010). As such, the best approach is to find new ways of addressing the core problems that manifest in disordered eating rather than telling community members to be less dramatic or to keep away from their only empathetic support networks. Practical steps

Anticipating the fact that the internet will never be scoured of self-harm material, many researchers have suggested that medical professionals help lessen the impact of pro-self-harm content by being aware of it and learning to discuss it with their patients. Harris and Roberts recommend that clinicians be mindful of internet usage amongst patients who self-harm and to discuss their motivations for using these sites.They suggest that a discussion of dangers and benefits would be useful and should form part of the treatment plan for a patient at

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risk (2013, p. e285). This seems like very reasonable advice as it concedes that positive outcomes are possible from viewing these sites. The Whitlock et al. study also recommends that mental health practitioners open up a dialogue about self-harm websites, inquiring if users have ever gotten advice from online sources or if they are discussing their therapy online (2007, p. 1141). This can give an indication as to whether they are dealing with competing ideas or sources of knowledge. It is also important for the medical community to realise that pro-self-harm sites do have the potential to help their members recover. Often this is because they allow users to reflect on the actual severity of their feelings and behaviours. For many self-harmers interviewed by the Adlers, deeply engaging online communities were the point at which they realised that they had a long-term illness as opposed to a private, eccentric, controllable stress-relief method (2013, p. 30). This developing self-awareness and acknowledgement of the severity of their actions led many to admit that they had a problem and honestly consider what the ramifications might be. Williams had a similar experience, explaining that anorexia was a very confusing and solitary experience. She was unable to articulate why she hated and harmed herself. When she connected with a proana community, she learned how to talk about her suffering and discovered that she was not alone (Williams 2014). Although this may seem minimal to an outsider, it is a very important step and helps those involved to acknowledge dangerous and addictive behaviour. For others, such communities are the only place they can reach out to in times of crisis. Roca Payne points out the fact that many people do not have reliable access to mental health services or the kind of health education that would allow them to realise they have a diagnosable condition such as NSSI. Because they cannot access therapists to talk to, “it’s easier to post about it on Tumblr”. From her personal experience, social media also gives her the boosts of self-esteem that she needs to survive through her eating disorder and selfharm. An acknowledgement of her content is a way of gaining validation and thus of getting through the day on low reserves of energy and esteem (Roca Payne 2016). For reasons such as this, Boyd et al. believe that pro-self-harm websites are part of peoples’ coping strategies and are not the underlying cause. They warn that taking away a person’s coping strategy should not be the focus of health practitioners. Instead, professionals need to address the underlying issues at play. Censorship often takes away people’s only safe space and can prevent them from helping others. This leads to further alienation and isolation for those who are already suffering from these lonely complaints (Boyd et al. 2011, p. 27). Such communities also need to be carefully appraised as part of a spectrum, and their danger assessed accordingly. Not every pro-self-harm community is a site of extremism, and not every discussion about anorexia becomes a membership rite into a high-demand group. Most tend to have an ambivalent stance about illness and recovery. For example, many people follow thinspo blogs and

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are members of anti-ED, pro-recovery communities. As one pro-ED participant explains, [m]any people might want to recover someday, but they feel they can’t let go of the behaviours now.They are not denying their illness, or that recovery will happen, or that it really IS a disorder, but, right now, recovery is just not an option. (Tetyana 2013b) This certainly does not mean that recovery will never be an option. Rather, the communities they are members of are a way of understanding and openly discussing their disorders – including the addictive nature of self-harm and starvation or the benefits that can be gained from it. Tetyana argues that proED communities are needed because eating disorders are so stigmatised that even medical professionals misunderstand them and place undue blame on their patients. Because of this hostility, people with eating disorders need spaces where they can discuss their feelings without the need for stigma and shame. She believes that these spaces are supportive of people who are not yet ready to recover and who wish to talk about what they gain from disordered eating. But they are also spaces where those who are ready to recover can receive support (Tetyana 2013b). Because there is such variety between pro-ED groups, it is unfair to say that all of them reject recovery on the basis that a few of the more extreme sites decry it. Tetyana makes it clear that if you wish to stop harmful material appearing online, the first step is to be kinder and more empathetic to your patients. She believes that pro-self-harm and pro-ED communities will continue to exist so long as people feel that their friends, families, and clinicians do not understand their perspective on the matter. To stop the need for such communities, she recommends that people be less hostile, judgemental, or wilfully ignorant (Tetyana 2013b). This can be compatible with recommendations such as those put forward by Lewis et al., who agree that people should not be outright banned from accessing harmful communities. Instead, they suggest establishing a beneficial pattern of online behaviours in order to replace problematic websites and friends and to gently orient a patient towards recovery (2012, p. e5). This seems more likely to create lasting change because it gives people something active to do that addresses their isolation, rather than merely telling them to stop connecting with people who understand them. As one former self-harmer explains, “[t]he question isn’t ‘how do we regulate self-harm on the internet?’The question is ‘how come so many girls hate themselves?’ ” (Zimmerman 2014). Again, this brings us back to the idea of treating the real cause, not communities that have been built to address the pain. Sternudd notes that the outcome of viewing triggering material has the most to do with the state that an individual is in at the time. If they are in a better mindset, they are less likely to harm themselves (Sternudd 2012, p. 433). Addressing

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core feelings of self-hatred and lessening the harsh social judgement against practices such as starvation and cutting will actually do much towards abating these actions. Zimmerman argues that many people, especially young women, harm themselves because they have been repeatedly told that “our bodies are sinful or offensive or not our own, and that we’re more valuable when we’re starving or suffering or at least in some way being punished for what we are”. She argues that changing the cultural pathology that leads to the promulgation of this message is far more effective than “taking pictures of cuts down from Tumblr” (Zimmerman 2014). This seems well reasoned. Zimmerman is opposed to censorship of problematic media because she feels as though problematic ideas already exist. Rather than being created by cultural narratives or dangerous gatherings of self-harmers online, people seek out problematic media because it represents beliefs and desires that they already have about themselves (Zimmerman 2008). She believes that young women who are seduced by Tumblr posts about cutting deeper are not just innocents “seduced by the internet blood-sirens”. Instead, they are girls who learned that they deserved pain and punishment, thought it was virtuous to damage themselves, or discovered that they “wouldn’t get validation for anything but being the most fucked-up”. While she believes that some of this message comes from the internet, it is also pervasive in our culture on a much deeper level (Zimmerman 2014). The internet just reflects what young girls already believe as a result of their offline socialisation. With all these factors in mind, it is clear that censorship is both impossible and pointless. In terms of legality, self-harm material falls into an ambiguous zone. While hosting platforms may regularly delete problematic content because it glorifies harmful behaviour, it is not easy to prove beyond doubt that such content actually incites suicidal behaviour. Without this proof, no actual laws are violated – just company-specific terms of service. Laws are also tied to nations, making international prosecution difficult. Attempts to censor generally backfire because they make communities close themselves up and become more resistant to external intrusion. This can radicalise them and make medical treatment into the enemy. It is important to be empathetic and aware of what communities actually offer to their members. Community leaders are generally well informed of what is being said about their groups and what plans the medical and legal establishments have for their undoing or removal. Importantly, they are also aware of the benefits of censorship and classification of material. Most communities already have stringent rules in place for which content is allowed and which is a punishable offense. Accusing them of disseminating problematic words and images without censure is inaccurate and unfair. To actually help those who use pro-self-harm and pro-ED communities, a person needs to be aware of the fact that these groups exist in response to pre-existing pain and anxiety. There are very few people who join such groups prior to harming themselves. Most are already entrenched in a cutting or starving behaviour and

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are looking for other people who can understand them and make them feel less alone. Addressing self-hate, loneliness, and negative cultural attitudes is the real way to stop harmful behaviour – not censoring social networks.

Conclusion Self-harm can happen spontaneously, or it can happen after exposure to people who take part in this behaviour. With the rise of the internet, we have seen more harmful behaviours that are in nodes or modelled on other people. In 1989, Favazza and Conterio published a study on female self-harmers. Of their subjects, 6% knew someone else who had injured themselves, and only 3% had ever read about it. All the other participants said their first self-harm episode “just happened” without any particular source of influence (1989, p. 286). In 2011, Favazza noted that “the tables have turned”, and the majority of self-harmers have been exposed to this behaviour before their first episode because of newspapers, magazine, TV shows, movies, and, most important, the internet (2011, p. 226). The communication and information revolution of the internet – first on home computers, then on personal devices – has created a massive shift in processes of learning and sharing ideas. In particular, the internet has created a space for the global communication of minority beliefs and values such as the celebration of self-harm. Understandably, this has caused concern. Many people, including parents and medical professionals, are growing increasingly worried about the Web 2.0 environment. Nowadays, internet communities can be easily formed by people who can quickly create and share their own, personalised content – outside of traditional censoring bodies. Adults can create content that is free from classification boards, and children can make and share texts without their parents’ consent. While most content online is fairly harmless and is kept in line by the websites that host it, problematic ideas have slipped through the cracks. Using tools like tagging, people can find others who wish to hurt or starve themselves or use the internet as a way of broadcasting a powerful and infectious selfhatred. Because self-harm is so contagious, this process can cause symptoms to escalate and inform people about new techniques for causing injury or starving themselves. Early theorists who examined the internet underestimated how much of an impact a disembodied medium could have on a user’s body. Although it may seem strange that people use the internet to talk about deeply body-oriented issues rather than revelling in anonymity, modern self-harm communities have shown that the online world coalesces with the offline body in a process of media hybridity that once seemed impossible. In earlier theories of online interaction, there was a belief that computer-mediated communication would always be inherently less intimate because of a lack of non-verbal social cues like facial expressions (Leiter and Dowd 2010, p. 32). This embodiment that leads to intimacy has been subsequently achieved in a variety of ways, such as

Self-harm on social networks 51

the recent rise of emoji to express facial expressions and mood. As the Fox study into pro-ana message-board notes, the framing of bodies through both text descriptions and photographs is frequently employed as a way of reflecting and strengthening the values of the pro-ana movement. For example, many people perform body hatred by staging selfies, which are captioned with phrases like ‘caution: this image might crack your screen’ because of the ugliness of their own faces and physiques (Fox et al. 2005, p. 955). Obviously, behaviour such as this encourages negative views about a person’s body and fosters poor selfesteem. It also helps people to work together in order to add their individual suffering into a larger group suffering. The existence of pro-ED sites is far from ideal, but they do showcase the complexities of online self-harm discourse and group interactions. They also show the variety of communities available. Content ranges from fairly quotidian support groups that advocate recovery if desired to those that are deeply ritualised and make intense demands of members. As Bates notes, tones can vary from sites teaching people how to restrict their eating without being detected and how to live life as an anorexic, to sites with a “radicalized death rhetoric” (2015, p. 197). Casilli et al. note that there is an ongoing debate in scholarship over whether eating disorders are disease or a lifestyle choice (2012, p. 126). For the most strident of devotees, the answer seems to be that they are both. People who are ‘true’ sufferers are those who describe themselves as being struck down by a disease that haunts them and has many downfalls and undesirable symptoms. But, at the same time, they are also members of the ED lifestyle who kowtow to the ideal of thinness and use ana as their muse. The disease is the gateway to the lifestyle, which is sustained by a like-minded community. Yet for others, a pro-ED group is simply a way of finding friends who understand without judgement. A canny clinician needs to understand that the vibe and behaviours of each community are different, and they should not be approached in the same way. The ‘radicalised death rhetoric’ groups are perhaps the hardest to engage with or treat as they exist in opposition to external intruders, misunderstanding doctors, and people who wrongly assume that an eating disorder is just an extreme diet. These high-demand groups admit only ‘true’ anorexics and filter out the pretenders: the wannarexics. This is primarily a way of showing that an eating disorder is a relentless and destructive illness, not “just some name tag that you can pin on your shirt when you feel like it!” (Paula 2015). These extreme sects are ways of standing against family members and doctors who suggest that their behaviour is a free choice or that they should be ashamed of their manipulative and physically destructive compulsions. Indeed, there is an undue amount of disgust and anger levelled at content that supports disordered eating or other harmful activities. Williams notes that even people with more liberal attitudes towards internet content and conduct are likely to express a knee-jerk revulsion, generally reserved for abominations like child porn, when faced with pro-ED content. She writes, “I’ve heard that the girls curating thinspo galleries

52  Self-harm on social networks

are sick and wrong for glamorizing eating disorders, that they teach impressionable young girls that would otherwise have totally healthy self-images how to starve themselves. I disagree” (Williams 2014). Her hesitation to agree with this perspective is valid as there is indeed very little evidence that healthy people are being converted by this kind of content. To understand how this controversial content is really spread – and thus who accesses it and to what end – it is important to look at social media sites and trends. Self-harm and eating disorders are popular content on sites like Tumblr, YouTube, Facebook, and Twitter. Yet, this content manifests differently in each. Different communities have different trends and endorse different actions. Tumblr is a visual medium, which is home to collectors of thinspo and images of cut bodies. It is also a place where expert curators can create intricate aesthetic trends that explore self-harm as a kind of creative expression and a thing of beauty. YouTube allows individual creators to make animated collages of their favourite images, or to orate on the topic of self-inflicted pain. Users are as likely to support self-harm as they are to express its dangerous and destructive nature. Facebook is more devoid of deviant content as it is a place where people are generally engaging with family members and colleagues under their full legal names. Each network has its own style and dangers. Because there is such variation, it is foolish to think that a single response to problematic content is valid. Sadly, a single response is what we tend to see. Mockery and disgust tend to be the most common knee-jerk reaction, while the legal and medical responses are a drive towards censorship for the protection of vulnerable people. On one level, censorship is tempting. We know that self-harm nodes have a real potential to flourish, and an online community is a powerful hub for this kind of copycat behaviour. People do replicate linguistic and aesthetic trends that they see in their favourite communities. They can also learn dangerous new tricks such as new tools to cut themselves or new ways to evade diagnosis at the doctors’ surgery. But, as the Boyd study shows, problematic content is only a visible manifestation of problematic practice and thought. If all problematic content were obliterated from the internet, individuals would still be harming and hating themselves. Censoring expressions of harmful behaviour is not tantamount to treatment (Boyd et al. 2011, p. 25). Hasty reactions to distasteful material do not help the people to whom this material appeals. Imprudent censorship relies on the reductive idea that people who talk about their problems and explain why harmful behaviours appeal are getting nothing good from this discourse.

Notes 1 ana and mia are most often written in lowercase despite being used grammatically as proper nouns. 2 Boero and Pascoe note the difficulty of determining if users of these sites would actually meet the diagnostic criteria for the eating disorders that they profess an interest in. They

Self-harm on social networks 53 warn against studies that conflate membership of these groups and an interest in anorexia as tantamount to actually having anorexia. Nevertheless, they concede that making any kind of diagnosis of any member is impossible from afar and focus instead on the way that anorexia impacts their subjects’ “discursive constructions of self and community” instead (2012, p. 38). I agree that this is the best approach, because it prioritises the conceptual role of eating disorders in the life of participants. 3 There are also some ‘anti-pro-ED’ groups online, with some existing in order to find and report problematic content. Others formed because of a dislike of ED sufferers, with a primary focus on derision. Juarascio et al. note that these groups are far smaller and much less active than their pro-ED counterparts. Users often join to show support but do not interact much beyond this initial gesture of solidarity (2010, p. 403). 4 Although these communities appear on sites like Facebook, which requires a full name and other personal details, users often interact with fake profiles or block family and other outsiders from their activities. 5 Using the ‘Wayback Machine’ internet archive, I could find imprints of this now-deleted website (www.plagueangel.net/grotto/) dating from November 6 2002 – July 13, 2006. This does not necessarily provide an exact history, but it does allow for a decent approximation. The ‘copyright’ declaration on the grotto reads ‘2001–2004’, and the website counter for Project Shapeshift has been in action since July 28, 2001. Singler notes that some of this material is actually Project Shapeshift’s second incarnation after a very thorough deletion of the first, earlier site, which existed in 2001. The older material was censored as part of the aforementioned Yahoo! purges of 2001 (2011, p. 17ff). 6 A small amount of content can be found at http://web.archive.org/web/20021223104320/ www.plagueangel.net/psboard/ 7 I have retained the original text from the primary sources used here. As such, many contain reproduced inaccuracies in spelling and grammar. 8 Arguably, the site reached its zenith in May 2013, when Yahoo! paid $US1.1 billion to acquire it in a bid to broaden its audience and revitalise the company in the wake of new microblogging trends. Tumblr is now reportedly worth very little and has been plagued by mass staff departures (Fiegerman 2016). Despite this mediocre financial performance, Tumblr remains an important locus for communities of all kinds, including marginalised ones. 9 Interestingly, these images have been drawn from a variety of places including public health campaigns. A 2003 World Health Organization (WHO) poster about the dangers of self-harm shows a sitting girl in black-and-white with bandaged cuts on her arms.The caption reads ‘I was Scratched by the Cat’.This same image with the WHO data removed has been circulating on YouTube montages (Sternudd and Johansson 2015, p. 348). 10 When examining the content of comments left on popular self-harm videos. Lewis et al. noted that only 4.51% of comments included a desire to recover; 51.19% of comments made no reference to recovery at all (2012, p. 384). Getting better is not a popular theme amidst those searching for triggering content. 11 As of January 2015, these pages can be found at https://support.twitter.com/forms/ suicide and https://support.twitter.com/articles/20170313-dealing-with-self-harmand-suicide. Twitter explains its policy for reaching out to users at risk: “After we assess a report of self-harm or suicide, Twitter will reach out to the reported user and let them know that someone who cares about them identified that they might be going through a tough time.We will provide the reported user with available online and hotline resources and encourage them to seek help” (Twitter 2015). 12 Pirkis et al. note some of the major concerns raised over the Suicide Related Material Offences Act. These include the fear that legitimate health care services could be seen as inciting suicide if they counselled people at risk in a manner that was deemed to accepting of their urge to die. There have also been concerns that discussions about euthanasia

54  Self-harm on social networks would also be caught in this net. Carefully wording in the final bill has done its best to alleviate these concerns, but we are still left with the strange situation of criminalising discussion of an act that is not in itself criminal. It is not against the law to complete or attempt suicide in Australia (Pirkis et al. 2009, p. 192). 13 In the wake of censorship, clusters are now closing in on themselves, with less external content or ideology filtering through (Casilli et al. 2013, p. 95).The logistics of penetrating this kind of network with content that the hub owners do not like is fairly dire. Trying to penetrate without the advocacy of hub sites means invisibility of content.

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Self-harm on social networks 57 Jade, 2017. I Hope I Die during 2017 [online]. Twitter. Available from: https://twitter.com/ bitethecrave/status/815439164170612737 [Accessed 2 Jan 2017]. Johansson, A., 2014. Hybrid Embodiment: Doing Respectable Bodies on YouTube. In: S. Lindgren, ed. Hybrid media culture: Sensing place in a world of flows. London: Routledge, 16–33. Juarascio, A.S., Shoaib, A., and Timko, C.A., 2010. Pro-Eating Disorder Communities on Social Networking Sites: A Content Analysis. Eating Disorders, 18 (5), 393–407. L., 2014. Ana Religion & Lifestyle [online]. The Pro-Ana Lifestyle Forever. Available from: https://theproanalifestyleforever.wordpress.com/religionandlifestyle/ [Accessed 23 Aug 2016]. Lax Abuse, 2016. Lax Abuse [online]. Twitter. Available from: https://twitter.com/laxabuse [Accessed 2 Jan 2017]. Leiter, D. and Dowd, J., 2010.Textual Expectations, (Dis) Embodiment, and Social Presence in CMC. In: J. Park and E. Abels, eds. Interpersonal Relations and Social Patterns in Communication Technologies: Discourse Norms, Language Structures and Cultural Variables. IGI Global, 32–47. Lejeune, L., 2011. How to Cut Deep (for Bigger Scars) [online]. YouTube. Available from: www.youtube.com/watch?v=hM320lqz1Ms [Accessed 17 July 2016]. Lewis, S.P. and Baker, T.G., 2011. The Possible Risks of Self-Injury Web Sites: A Content Analysis. Archives of Suicide Research, 15 (4), 390–396. Lewis, S.P., Heath, N.L., Michal, N.J., and Duggan, J.M., 2012. Non-Suicidal Self-Injury, Youth, and the Internet: What Mental Health Professionals Need to Know. Child and Adolescent Psychiatry and Mental Health, 6 (1), 13. Lewis, S.P., Heath, N.L., Sornberger, M.J., and Arbuthnott, A.E., 2012. Helpful or Harmful? An Examination of Viewers’ Responses to Nonsuicidal Self-Injury Videos on YouTube. Journal of Adolescent Health, 51 (4), 380–385. Lewis, S.P., Heath, N.L., St Denis, J.M., and Noble, R., 2011.The Scope of Nonsuicidal SelfInjury on YouTube. Pediatrics, 127 (3), e552 – e557. Lincoln, B., 2006. Holy terrors:Thinking about religion after September 11. Chicago: The University of Chicago Press. Lyons, E.J., Mehl, M.R., and Pennebaker, J.W., 2006. Pro-Anorexics and Recovering Anorexics Differ in Their Linguistic Internet Self-Presentation. Journal of Psychosomatic Research, 60 (3), 253–256. Martin, A.K., 2005. ‘Stick a Toothbrush Down Your Throat’: An Analysis of the Potential Liability of Pro-Eating Disorder Web Sites. Texas Journal of Women and the Law, 14 (2), 151–178. meanspo-for-me, 2016. ~meanspo~ [online]. Tumblr. Available from: http://meanspo-forme.tumblr.com/post/146749725721/meanspo [Accessed 7 July 2016]. Narscissa, 2001a. Deleted ALREADY? [online]. ana’s underground grotto. Available from: https://web.archive.org/web/20030204153740/www.plagueangel.net/grotto/analog/ id9.html [Accessed 6 Sep 2016]. Narscissa, 2001b. A Bone Above Any Other [online]. ana’s underground grotto. Available from: https://web.archive.org/web/20030204153415/www.plagueangel.net/grotto/analog/ id3.html [Accessed 6 Sep 2016]. Paula, 2015. Don’t Be Pretending You Have Ana, Girl [online]. Tumblr. Available from: http:// barrettsterrapin.tumblr.com/post/63816725897/dont-be-pretending-you-have-ana-girlthis [Accessed 7 July 2016]. Peebles, R., Harrison, S., McCown, K.,Wilson, J., Borzekowski, D., and Lock, J., 2012.Voices of Pro-Ana and Pro-Mia: A Qualitative Analysis of Reasons for Entering and Continuing Pro-Eating Disorder Website Usage. Journal of Adolescent Health, 50 (2), S62.

58  Self-harm on social networks Pirkis, J.E. and Blood, R.W., 2001. Suicide and the Media. Part III: Theoretical Issues. Crisis, 22 (4), 163–169. Pirkis, J.E., Neal, L., Dare, A., Blood, R.W., and Studdert, D., 2009. Legal Bans on ProSuicide Web Sites: An Early Retrospective from Australia. Suicide and Life-Threatening Behavior, 39 (2), 190–193. Pro Ana Princess, 2011. Ana Religion + Quotes [online]. Pro Ana Princess Club. Available from: http://proanaprincessclub.webs.com/anareligionquotes.htm [Accessed 23 Aug 2016]. Quiroga, R., 2015. Bruises [online]. WeHeartIt. Available from: https://weheartit.com/ RochyQuiroga/collections/13971268-bruises [Accessed 4 Mar 2015]. Rainie, L., Brenner, J., and Purcell, K., 2012. Photos and videos as social currency online.Washington, DC: Pew Internet & American Life Project. Religion [online], n.d. The Pro Ana’s. Available from: http://anacamp.webs.com/religion [Accessed 23 Aug 2016]. Roca Payne, S., 2016. Social Media as a Coping Mechanism [online]. Hooligan. Available from: www.hooliganmagazine.com/blog/2016/3/12/y2fzvkimpwhkteqkbysrhoo5vjnz4x [Accessed 4 July 2016]. Rouleau, C.R. and von Ranson, K.M., 2011. Potential Risks of Pro-Eating Disorder Websites. Clinical Psychology Review, 31 (4), 525–531. Science of Eating Disorders, 2017. About [online]. Science of Eating Disorders. Available from: www.scienceofeds.org/about-2/ [Accessed 3 Jan 2017]. Seko, Y., 2013. Picturesque Wounds: A Multimodal Analysis of Self-Injury Photographs on Flickr. Forum: Qualitative Social Research, 14 (2). Seko,Y. and Lewis, S.P., 2016. The Self – Harmed,Visualized, and Reblogged: Remaking of Self-Injury Narratives on Tumblr. New Media & Society, 1–19. Sharpe, H., Musiat, P., Knapton, O., and Schmidt, U., 2011. Pro-Eating Disorder Websites: Facts, Fictions and Fixes. Journal of Public Mental Health, 10 (1), 34–44. Sharrock, J., 2013. Meet The Girl Behind One Of Tumblr’s Biggest Self-Harm Blogs [online]. BuzzFeed News. Available from: www.buzzfeed.com/justinesharrock/meetthe-girl-behind-one-of-tumblrs-biggest-cutting-suicide?utm_term=.krbPQYv0o1#. yiE58dg0D4 [Accessed 19 July 2016]. Shaw, D., 2013. Traumatic narcissism: Relational systems of subjugation. Hoboken: Taylor and Francis. Singler, B., 2011. ‘Skeletons into Goddesses’: Creating Religion, the Case of the Pro-Ana Movement and Anamadim. MPhil Theology and Religious Studies. The University of Cambridge, United Kingdom. Slim Thintetions [online], 2016. Tumblr. Available from: http://slimthintentions.tumblr.com [Accessed 14 Dec 2016]. Sternudd, H.T., 2012. Photographs of Self-Injury: Production and Reception in a Group of Self-Injurers. Journal of Youth Studies, 15 (4), 421–436. Sternudd, H.T. and Johansson, A., 2015. Iconography of Suffering in Social Media: Images of Sitting Girls. In: R.E. Anderson, ed. World suffering and quality of life. Netherlands, Springer:341–355. Sucker for Pain,2017.IWasn’t Supposed to Be Alive Long Enough to See 2017 [online].Available from: https://twitter.com/built4theabuse/status/815310980724965377 [Accessed 2 Jan 2017]. Tam, C.K., Ng, C.F., Yu, C.M., and Young, B.W., 2007. Disordered Eating Attitudes and Behaviours Among Adolescents in Hong Kong: Prevalence and Correlates. Journal of Paediatrics and Child Health, 43 (12), 811–817.

Self-harm on social networks 59 Terman, D.M., 2010. Theories of Group Psychology, Paranoia, and Rage. In: C.B. Strozier, D.M. Terman, J.W. Jones, and K. Boyd, eds. The fundamentalist mindset: Psychological perspectives on religion, violence, and history. New York: Oxford University Press, 16–28. Tetyana, 2013a. Why Banning Pro-Ana Is a Bad Idea [online]. Science of Eating Disorders. Available from: www.scienceofeds.org/2013/07/20/why-banning-pro-ana-is-a-badidea/ [Accessed 3 Jan 2017]. Tetyana, 2013b.What Really Goes On Inside Pro-Ana Communities? (Maybe They Are Not So Bad After All) [online]. Science of Eating Disorders. Available from: www.scienceofeds. org/2013/01/30/what-really-goes-on-inside-pro-ana-communities-maybe-they-arenot-so-bad-after-all/ [Accessed 2 Jan 2017]. THlNB0NES, 2016. New Years Resolution [online]. Available from: https://twitter.com/ THlNB0NES/status/814859404491321344 [Accessed 2 Jan 2017]. Tong, S.T., Heinemann-LaFave, D., Jeon, J., Kolodziej-Smith, R., and Warshay, N., 2013. The Use of Pro-Ana Blogs for Online Social Support. Eating Disorders, 21 (5), 408–422. trying, 2017. 2017: Get Thin [online]. Twitter. Available from: https://twitter.com/strongregrets/status/815435846669123584 [Accessed 2 Jan 2017]. Tumblr Staff, 2012. A New Policy Against Self-Harm Blogs [online]. Available from: https:// staff.tumblr.com/post/18132624829/self-harm-blogs [Accessed 8 June 2016]. Tumblr Trust & Safety, 2016. Re: Tumblr Account Terminated. Twitter, 2015. Twitter Help Center | Dealing With Self-Harm and Suicide [online]. Available from: https://support.twitter.com/articles/20170313-dealing-with-self-harm-andsuicide [Accessed 30 Jan 2015]. Twitter Usage/ Company Facts [online], 2016. Twitter. Available from: https://about.twitter. com/company [Accessed 2 Jan 2017]. von Lojewski, A. and Abraham, S., 2014. Personality Factors and Eating Disorders: SelfUncertainty. Eating Behaviors, 15 (1), 106–109. Warning [online], 2016. Psyke. Available from: www.psyke.org/warning.html [Accessed 28 July 2016]. whiteskeletons, 2016. Thinspo Is More Than ‘thin’ [online]. Tumblr. Available from: http:// whiteskeletons.tumblr.com/post/145439386237/thinspo-is-more-than-thin [Accessed 27 June 2016]. Whitlock, J., Lader, W., and Conterio, K., 2007. The Internet and Self-Injury: What Psychotherapists Should Know. Journal of Clinical Psychology, 63 (11), 1135–1143. Whitlock, J., Purington, A., and Gershkovich, M., 2009. Media, the Internet, and Nonsuicidal Self-Injury. In: M.K. Nock, ed. Understanding nonsuicidal self-injury: Origins, assessment, and treatment. Washington, DC: American Psychological Association, 139–155. Whitlock, J.L., Powers, J.L., and Eckenrode, J., 2006. The Virtual Cutting Edge: The Internet and Adolescent Self-Injury. Developmental Psychology, 42 (3), 407–417. Williams, M., 2014. Unpopular Opinion: Pro-Ana Websites Were a Positive Influence In Helping Me Recover From My Eating Disorder [online]. xoJane. Available from: www. xojane.com/issues/unpopular-opinion-pro-ana-websites-were-a-positive-influence-inhelping-me-recover-from-my-eating-disorder?utm_medium=facebook [Accessed 3 Jan 2017]. Williams, S. and Reid, M., 2010. Understanding the Experience of Ambivalence in Anorexia Nervosa: The Maintainer’s Perspective. Psychology & Health, 25 (5), 551–567. Wooldridge, T., Mok, C., and Chiu, S., 2014. Content Analysis of Male Participation in ProEating Disorder Web Sites. Eating Disorders, 22 (2), 97–110.

60  Self-harm on social networks Yeshua-Katz, D. and Martins, N., 2013. Communicating Stigma: The Pro-Ana Paradox. Health Communication, 28 (5), 499–508. Zimmerman, J., 2008. On Twilight, Romance, and Antifeminist Ideas [online]. Shapely Prose. Available from: https://kateharding.net/2008/12/21/on-twilight-romance-and-antife minist-ideas/ [Accessed 19 July 2016]. Zimmerman, J., 2014. Blood Sisters: Why Girls Cut Themselves, and Why We Can’t Blame Tumblr [online]. Medium. Available from: https://medium.com/the-archipelago/bloodsisters-7c792f3b9b07#.s32a4b239 [Accessed 19 July 2016].

Chapter 2

The aesthetics of self-harm

The aesthetics of self-harmThe aesthetics of self-harm

Visual rhetoric as a key to understanding online activities

For many, the idea of an aesthetic value to self-harm is a stretch.The cuts, blood, emaciated physiques, and bruised flesh of self-harmers are not things that we are necessarily accustomed to seeing. Nevertheless, major dynamic within selfharm communities – and one that appears to be growing ever more prominent and powerful – is a strong sense of aesthetic identity. The communication of a particular aesthetic is integral to the communication of selfhood. Online aesthetics can, and do, have a direct impact on the physicality of an individual’s body. These physical states are a powerful communication device, which can be read through a system of visual rhetoric via physical composition. When exploring the impact of online communities on self-harm behaviour, the puzzle is incomplete when divorced from aesthetic identity. Representations of the body on the internet form a dimension in which online and offline spaces can start to engage in an intertwined process of feedback. For example, Johansson explores how the cuts of a self-harmer onYouTube operate in a hybrid media space. If a self-harmer cuts herself, then shows images of these cuts to others on YouTube, she has transposed her cuts from her physical body into the digital domain. Thus, “the medium in some sense becomes part of the body, the body also becomes part of the medium” (Johannsson 2014, 21). Her body also enters a space of endless replication where mobile technologies allow her image and her self-harm wounds to appear in many places simultaneously. She is also part of a process of interaction on the communitybased project that is YouTube (2014, p. 21) This is a zone where other self-harm advocates or dissenters will aim to support or ridicule her online, which is then likely to have an impact on her body and how she relates to it in a more material sense. Online comments and communal values can pause or accelerate self-harm behaviour in keeping with group standards, which are shared in a virtual space, and have a direct bearing on the physical body. So how separate can these worlds really be? In agreement that the body and its materiality are very much important elements of pro-self-harm websites, Gradin Franzén and Gottzén note that scars are often perceived by users as reflections of inner turmoil. As such, scars are often seen as beautiful because they reflect truth rather than as ugly because

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they show pathology. Epitomising this, they quote a user called ‘Lolita’, who explains: True emotions are beautiful. I automatically think your scars are beautiful. Just as I also think that YOU are [beautiful]. But I have always thought that blood and damaged skin shown because of intense emotions are beautiful. (2011, p. 288) Here she makes it clear that sharing damaged flesh is a way of exchanging images of beauty. This is also relevant to Foss’s schema for a visual rhetorical analysis. She suggests that we look at the nature of an image (such as what it is made of and where it is found), the function of an image (how it operates for its viewers), and evaluation (a scholarly assessment).The actual nature of this scholarly assessment can vary (2005, p. 147). When looking at self-harm imagery, I think the most relevant form of assessment is a discussion of how self-harmers represent themselves, how they represent group identity, and how outsiders – including mental health professionals – respond to their imagery.This will allow us to understand community dynamics and thus aim towards new treatment methods. Foss’s methodology also helps us to address the uncommon but highly important question of what makes an image appealing to others and why (1993, p. 214). Many of the images I present in this chapter have very strong generic conventions and a preoccupation with the eternal aesthetic pursuit – the creation of beauty. In the Preface, I introduced the idea of visual ‘modes’ as discussed by Jenkins. He calls these modes a set of collective visual phenomena expressing “the circulating energies of contemporary existence” (2014, p. 443). For example, images of emaciated collarbones, which are quickly divorced from their original creators and models because of the endless reblogging of Tumblr and the primacy of image collectors rather than image creators. These modes subvert the usual practices we employ to understand images that are made by specific artists with a set audience in mind. Because modes are virtual – constantly changing, multiplying, and appearing in new contexts and collections – we need to view and understand them in a non-traditional manner. Instead of looking for a static audience, author, and context, we need to view these texts as manifestations of mass image circulation and the replication of desired styles and forms of communication. Modes enable us to see recognisable structures that are continually remade, adapted, and added to (Jenkins 2014, p. 443). Individual rhetors are not as primary in this system of group assemblage where collective phenomena are expressed and shared by multiple authors simultaneously. Instead, a flâneur who endlessly browses tags to create a thematic collection is as important as any initial photographer who creates an image. We need to focus more on Jenkins’s ‘circulating energies’ if we are to understand the actual system though which self-inflicted injuries become a vital social currency and a means of expressing

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the forms of beauty elevated by the pulsating online energies of the contemporary self-harm lifestyle. In the following, I explore some of the major aesthetic forms that are associated with self-harm and evaluate how this relationship has formed and what its impact is on today’s online world.

Emerging self-harm aesthetics Dark Tumblr

‘Dark’ aesthetics are notably common on social networking sites that deal with themes such as suicidal ideation, self-harm, and eating disorders. In her study of self-harm videos on YouTube, Johansson notes that the majority of imagery selected in slideshow-style montage videos is black and white with occasional red (2014, p. 18). Similarly, Lewis and Baker noted that 83.10% of the self-harm sites they investigated had “melancholic tones”, dark colours, and words and images of despair (2011, p. 393). In both these cases, the majority of problematic sites draw from the same basic aesthetic structure. A think piece in The Atlantic made the perils of this aesthetic clear.The article follows 16-year-old ‘Laura U.’, who became fascinated with images of eating disorders and emaciated woman on her Tumblr dashboard: She pined to be mysterious, haunted, fascinating, like the other people her age that she saw in black and white photos with scars along their wrists, from taking razor blades to their skin. (Bine 2013) Laura was seemingly infected by these black-and-white images of romanticised depression. She was also enraptured by melancholic quotations shared on the site, including “Can I just disappear?” and “People who die by suicide don’t want to end their lives, they want to end their pain”. She started to feel as though these statements applied to her personally after seeing them over and over. Bine calls this Tumblr aesthetic a “distorted vision” of depression, which makes it seem both romantic and accessible. She blames social networking for a new image of depression that values “exhibitionism of self-harm, suicide, depression, or self-loathing under the pretext that it is beautiful, romantic, or deep” (Bine 2013). Common tags used for Dark Tumblr are #goth, #emo, #dark, or #dark aesthetic. Content from this folksonomy includes photographs of fresh self-harm injuries from cutting, extremely skinny female legs or torsos, captions referring to negative conceptions of fatness (e.g., “I hate myself for eating so much” and “she’d rather die than be fat”), nihilistic movie or television stills with subtitles, photographs of cigarettes, and content referring to a need to give up or die. The most obvious aesthetic choice is the exclusive presence of black-and-white images. The self-harm wounds that feature also have a particular aesthetic. The

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cuts are thin, placed close together, and are generally shown in a bloody state or bandaged (Plate 1), indicating that they are fresh and raw. In high-contrast black and white, the blood and gashes are extremely clear against the pale skin of the people who are modelling them. There are also common poses, such as furtive reveals of cuts under long sleeves or shirts. The Definis-Gojanović study investigated whether dark subcultures were a suicide risk factor, or if they were more of a “beacon call of a young mind for special attention” during the trials of adolescence (2009, p. 174). From studying sites like Tumblr, it is apparent that dark genres are a way of showing suffering, and a way to show rebellion against social norms – including norms of wellness and bodily integrity. Sternudd and Johansson note that most mental health material online is accompanied by bright and colourful images, often showing families and friendship groups in order to promote healthy living and give a sense of hope for recovery. The darker black-and-white aesthetic represents the vernacular discourse on mental health in opposition to the cheerful official discourse. This vernacular discourse challenges socially sanctioned ideas of seeking happiness and draws more on the idea of suffering and existential angst, leading to the potential creation of “a suffering identity” (2015, p. 352). People may engage with this identity because they have a general desire for rebellion, or they may engage because they have a severe mental illness that is reflected in these melancholic themes. These dark aesthetics match low mood and can support a low mood level, even though there is little evidence that ‘dark’ culture causes ‘dark’ thoughts. Sad Tumblr

New self-harm aesthetics have emerged in the past few years, which have changed the face of visual expression and emotional communication online. A newer kind of ‘Sad’ Aesthetic has come exclusively from the internet generation and new modes of mass communication. To explore this aesthetic and its context, it is vital to understand the Tumblr Teen Girl Aesthetic – a new aesthetic mode that is both powerfully emotive and deeply ironic. This aesthetic focuses on the female body and its presentation, demonstrating that the divide between online and offline bodies grows ever smaller. This aesthetic includes the genre of Soft Grunge, where self-harm images are an important currency, and has spawned the Sad Girl movement, where people are invited to perform their emotions in a dramatic celebration of negative affect and the pains of everyday life. In 2013, Sarah Owen from the trend-forecasting agency WGSN started following the Sad Girl Aesthetic. She did this because subcultures like Emo had started to disappear, and she wanted to discover what contemporary form this genre had morphed into. In its place, she discovered a new kind of performative online sadness. Owen describes this new popular form of sadness as an aesthetic that “straddles the line between girly and grungy, with added inspiration from

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Japanese kawaii culture”. She feels that this contrast is appealing because many young teenagers not only enjoy “pretty pastels” but also yearn to express the darkness of heartache and depression (Owen in Jennings 2016). Owen’s predictions were on point, and in 2014, internet commentators started to note the rise of the Sad Girl. Gore declared 2014 to be the year in which “feelings have been verified” with a range of Tweets, hashtags, and blogs letting out emotions to strangers while keeping a cool façade in public. She notes that a Sad Girl is rarely frail and is more likely to be “sarcastic, witty and self-deprecating”. She has friends, eats junk food, and has a great sense of style when chilling at home or dressed up for a party, and has a sense of humour that is “funny in a #dark way” (Gore 2014). A Sad Girl also understands the complex interplay between the internet and the physical body. Taking many early theorists by surprise, the body has a very large role to play in today’s internet. In the mid-1990s, scholars such as Turkle and Castells focused on the emerging demarcation between the online and offline selves and the conceptual differences between online and offline space. This led to a scholarly conceptualisation of the internet as a place of real difference from one’s everyday reality (Lindgren et al. 2014, p. 2). This difference manifested in the fact that online spaces of this era were primarily disembodied and anonymous. Web 1.0 hid the race, gender, and age of participants in order to create a supposed level playing field free from bias. While reality was never quite this ideal, there was still a powerful feeling of freedom from the constraints of one’s body or one’s status in the offline world. This egalitarianism and homogeneity have been eroded by the strong focus on name and image in the highly visual and individualistic Web 2.0 atmosphere. This personal turn was unprecedented by many early commentators on the internet. As Bell explains, the internet was originally imagined as a disembodied utopia. Here, people would overcome the problems and inequalities experienced in the physical world and achieve a sense of personal and psychological safety. Unfortunately, these lofty hopes never came to pass and seem less likely to occur than ever (2013, p. 32). Instead, we have a virtual world that is part of a dynamic intertwinement with the material world. It is bound to our economic, cultural, and social capital and to the power dynamics therein (Lindgren et al. 2014, p. 9).1 The human form plays a core role in communicating online selfhood. So, when people engage in aesthetic communities online, these aesthetics often cross over into their own lives. If the aesthetic involves a glamourisation of self-harm, this can also very early manifest on the physical bodies of participants. Understanding the connection between online aesthetics and the physical human body can help us to understand the need that participants feel to add their bodies into the discourse and be inspired by a group aesthetic by rendering it into their actual physical forms. The connection between social media, self-harm, and the visual world has been picked up by journalists in recent years. For example, in an investigation of the relationship between hashtags and

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self-harm behaviours, Australian teenager Samantha Williams remarks, “It’s not just about the pain, there is a big visual component to cutting” (Chang 2014). In addition to this aesthetic dimension of the act, images of self-harm also have powerful cultural capital. To this end, Seko has explored the materiality of selfharm photographs. She describes them as “cultural objects to be shared, which in turn may engender a new form of solidarity and sociality beyond dominant, often hegemonic discourses”. In this manner, Seko posits the image-making process as one of identity creation and as a means of speaking beyond a medicalised discourse of self-harm (2013, p. 4). They are the ones who get to decide if they are ill or not, and they are the ones who get to decide how their bodies are presented to the world. The Tumblr Teen Girl Aesthetic and the New Aesthetic

Aesthetics can function in a contagious manner, much like self-harm and suicidal behaviour. With replicated jokes, images, and language, a recognisable online communication style can be created. Amongst the first commentators to note the rise of the Tumblr Teen Girl Aesthetic2 were Eler and Durbin whose editorial on the topic brings new light to the pervasiveness of online adolescent culture and the channels that carry it (Eler and Durbin 2013).The Tumblr Teen Girl Aesthetic is a subset of broader contemporary online aesthetic trends. It is heavily influenced by what has been dubbed the New Aesthetic. Originally coined by James Bridle in 2011, the New Aesthetic is a powerful aesthetic turn enabled by the rise of new technologies that include a visual component. For example, we can now view the world through the digital camera of a satellite, allowing us the new privilege of “seeing like digital devices” (Bridle 2012a). This conscious and accidental collaboration with visual data from machines blurs the lines between what is real and what is digital. Importantly, it does so through a recognisable aesthetic pattern. The data we get from machines tend to look “glitchy and pixelated” (Bridle 2012a). Visual artefacts showing this aesthetic include “computational miscalculation” such as “glitches, compression and codec artifacts” (Plate 2), and the low-resolution data of satellite images (Contreras-Koterbay and Mirocha 2016, p. 11). Also relevant are “streams from surveillance cameras, artifacts left by corrupted files, and low-res 8-bit graphics from the 1980s” (Sterling 2012). Because this aesthetic is based on the digital gaze of machinery, Sterling describes the New Aesthetic as a point at which “the art world sidles over toward a visual technology and tries to get all metaphysical” (2012). Images in the New Aesthetic are notable because they rarely have a human creator or composer. Instead, many are the visual trails left behind by machine algorithms – created by computers with no sense of aesthetic value or beauty. Although software is initially created and programmed by humans, it can now adapt to new circumstances and data in such a rapid and independent manner that the initial programmers lose control over the behaviour of the systems they

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create. As such, Contreras-Koterbay and Mirocha argue that we have entered a world beyond Baudrillard’s simulacrum. We no longer reside within a world that contains simulations made by our own hand. Instead, our simulations are producing their own simulations. Contemporary culture exists in the form of a data feed that we tap into using our electronic devices (2016, p. 9). The New Aesthetic is the visual form this data feed takes. Bridle later confessed that he named this movement badly. He feels that “[m]uch of the critical confusion around the New Aesthetic has clustered around the use of the term ‘aesthetic’, by which I meant simply, ‘what it looks like’ – I wasn’t even really aware of how key the term aesthetics was to art historical and critical discourse” (Bridle 2013). The New Aesthetic is not a new theory of beauty for a new millennium. Instead, it is a way of understanding the impact of computers and digital technology on the images we see and on the way we engage with the world through our digital devices such as computers, tablets, and wearables. Bridle calls the New Aesthetic “a rubbish name” but concedes that “it seems to have taken hold” (2011a). One of the reasons why its grasp is so strong is that it explores the very peculiar part of history we have found ourselves in where digital technologies have become such a part of life that they have permeated the gaze with which we see our world. It is also something that exists around us without the requirement that we do or ascribe to anything. Bridle explains that the New Aesthetic “is not a movement, it is not a thing which can be done” (Bridle 2016). Rather, it refers to a series of artefacts that show the overlap between human and technological vision. This aesthetic is from a world where “the direct use of digital techniques as both the means of production and as art itself ” (Contreras-Koterbay and Mirocha 2016, p. 11). There is no New Aesthetic manifesto to rely upon. As such, “[i]t’s a vibe, an attitude, a feeling, a sensibility” that we can learn to recognise.This sensibility is tied to a recognition of computation and digital devices and an ability to ‘see’ through the eyes of the machine, respond to the digital gaze, or be attuned to its existence (Berry et al. 2012, pp. 12, 41). Bridle writes, [I]f you look very, very closely at these imaginary places, you can start to see the grain of them, the outline of them, which is which is pixelated, which is digital. Because these spaces of our imagination are entirely digital now. (Bridle 2011a) So why is this New Aesthetic so appealing and pervasive? Partially, it is appealing because it is a nostalgic exploration of the recent technological past. Berry et al. believe that an obsession with “8-bit retro” was to be expected in the present era, as this graphic style is now an instant shorthand for the early digital world – something we have left behind but which most of us still remember fondly. Meanwhile, advancing digital graphics are becoming so high-definition that their pixel structure is almost imperceptible (2012, p. 42). This nostalgia is

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a balm against the anxiety that rapid technological change can bring. Not long ago, Bridle worked at a publisher where he was the only employee trained in computer science. He still remembers his colleagues’ anxious, frenzied reactions to what they thought was the death of print. Trying to understand their “intense, emotional reaction”, he realised that his colleagues were panicking because their analogue modalities for processing the world were being threatened (Carp 2013). By breaking down the rise of the digital via the New Aesthetic, we can critique this new modality, investigate the way it looks and feels, and thus digest our new century with greater ease. Critiquing the New Aesthetic: teen bodies online

On some levels, sites like Tumblr are an integral part of the modes that allow the New Aesthetic to exist and thrive. Giving instructions as to how one can find the new worlds offered by online data, Bridle explains: You do not need to leave your room. Remain sitting at your table and listen. Do not even listen, simply wait, be quiet still and solitary. The world will freely offer itself to you to be unmasked, it has no choice, it will roll in ecstasy at your feet. (Bridle 2012a) This is deeply reminiscent of the process of scrolling through Tumblr and processing seemingly endless stream of data with minimal effort. The usergenerated content of Web 2.0 does indeed allow the world to flow through one’s Tumblr dashboard. But despite this congruence with broader New Aesthetic trends and modes of delivery, the Tumblr Teen Girl Aesthetic has one important difference. The New Aesthetic relies on the idea that the art object is now digital – not physical. Most of the art objects that exist within the New Aesthetic have no human creator. They are digital glitches or the visual remnants of the actions of a piece of software, which are subsequently elevated by humans for the visual enjoyment of their peers – somewhat like a found object or one of Duchamp’s Readymades. The Tumblr Teen Girl Aesthetic takes on the look, feel, and meaning of the New Aesthetic whilst frequently placing young female bodies front and centre of the discourse. In describing the Tumblr Teen Girl Aesthetic, Eler and Durbin explain that the art ‘object’ extends to the bodies of girls both on and offline; the fetish is not contained in a static image. Even the images themselves are constantly moving and perpetuating themselves on Tumblr, breathing and existing in time and space as a living body. (Eler and Durbin 2013) This produces a kind of digital, infinite hyper-girl or übermädchen who represents the shared concerns of the feminine teen. The amount of bodies that

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add up to the digital übermädchen is massive. Eler and Durbin joke that Tumblr is “bloated with more bodies than a porn video warehouse”, including selfies and self-portraiture, celebrities renowned for their physical form like Kim Kardashian, former porn actors like Sasha Grey, and fine art female nudes. This is quite different from the mainstream of the New Aesthetic where human bodies are always remote – presented in the form of humanoid robots or Bridle’s ‘render ghosts’, which appear as decorative features on architectural plans. Eler and Durbin (2013) note that the female body and female nude are particularly absent. By taking images of women from porn, the art history canon, or their own camera phones, exponents of the Tumblr Teen Girl Aesthetic borrow from the hyper-modern stylisation of the New Aesthetic while ensuring that their own image and message is central to the design. In this way, female creative minds are making room for their own perspectives and experiences. Revealingly, the vast majority of commentators on the New Aesthetic are men. Ashby (2012) describes the seminal texts of the movement as “mostly written about men, by men”. Aima (2012) agrees that “thus far, with few exceptions, it [has been] a whole lot of men doing the looking, talking, and writing about the New Aesthetic”. Ashby believes that this lack of female commentators is due to a few factors. Fewer women work as tech reporters; thus, a journalist covering an internet issue is more likely to be a man. Women are also shut out of deeper engagements with technology, especially if they use that technology for the purpose of ‘girl stuff ’ like fashion or crafting. But, most important, their absence seems to primarily be a matter of perception and stereotype. Men trained in technological security and espionage get respectable jobs in the NSA; equally investigative women are not governmental agents – they are eavesdroppers, curtain-twitchers, and gossips. Girls do arts and crafts, while guys start Art Movements (Ashby 2012). Even in the supposed democratic age of the internet, the digital übermädchen has been ignored in order to foster the argument that online spaces are post-human. This is certainly not the case when we examine the actual statistics of bodyrelated images that can be found online – especially as part of body-oriented discourses like self-harm. In the Juarascio et al. study, researchers logged pictorial content across Facebook and MySpace. They discovered that pro-ED sites have a substantial focus on depicting not only the human form – primarily the emaciated female form – but also other associated body parts, favour photographs of thin celebrities, and occasionally use pictures of overweight women as a form of negative inspiration. Flowers, food, and inspirational quotes also featured in some of the groups they discovered (2010, p. 398). Similarly, Tong et al. found that the majority (79.2%) of pro-ED blogs they located had a strong visual component (Tong et al. 2013, p. 415). When people explore topics such as body image, mental illness, and mutilation of the body, they do so with the use of body-centric imagery.There is also something lonely about this world of the pure New Aesthetic. Sterling notes that an absence of human figures leads to an absence of aura and credibility. He argues that making machines into our friends will do nothing to “gloss over this gaping vacuity” and hide the lack of

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emotional depth at the core of the New Aesthetic. Machines may be able to sit against our flesh and run algorithms on our bodies and out productivity, but they are not intimate partners, and they are not art critics who can understand the reality of their forms being represented in a creative way (Sterling 2012). If we want to talk about the human experience, human pain, and human creativity – we need art that is tied to real human forms. This is something that many young creative women have already discovered. Because the Tumblr Teen Girl Aesthetic is used to speak about female experience – the pain of self-harm and mental illness – it does so using the language of the human form. It is an aesthetic with a strong awareness of the digital space and of the infinite ephemera and passionate tractates that Tumblr broadcasts to the world. But it is also one that adds to the digital übermädchen of our era with a very corporeal discourse on what it means to exist in a politically loaded and subjugated form. For example, Durbin created the art projects Girls, Online (2012) and Women as Objects (2011–2013). Both of these projects collate artefacts that represent the objectification of women. This is combined with a strong self-awareness of the kind of “radical self-objectification that the girls practice on their own Tumblr blogs” (Eler and Durbin 2013). Some of Durbin’s content is reblogged text posts about self-harm and high school abusers leaving for college. Images range from female nudes by the male Russian artist Aydemir Saidov to Lady Gaga. gifs and a photo of a woman on a car with her crotch resting behind a Mercedes Benz hood ornament. All these images and tractates represent a dimension of the way in which female bodies are presented online and are increasingly disseminated as a new kind of low-cost sexual currency. Spin-offs from this project include a piece of video art titled TUMBLR IS THE ONLY PLACE I DON’T PRETEND I’M OKAY (2012). Heavy with background static, this piece rolls credits on a Tumblr dashboard, recorded slightly out of focus on what is probably a smartphone rather than a professional recording device. This allows Durbin to focus on the materiality of Tumblr: a series of pixels broadcast on a screen. Most of the video involves Durbin scrolling through her Tumblr dash and looking briefly at images of models, drugs, flowers, ice, and other assorted themes. She finds an image of Lady Gaga and reblogs it. The film then transitions into a monologue from Durbin, who sits in a bathtub filled with flower petals. She wears a silver dress and wig, and her face is covered in Hello Kitty stickers. Her intense monologue to the camera is inspired by her 20th birthday and her thoughts that she should probably delete Tumblr and grow up now that she is no longer a teenager. Durbin tells us of her desires to be “filthy fucking rich”. She states that her hair smells like “cigarettes and cotton candy”. She also takes on the persona of a wise woman with a tangled purple wig who stands behind the shower curtain and tells the audience that they are single because their daily lives have precluded their true knowledge of self. A white mannequin head stares.The two characters converse with each other using the kind of language popular on Tumblr. The overall impression of TUMBLR IS THE ONLY PLACE I DON’T PRETEND I’M

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OKAY is one of deep anxiety and an inability to inhabit a single persona. But despite its confusing themes and erratic jump cuts between unnamed personas, the sentiments expressed are quite familiar to anyone who has visited the Tumblrs of teen girls – as are the images and linguistic choices. Durbin’s Girls, Online project is featured on the gallery website Bright Stupid Confetti. This collection is riddled with representations of the female body, often connected to notions of fame, beauty, romantic rejection, and loss of dignity.While some images show a technical prowess in fields such as pen-and-ink drawing, many are purposefully low-fi and low-skill, often engaging with the New Aesthetic. They involve bad rendering and layering of images in cheap software, glitch art, and angry red text. Many are stolen screenshots from games, images from softcore pornography, and text boxes created in Google searches, URL chains, and iMessage. Most of these emotions and aesthetic choices are funnelled through young, pale, female bodies. They are exactly what Bridle or Stirling would recognise as the New Aesthetic, yet the presence of the human body is important. For the women who have volunteered to use their own bodies as part of this art, their presence in these images is eternal and beyond the traditional author crediting system of the art world. Indeed, Durbin regrets having to make these images anonymous and admits, “I can only direct you to the Women as Objects archive project itself if you are interested in seeking out the girls behind/with/in/these images. Even there, they may elude you” (Durbin 2012). If a project like Women as Objects is a catalogue of the teen-girl Tumblr aesthetic, then it is a catalogue of the future: a future that is liquid, where the lines between online and IRL are less rigid. Plastic Pony, when asked what she wanted the world to know about Tumblr, said, “I would like the world to know what it feels like to be able to do whatever you want freely and to let everyone else do whatever they want” (Eler and Durbin 2013). This means inhabiting multiple personas and slipping between them to suit different contexts and needs. It also means expressing deep anguish and pain in one image and sweet childhood nostalgia in the next. Politically speaking, it means that a person can be an avowed feminist in one post and then reblog an over-sexualised image of a porn star in the next. This does not necessarily mean that the typical user of Tumblr is disingenuous or inconsistent – rather, it means that many young women are trying to come to terms with a dangerous and confusing world in which not only they feel objectified and demoralised but also are praised for good looks and sexual availability. While Eler and Durbin do worry that elements of the Tumblr Teen Girl Aesthetic perpetuate misogynistic cultural narratives, this aesthetic is also a place of experimentation. It is a zone in which people can enact “dramatized, nearly hyperreal and fictionalized” performances of the self (Eler and Durbin 2013). This is a mechanism by which younger people seek an adult identity and play with new personas in order to discover what the reaction to them might be or how different spaces can be inhabited by different characters.

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This art is also a powerful discourse on what it is like to be watched. One of the reasons why TUMBLR IS THE ONLY PLACE I DON’T PRETEND I’M OKAY involves a long, scrolling sequence is because Durbin believes this is the best way to understand the complex affect of the Tumblr Teen Girl Aesthetic. She and Eler explain how scrolling through Tumblr allows one to “[take] in the images as they slip over each other in the moving stream, intersecting with other girls’ images and aesthetic worlds. In isolation they are static,” but together, they show a full and lively picture. This picture includes a complex combination of “a darker edge, an undermining of the heterosexual male gaze, as well as an ever-present extreme vulnerability” (Eler and Durbin 2013). This is quite different from anxieties behind the normative New Aesthetic, where visual phenomena are so divorced from the human body that they are often autonomous and beyond human control (Contreras-Koterbay and Mirocha 2016, p. 9). Instead, the Tumblr Teen Girl Aesthetic explores new visual information and styles that pertain directly to the human body and its observation. This is already a point of contention amidst feminist commentators on the New Aesthetic. Many males are now feeling a sense of anxiety over the everpresent gaze of machines in the human environment – ranging from CCTV to more advanced facial recognition software that can actively track down a specific individual. By exploring images such as the feed that these devices receive as they break down faces into a set of unique measurements and ratios, proponents of the New Aesthetic have sought to understand and comment on this new threat to personal autonomy and privacy. But for females, this constant observation is not a new anxiety; it is something we have dealt with our whole lives. Ashby notes how it took the invention of CCTV for men to feel the same intense gaze that women are born under: That sense that someone’s peering over your shoulder, watching everything you do and say and think and choose? That feeling of being observed? It’s not a new facet of life in the twenty-first century. It’s what it feels like for a girl. (Ashby 2012) Her recommendation for men who are startled by this new reality of constant digital observation is to reach out to women who have been dealing with unwanted invasions of privacy and unsolicited attention for far longer than they have (Ashby 2012). As it happens, one does not even need to reach far to find discourses like the Tumblr Teen Girl Aesthetic, which explores both the rise of a new, digital gaze and the ongoing reality of the ever-present, everjudgemental human gaze that is equally powerful and pervasive. Aima argues that the attraction of the New Aesthetic for men is the unnerving but titillating chance to “briefly experience a traditionally feminized, objectified subjectivity”. Males exploring this aesthetic turn and playing with its visual qualities can make a game of seeing themselves reflected through the ‘eyes’ of someone or

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something else. They can “build an identity predicated upon [their] reflection and image on the screen”, which is something that young women are already deeply connected with (Aima 2012). For participants in the New Aesthetic, playing with the gaze of machines is something of a game. For those who engage in the Tumblr Teen Girl offshoot, it is a very powerful and profound comment on the anxieties of living within a female body. Horror modes and self-harm nodes

Many of the important images and trends within the aesthetic of self-harm contain a balance between irony and the macabre. Emberley, in a discussion of how self-harm is shown in art and film, notes that “irony is essential because it ensures the minimalization of an aesthetics of horror”. She explores how the artist Orlan orchestrated a public performance of grotesque plastic surgery in order to simulate fear and revulsion. Because this performance turned the “culture of cutting” into a fetish and a spectacle, it distanced the viewers from her pain at the same time as it graphically expressed it. This is the core of the irony (2009, p. 6). Irony and the New Aesthetic are also part of the process of constructing an anxiety language – in part, deeply genuine and emotionally expressive and, in part, comical or absurd. Berry believes that the New Aesthetic fetishises and reproduces the hidden patterns of computation to the surface. In doing so, it allows us to glimpse the unseen parts of ‘intelligent’ machinery and computational society, which can be anxiety-inducing (Berry et al. 2012, p. 41). There is a balance between the seen and the unseen, the horrific and the humorous. For many people, this is the only way that disturbing imagery and themes can really be dealt with. This process of working around horror through visual mediation is certainly not unique to internet expression. It has existed for some time through confronting artistic genres such as Body Art. Foss came face-to-face with bloody and brutal artworks (including self-harm imagery) when visiting the “bodyworks” exhibition at the Museum of Contemporary Art, Chicago, in 1975. She viewed art such as Rudolf Schwarzkogler’s Aktion 3 (1965), where he appears to cut off his own penis. Foss was surprised to find this body art as appealing as it was repulsive (1987, p. 122). It is important to remember that the images of selfharm that appear in genres like Soft Grunge are enjoyed and aesthetically valued by many. Horror and gore do not preclude an image from being positively received. Foss argues that appealing images are those that contain some sort of technical novelty or excellence that violates viewer expectations, generates awe and bewonderment, and gives a feeling of having seen something special (1993, pp. 215–216). A delicate, pale, misty photograph that is slashed through with a river of blood might be disgusting to some. But it is also exciting, novel, and disruptive. As such, it can invite admiration and sustain viewer interest. In terms of addressing their function as pieces of visual rhetoric (Foss 1994, p. 217), we could say that many of the images discussed in this chapter aim to

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express the profundity of sadness. For some audiences, this is a hallowed and important topic. If an image has good aesthetic qualities and communicates this meaning well, then it is a functional piece of visual rhetoric. If, however, a person who is disgusted by self-harm or opposed to the practice should see the same image, it may be rejected as ugly or degenerate. Alternatively, it may be used to educate and horrify concerned parents or health workers. Many of us are led to believe that the most important evaluations of art come only from trained critics with developed sensibilities, but the discourse of visual rhetoric invites us to consider the responses of ‘lay’ viewers as well, drawing on their own life experiences and knowledges. Thus, any reaction is a valid reaction for serious study and serious consideration (Chryslee et al. 1996, p. 10). There is also no such thing as a visual artefact that is aesthetically insufficient for serious study. Indeed, Foss shows us how a Burger King fast-food outlet can be rhetorically analysed in order to determine how the chain puts forward a persuasive argument of affordable and efficient food service (1982, p. 61). By the same token, it is not appropriate to disregard the deep emotional message of the images discussed in this study either because they are too bloody and horrific or because they read like jokes. Instead, there is much more to gain from a consideration of these unique modes of communication and what they reveal about the patterns and purpose of self-harm amongst those who use them to communicate. In Jenkins’s Deleuzian take on modes and affect, he explains that modes are themselves bodies: social bodies, linguistic corpuses, collective ways of seeing (2014, p. 448). Thus, the teen-girl Tumblr body is more than just a representation of a physical form. It is a representation of contemporary teenage culture, the value of bricolage in the creation of identity, an ironic celebration of verbal and visual ugliness, and a shared, collective, ever-developing vision of the New Aesthetic.The affect of this mode can vary from the genuine anxiety depicted in a photograph of a mutilated arm to the lampooning, faux-anxiety of a ‘sad pepe’ – a weeping PS Paint frog whose current ubiquity is a mode in its own right. Both of these affects are equally valid within this mode, allowing viewers access to a selfdeprecating humour that is often underwritten by very genuine sadness. Modes can become iconic. Jenkins takes this nomenclature from Orthodox art in which relatively realistic images of hallowed people “serve as embodiments of transcendent events or values”. This communication is aided by the fact that an Orthodox icon is easily recognisable due to the use of consistent aesthetic features. The communication permitted by this aesthetic language is very emotive and candid, feeling into a collective human experience.This emotional collectivity is powerful, allowing a mode to define a community (Jenkins 2014, p. 455). Working from this form of methodology, Seko and Lewis believe that shared iconic modes on Tumblr have profoundly changed the way that participants view self-harm. Instead of the conventional, medical perception that sees self-harm as an individual pathology, the Tumblr perspective seems notably different. Because of the wide and rapid sharing of what the researchers

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dub “hopeless memes”, self-harm has been framed as a kind of struggle that is a typical part of life and a real possibility for anyone. As Tumblr allows for the circulation of subcultural materials amidst tight-knit groups, these materials become part of the collective meaning and unified intelligence of a community. As such, members are influenced by shared expertise (right or wrong), important expressive artefacts, and tokens of shared tastes and identity. This can be far more powerful than the dull psycho-medical understanding of NSSI, which is replaced by more energetic and community-focused narratives (Seko and Lewis 2016, p. 14). Internet modes can be very powerful. Successful modes allow a community to reach a state where their “capacities become activated and feelings become energized” (Jenkins 2014, p. 448). The virtual world can easily become embodied when an aesthetic causes those who engage with it to have deep feelings and act on them. If this aesthetic is part of a healthy and self-reflexive bricolage like the broader teen-girl Tumblr aesthetic, I think it is fairly safe and is likely to lead to better mental health and a deeper understanding of the self and the presentation of one’s body. If a person is too deeply enmeshed in a more limited and intensive virtual mode – such as the Sad Aesthetic or some subgroups of Soft Grunge (explored in the next section) – they may find themselves inside a less constructive echo chamber of depression.These modes energise group feelings of self-hatred, rejection of mental health practitioners, and a conspiratorial attitude towards anyone who seems opposed to the expression of sadness in whatever way an individual might choose. These modes also elevate the beauty of pain in a way that ascribes it a deep emotional and communal value. This is where the larger dangers lie. Soft Grunge

It is appropriate to explore a full and nuanced definition of Soft Grunge as we discuss the visual dimensions of self-harm in depth, and look at Soft Grunge as an important affective mode. Described as the “dark, freaky part” of Tumblr3 (Sloan McLeod 2013), the Soft Grunge genre is shared by a reasonably large number of blogs – particularly those owned by young women. Soft Grunge is usually supported by a folksonomy of tags. Carmichael and Gillespie (2014) associate #softgrunge with #pale, #skinny, #selfharm, #indie, and #emo. It can be seen as an offshoot of the broader teen-girl Tumblr aesthetic, with adherents exploring themes ranging from the fun and experimental bricolage of teen Tumblrs to the darker romance of blood, gore, and unhealthy habits. Both poles value some kind of interruption to normal ways of seeing. This interruption can be through the aesthetic qualities of smoke, mist, or pastel colours. Or interruptions can be found through stark images of death or aggressive language. Grunge refers to this kind of grime and misplaced, disruptive items – an exploration of the ‘fly in the ointment’. Soft denotes the more traditional beauty also celebrated by the movement such as a love

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for the colour pink, hearts, delicate atmospheres, and childhood nostalgia. It is a genre where one can find “depictions of pain and harm (like blood and bruises) that are meant to be beautiful in their tragedy” (Tatum 2013). Soft Grunge imagery creates a mode where death can be seen as beautiful and danger as romantic. Skin is a very common theme of Tumblr, Flickr, and WeHeartIt collections in the Soft Grunge milieu. Skin collections often house a variety of injured flesh images and a variety of harmful behaviours, commonly including smoking, drowning, or emaciated bodies. Ophelia-esque women float in bathtubs; glitter, rainbows, and flowers are often used to decorate skin. There is a fetish for textures: bumps, dimples, delicate hairs, and crevices are captured in detail. Yet there is still control over whose ‘imperfections’ are shown. The hair that features most prominently is the peach fuzz that grows on the forearms of blonde people, and the wrinkles are only ever in the supple joints of young hands, necks, and legs. Some users obsess over death and disease. The popular ‘Hellbent Anatomy’ collection celebrates bloody teeth, chopped tongues, sharp razors taken to the lips, bruises and stitches from fresh wounds, and rolled-back eyeballs (lilly. 2015).The strong focus on damaged eyes is fairly unique in global self-harm culture. Favazza notes that the eye does not have a history of ritual self-mutilation in any culture, although plucking of the eyes appears in myth and other fictive narratives (2011, p. 82ff).Yet sore eyes are a highly prized visual item in Soft Grunge communities. With the subtitle “no guts no glory,” this ‘Hellbent Anatomy’ collection could be perceived as encouraging dangerous acts for their aesthetic power. Many Soft Grunge images also celebrate the aesthetics of the implements used to self-harm. Razor blades and other sharp household objects are very popular, as are other substances that can cause internal damage such as pills and alcohol. Cigarettes and tobacco paraphernalia such as decorated cigarette packets are especially popular emblems, particularly the Marlboro brand. Teenager girls who smoke have been correlated with higher-than-average self-harm rates, which may explain the notable popularity of this symbol (Laye-Gindhu and Schonert-Reichl 2005, p. 452). Implements of self-harm also seem to have a fairly special place in the hearts of many who use them. Analysing the results of studies into self-harm in residential treatment facilities, Raine noted that razor blades and sharp pieces of glass were the usual tools. These items were “often stolen and hidden and cherished,” demarcating them as secret and special equipment. Interestingly, Raine also notes that wards which allowed the free use of razor blades did not report any increased cutting activity as a result (1982, p. 4). Razor blades seem to be more important and symbolically powerful when they are scarce and hidden as opposed to when they are abundant and permissible. In the world of Tumblr, images of razor blades and other self-harm items are prone to censorship and deletion or can cause posters to be labelled as sick or damaged people.This creates a context in which self-harm imagery is secretive, risky, and titillating.

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Gradin Franzén and Gottzén reproduce a ‘fairy tale’ created by a member of a self-harm website, which is titled A Desired Gift. This poem is a good way of understanding the beauty and excitement of an implement in the eyes of a selfharmer. Author ‘Yasuko’ writes, I sat speechless. Because in my hand lie a razorblade. Oh, you beautiful object, what joy to own something as sharp as you! I caressed and examined the razorblade (of highest quality I must add!) yet again before I kindly asked if I could keep it. Other members of her community looked favourably upon this writing, as razor blades are a popular tool for self-harm.They are also deemed to be beautiful, as are the injuries they cause. Thus, ‘Yasuko’ taps into the spirit of her selfharm community with her ode to one of its post-favoured tools (2011, p. 288). In addition to verbal texts, specific photographs are often treasured and become part of a currency whereby valued items are exchanged with other admirers of the aesthetic. As Sternudd notes, “by publishing SI-photos you return to others a gift” in reciprocity for what they have given to you. Sharing secrets and moments of pain are methods for community members to reach out and tell others that they are not alone (2012, p. 429). This gesture is very sincere and loving and is an important way of sharing stories about injuries and clandestine tools for causing harm. More abstract representations of mood are also popular. Indirect images of self-harm such as gloomy landscapes or sad characters from TV shows often have a more ‘hopeless’ tone than direct and overt images of self-harm (Seko and Lewis 2016, p. 9). Soft Grunge blogs often include replicated and reappropriated images in the form of screenshot stills from movies, video clips, and karaoke machines. Some emotional images of this nature have been catalogued in the Soft Grunge collection page of the user ‘Nostalgia’ on WeHeartIt. These images are often isolated from their source texts in a powerful and poignant way, reducing them in fragments of anxiety, sorrow, and heartache. Images include a dark, misty forest with ‘ALL ALONE’ typed in a karaoke machine font. Another image seems to be a screenshot from a film where a man runs his hand across the hip of a naked woman who lies in bed. The caption reads, “Her skin is smooth and invites thoughts of lust”. In another screenshot image, a man holds a woman’s heavily bleeding hands with a caption reading, “It’s very romantic, baby” (Nostalgia 2015). More people seem interested in this vague description of sadness than they do in specific images of self-harm. In a fascinating discovery, Seko and Lewis determined that images of self-inflicted injuries received 10 times fewer reblogs than sad images without wounds. Images that convey hopeless moods are the most popular and widely reblogged (2016, p. 1). A popular post on Tumblr, with more than 7,000 notes at the time of writing, announces that “the favorite aesthetics are ‘foggy empty parking lot at night’ and

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‘glitchy 90s VHS tape’ ” (Gianna 2015). This encompasses the dual Soft Grunge elements of pale and mysterious suburbia plus fractured and irreverent nostalgia. The typical blog in this genre combines very serious and worrying self-harm posts and gore, interspersed with vaguer emotional images and fairly sweet or comical content. For example, lovelysoftgrunge.tumblr.com bills itself as a general representation of the genre. It has been running for several years now. In 2014, when I initially discovered it, the blog contained images of teenage boys smoking, teenage girls amid natural scenes such as lying naked in rivers and posing in dappled sunlight. Dark tinges emerged through an image of a woman wrapped in plastic like a body bag and a lady jumping deep into the ocean without attempting to swim. At the end of 2016, the blog’s front page contained images with poignant phrases like ‘FORGET THE ONES THAT FORGOT YOU’ and piles of cigarettes and a lady pointing a gun to her head. It is not, however, all gloomy. In one image selected, a woman laughs after being submerged in a bathtub fully clothed. In another, a rabbit has tea with two dolls (Soft Grunge Tumblr Blog 2014). Other Soft Grunge blogs have more of a hyper-colour, DIY aesthetic. Plastic Pony is a popular Soft Grunge blogger at this end of the spectrum. In February, 2015 her blog contained cartoon images of characters like Miffy the sweet pink rabbit and biscuits from Disney’s Alice in Wonderland. Other images showed hints of adult sexuality such as a lacy lingerie set and a woman lying on a bad with skin exposed. Next to these images, Plastic Pony also reblogged a graphic scene of gore where women lay eviscerated with their skin peeled off and bright red blood poured across the floor (Plastic Pony 2015). Pale blogs

Other Soft Grunge blogs are rigidly curated in keeping with a #pale aesthetic. They bring to mind Ping-Nie Pao’s idea of ‘delicate self-mutilation’, including a massive over-representation of female bodies and feminised pain. In 1969, Pao came up with the notion of ‘delicate’ cutting – a powerful concept that lingers in the reception and diagnosis of self-harm today. Based on his observation of patients in the Chestnut Lodge facility in Maryland, US, he divided cutters into ‘coarse’ and ‘delicate’. The former made single, deep cuts near to vital points such as arteries.This was usually limited to a single episode of distress.The latter repeatedly created “superficial, delicate, carefully designed incisions”. Pao noted that the majority of coarse cutters were male and that the majority of delicate cutters were female (1969, p. 195). Pao also claimed that some of the female delicate cutters were aggressive, competitive, and envious of men’s achievements. They preferred the company of male friends, and some were ‘tomboys’. Nevertheless, he specifies that they looked feminine when they were dressed up. As for the male patients, Pao describes them as “ ‘pretty boys’ and quite effeminate” (1969, p. 197). In this way, he shows that the typical cutter is aggressive and maladjusted to his or her gender role. But he is also able to establish that cutting is a feminine tendency.

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Pao’s delicate cutters were also associated with a list of recurrent comorbidities including anorexia and bulimia, mood swings, brief lapses in consciousness, escape attempts, promiscuity, suicidal thoughts, injection of harmful materials like drugs or sharp objects, and a tendency to burn themselves or other objects (1969, p. 196). Interestingly, he categorised their cutting as the main focal point of study and diagnosis despite other severely dangerous and harmful behaviours that also seemed to match this profile. This was a process of selecting data that confirmed his hypothesis and putting aside that which did not. This led to the idea that self-harm is a feminine problem that predominantly manifests in repeated cutting of the skin. In a critique of Pao’s phraseology, Brickman explores some of the connotations of delicate and mutilation. The former word gives us a vision of something frail, dainty, and fragile.The latter word represents an aesthetic aberration. But for an act to be so horrifying as to be described as ‘mutilation’, Brickman suggests that the mutilated form needs to be seen as something prized. Thus, ‘delicate self-mutilation’ implies the savage destruction of beautiful, precious feminine skin. Because attractive female flesh is so culturally sanctified, its destruction is well outside of the bounds of normality. Maiming this delicate skin is “an act in defiance of the cultural mores professing faith in the ideal body” (2004, pp. 97–98). Brickman beautifully describes the horror that we derive from such a scene and intends this as a criticism. But it is also important to remember that horror is exciting, and what is taboo can easily become a fetish. A popular #pale Soft Grunge blog is the Tumblr ‘Bruised Porcelain’. Its creator describes her collection as “[a] blog dedicated for my alabaster skin and porcelain body. An escape for all things and people whom are pale, with a twist of gore” (Sora 2014). Some of her favourite content includes lace outfits, pale skin, and glitter. In one image, a pale person scratches their flesh hard, and, in another, we see a small glittery coffin. Individual images in this genre are also quite revealing. A particularly popular photograph (with no clear author) shows a very pale, beautiful lady with white-blonde hair. She appears to be in a hospital and wears a nasal cannula and pulse oximeter. Her heavily bandaged arm and a gash on her face suggest she is injured. Her lips are chapped, and her closed eyelids showcase her delicate veins – possibly telangiectasias. Originally uploaded by ‘Lucy ñiñi❀’, this image was tagged with #bruise #girl #hospital #injured, and #pale skin (ñiñi❀ 2015). Lucy ñiñi❀ has a variety of image collections, focusing on themes such as Soft Grunge, pale skin, and fashion. As is common with the endless sharing of online imagery, it is difficult to know if she is a creator or an appreciator of these images. Nevertheless, she taps into some of the major themes of #pale including very slender female forms with visible bones, ribcages (Plate 3), pale hands holding flowers (Plate 4), rough tattoos on pretty flesh, and injuries like bruises, cuts, and abrasions (Plate 5). There are also specific artists of note who fit within this genre. Photographer Abby Kroke showcases her photography on Flickr to much acclaim. Her photograph Untitled (2012) functions as a self-portrait of her depression and

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represents something that is normally kept private. She explains,“it took a lot to actually post it” (Kroke 2012). Untitled shows Kroke in a bathtub, semi-dressed. White daisies and blood-red gerberas float around the milky water. The red is repeated in her bright nail polish and in the fresh cuts running along the top of her thighs. The soft, feminine photograph has received a great deal of praise from Flickr users, and Kroke is lauded for her courage in expressing depression and implied self-harm. One user has left a message of love hearts on top of her bleeding skin in a sweet gesture of communal support. Kroke also has some more suggestive works like Collar Bones and Blades (2013). In this photograph, she holds a serrated knife up against her décolletage with the tip poised to pierce. Another major self-harm Flickr artist working in the Soft Grunge genre is Ruby Victoria who lives in Finland. She is open about her mental illness journey and photographs symbols of her sickness such as packets of drugs like mirtazapine and diazepam. One of her major self-harm collections is a series titled Summer Ends Here: Diary of Lows (2010), which contains five evocative and haunting photographs. In one, we see her arms draped over a white bedsheet, unmoving and covered in deep scars (Plate 6). This is followed by an image of her substantial razor blade and analgesic cache, an image of deep scars with a rose (Plate 7), and a document outlining her triggers and signs of relapse. The series finishes with a disturbing diary entry about her desires to kill. Ruby’s diaries also feature in other series. In one untitled work from 2010, she writes an angry letter to a ‘friend’ called Ruth in her diary where she sarcastically thanks her for reminding the artist that she is just “a disgusting parasite inside a hollow human body” amongst other lowly things.The page is covered in blood from fresh wounds on Ruby’s forearm. Some of her diary pages are wordless and covered in thick, clotted blood, implying that her pain is beyond any other expression. Her artworks are a broader form of ‘diary’; thus, her Flicker account is titled ‘d e a r d i a r y’. Her self-harm wounds are part of her ongoing process of logging pain in a more permanent form. They also log healing journeys, as some photos show very fresh and bleeding wounds, some show cuts that are starting to scab over, some show puffy hypertrophic scars (Plate 8), and others depict old scars that have flattened and faded (Plate 9). Her diptych Untitled (2010; Plate 7) shows a deeply sliced arm with a variety of cuts; some of which are old, pink, and healed and others that are fresh, red, and raw. Her narrow depth of field brings some of the larger wounds into clear focus and abstracts the remainder of the image into a dreamy haze. In the other panel, there is an open pink rose. Both the rose and the wounds are treated in the same aesthetic manner. Like with Kroke’s artwork, one user has left a kissing face on the deepest cut to show tenderness and support. She describes this as “a kiss to heal your wounds” (Ruby Victoria 2010). Sadly, in 2014, Ruby Victoria returned to Flickr with a new image of gaping wounds and bright red blood bleeding on to fresh linen titled gifts from my

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wrist. In the artist statement for this piece, she explains that she had hoped to be at a point where she was only posting pictures of trees, flowers, and sunsets. Instead, “that dark cimson [sic] shade against pale white sheets caught my eye, that feeling of total agony came over me again”. This led to a severe episode of self-harm where she sliced down to the fat in her arm and felt sick. As part of coming to terms with her sense of self-loathing, she made gifts from my wrist (2014). The artwork is placed in a collection called ‘Bullying’, which may give a clue as to her relapse. In August 2016, further self-harm photos with Ruby Victoria’s gashed and bleeding arm contrasted with lilac blooms were posted. Flickr has proved an effective venue for this delicate and dream-like expression of chronic self-injury. Soft Gore

Soft Gore is a more recent offshoot from Soft Grunge and may well overtake it in terms of popularity and the volume of folksonomic references. Soft Gore content draws on the Japanese guro tradition, which emerged in the late 1920s under the full name ero guro nansensu or ‘erotic, grotesque, nonsense’. The guro part of this movement takes its name from the word gurotesuku – a translation of the English grotesque. Guro often includes sexual violence and sadomasochism and images of torture or capital punishment. As a whole, the movement celebrated a kind of absurdist black humour (Monnet 1999, p. 61). In its modern adoption by the Anglosphere, guro refers to gory images illustrated or sculpted in a Japanese style. In keeping with its heritage, these cartoonish scenes are often semi-erotic or show participants clearly enjoying activities like disembowelment. Happiness, pain, and humour are interlinked. In addition to guro content, Soft Gore tags take viewers to images of selfharm – often more extreme pictures showing major tissue damage. They also lead to images of car crash victims, pedestrian fatalities, murder victims, and mysterious pools of blood. Some images are taken from movies, but the majority are from real-life crime scenes. As with guro, torture and capital punishment also appear. Viewers can satisfy their curiosity about questions such as ‘What would my body look like if I was thrown off a motorbike?’ ‘What do the inside of my teeth look like?’ or ‘How many stitches do you need to fix a slit wrist’? As Sternudd notes, many people view images of self-harm online because they have an interest in medical processes like healing. One of his interviewees explained, “It’s kind of like when you see a car accident . . . you’re horrified, but you HAVE to look” (2012, p. 427). This epitomises the morbid curiosity at the heart of Soft Gore. As with Soft Grunge, it is unclear as to how triggering this material is as compared to its therapeutic potential. As one user explains, “i think this shit is great and it helps me relax and not think about hurting myself like i tend to do sometimes” (pastelgore 2017). By playfully exploring extreme and explicit images of death and pain, many Soft Gore fans seem to satisfy their curiosity without actually needing to harm themselves or get into

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dangerous situations. Others use Soft Gore as a way of representing the deep pain and anguish that they feel internally by showing an equivalent external injury (Plates 10 and 11). Lolita

Another potentially problematic aspect of the Soft Grunge genre is its connection to Lolita imagery, which feeds into an obsession with violated innocence. Initially inspired by Vladimir Nabokov’s 1955 novel of the same name, the Lolita archetype explores a taboo cross-section of childhood innocence and adult sexual desire. Content ranges from “superficial feeds of anything pastelcoloured” to explicit pornographic imagery and dark, sinister material concerning relationships of unequal power. The two film adaptations of the novel frequently appear, as does material from other ‘age-gap’ movies (Cleaver 2014). The occasional piece of Soft Gore will also surface: It’s not unusual to find something upsetting enough to make you close the tab in a nymphet blog; the gruesome dismembered body of Elizabeth Short (aka The Black Dahlia) just down the page from a pinterest-y shot of pastel colour silk dresses hanging in a vintage wardrobe. (Cleaver 2014) With Tumblr usernames like ‘sweet-softgrunge-lolita’ and tags like #nymphet, this subgenre is not hard to find. Searching relevant tags brings up images of candy-covered handguns, underwear with ‘YES DADDY’ printed in bubblegum pink, and slender bruised legs in lacy miniskirts. The appeal of images like a smoking girl in messy pigtails is the combination of sweetness, beauty, and innocence with a feeling of violation, harmful adult influences, or sickness.This is epitomised in Daniel Pasikov’s Scar (2014; Plate 12), which was not initially intended to fit within this genre but which communicates a compelling story about pain and purity through a pretty doll with a gash on her face. As Hoosen (2016) argues, this aesthetic lends itself to an evocative combination of elegance and horror. Lolita imagery helps to tell a compelling story of corruption and a loss of innocence. For some, this interest in a Lolita persona feeds into a sexual role-playing game (often called dd/lg, short for Daddy Dom/Little Girl), which is a popular dynamic in the BDSM community. Participants often combine stuffed animals and pacifiers with disciplinary beatings. The role of the dd is to punish and protect while the lg is charming, needy, mildly disobedient, and in wont of a spanking. Many dd/lg players take photographs of their bruises and welts, which often find their way into the same blogs as self-harm images. Although childish underwear on a vaguely adult woman might be a little risqué, it tells a story that appeals to many people – including many females and victims. This imagery allows for a narrative about being alone, frightened, and on the cusp of

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losing one’s innocence. As Cleaver (2014) argues, “Lolita blogs are always sad”. It is easy to see why this kind of violating, transgressive imagery and playacting would be appealing to someone who is on the traumatic journey from childhood to adulthood. This ‘sexual vulnerability’ imagery is not limited to Tumblr communities. It has also found its way into the mainstream representation of young women. Savage notes that much of the Lolita imagery that pervades the contemporary American aesthetic is not ostensibly pornographic. Much of it appears in teen magazines and fashion editorials, showcasing young women who look vulnerable, in need of protection, or lonely (2011, p. 103). Sternudd and Johannsen show how many images of suffering girls, which are replicated on YouTube selfharm videos, have a similar quality of infantilisation. Many are shown sitting on the ground or on the footpath, which is a subordinate position – childish and docile. This position leaves a person looking both alienated and vulnerable (2015, p. 347). On Tumblr, tags like #lolita and #nymphet lead to images of what people view as the ultimate young girl: “white, female, mousy-haired, clad in light pink and heart-shaped sunglasses”. Rather than contextualising such as figure as part of a story of abuse, Lolita becomes a “dreamy fable of misunderstood love and flirtation” (Coronado 2016). For these reasons, the Tumblr Lolita figure is someone who needs protection and can express her desire for security and firm guidance. There are many young women who find this aesthetic compelling because they have been in unequal relationships with older males or see this kind of power dynamic valorised in the media they consume. For example, Petra Collins started her photography career in earnest while she was 16 and in a relationship with a someone considerably older than herself. She also developed an eating disorder at this time. She received pleasure from being in a subjugated position and replicating the kind of dynamics that were shown to her in the culture she consumed. Rookie editor Tavi Gevinson describes the Lolita phase in her life as a reflection of her desire to be coveted. This need came from juvenile misreadings of texts like Lolita and The Virgin Suicides, where themes of innocence, pain, and corruption are poetically explored. An interest in the Lolita aesthetic also reflects the media of their formative years, where Collins and Gevinson recall the ideal female body being “really skinny, really young” (Collins 2014, pp. 104–105). A starved, vulnerable, immature body is one that is encouraged and coveted in many cultural sources. In her editorial on Tumblr Lolita culture, Hoosen confesses that she has always related to the character of Lolita because she lives within a socio-political context that claims ownership over young, female bodies in order to both fetishise and vilify them. By seeing a character who went through the experience of abusive, damaging obsession from an older man, Hoosen saw something of her own situation reflected back at her (Hoosen 2016). Nevertheless, she knows the Lolita aesthetic is unpopular interest that is criticised widely. There is often a desire to blame those whose images become embroiled in Tumblr explorations

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of the teenage cusp between innocence and experience. Savage explores public figures such as Miley Cyrus, who had to apologise after a Vanity Fair shoot that showed her 15-year-old body naked underneath a satin blanket. She and others have had to say sorry to their fans when images such as these have been published and circulated beyond their control (2011, p. 106). Young women on Tumblr who present themselves as part of the Lolita archetype are also met with suspicion, disgust, or pity despite the extreme social pressure that many of them feel to be sexualised and innocent simultaneously. Hoosen maintains that her engagement with the Lolita subculture has been “an act of subversion, an act of catharsis” in a community that is claiming back their bodies after experiencing trauma and abuse or simply existing as part of the “everyday violence of living as a girl”. Although members of this subculture are well aware that others see them as debased or misled, the community itself is a powerful way of playing with social expectations and coming to terms with conflicting messages about female sexuality (Hoosen 2016). The user-generated content of Tumblr also adds in an interesting dimension to the discourse that is not present in more simple cases like the teenage Cyrus photoshoot. Savage rightly notes that “the rhetoric of innocence is good business” (2011, p. 110). In more traditional media such as magazines, this business benefits the photographer and the publisher much more than it does the model. But what happens when innocence rhetoric is employed by the models themselves? What happens when the fragile Lolita is both subject and rhetor? In the online Lolita aesthetic, these questions are explored. Girls who reblog stills from the Lyne adaptation of Lolita often take photos of heart-shaped sunglasses, blog about their nymphet lifestyles, and fend off online perverts who see their lifestyle as an invitation for male attention. This gives them far more ownership in their images and lets them reflect on multiple dimensions of the sexualisation of young women.While this may not be ideal, at least it gives them a greater voice and far more opportunity for reflexivity than they would have if they were just subjects and not also creators of content. Many are also interested in real-life Lolita characters such as the singer Lana Del Rey. Members of the subculture have been described as “adopting a Lana Del Rey starlet aesthetic” for themselves and their blogs, borrowing from the visuals of Lolita but not its moral message (Coronado 2016). Del Rey is described as a fellow nymphet whose “mournful strains” provide a soundtrack to the “pink-tinted” Tumblr blogs of the Lolita subculture (Cleaver 2014). Her suitability as the musical voice of this subculture is not accidental. Del Rey frequently references quotations and concepts from Nabokov’s book and the film adaptations, imagining herself as the innocent, but sexually desired, Lolita. Her song titled “Lolita” (2012) paints a vivid image of a modern-day nymphet whose unselfconscious image charms the boys. Cleaver (2014) argues that even her songs that do not overtly reference Lolita “still evoke that same type of doomed love”. As such, Del Rey is an active part of the reinterpretation of this text, as she shares stories of her doomed relationships with older men and

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use of innocence for the titillation of others. As Hoosen (2016) notes, “[o]n the surface, this ends up seeming like self-fetishization”. To some degree, it certainly is. But before dismissing all Tumblr nymphets as betrayers of female autonomy or mindless victims of culture, it is important to consider why so many young women are obsessed with presenting themselves as alienated, vulnerable, victims. Virgin suicides

Another popular novel/movie combination in these circles is Jeffrey Eugenides’s The Virgin Suicides (1993), which was adapted into a film by Sofia Coppola in 1999. Both texts are dreamlike and emotionally evocative, telling the story of five beautiful teenage girls from suburban Michigan who take their own lives. Many women who have gone through bouts of self-harm, disordered eating, and suicidal thoughts feel a strong connection to this text. For example, Kelly describes her experience of watching The Virgin Suicides at age 14, enjoying the “dreamy and silken, powder-puff pink” aesthetics of the film. At the time, she considered the suicidal behaviour it depicted as quite normal and reasonable. Kelly explains herself as “a teen primed to understand that self-harm was simply a part of the fabric of life, love, and growing up” (2015). This normalisation of suicide in the film has also been confirmed by the Zahl and Hawton study where a self-harming patient explained that this film, showing five different suicide methods for five different sisters, had made her think about different ways of hurting herself (2004, p. 193). Others have connected to the story because it captures an authentic vision of young womanhood. Collins, for example, admires the movie as a reflection of what her own teenage years felt like (2014, p. 104). The main female characters are all very beautiful, enigmatic, and admired by the local teenage boys who come under their spell and spend decades trying to solve the mystery of their deaths. While the story is clearly tragic, the deaths of the sisters are also enchanting and bewitching. I predict that the next film to have this kind of impact on the community will be the upcoming adaptation of Sylvia Plath’s The Bell Jar, scheduled for a 2018 release.This production will be written and directed by The Virgin Suicides star Kirsten Dunst and will star blonde, waiflike Dakota Fanning in the lead role of Esther Greenwood. Oyster magazine is already predicting that the film will appeal to “a certain kinda girl” for whom “the poetry of Sylvia Plath has held a very special place in your heart since you discovered it in the most emo stage of your adolescence” (Bailey 2016). If the cinematography can capture the same kind of melancholy dreamscape of Dunst’s fictional adolescence in The Virgin Suicides, it is likely to make a strong impact on this same demographic. The Virgin Suicides, both book and film, has been described as “a proto-Sad Girl text” (Hines 2015), so it will be interesting to see if a self-consciously Sad Girl movie can have the same effect.

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Criticism of Soft Grunge and associated sub-genres

Even within its primary audience of young adults, Soft Grunge is often criticised as derivative, posturing, or dangerous. Many people feel concerned about the behaviour it promotes. The @DecisionSeries Twitter runs a range of surveys – ostensibly by teens and for teens.Their survey pertaining to Soft Grunge reveals attitudes towards this genre from the perspective of adherents and members of the prime demographic. It defines Soft Grunge as “teenagers & young people’s use of social media to discuss, post pictures and memes relating to self harm, depression, self hate, suicide, cutting and so on” (Carmichael and Gillespie 2014). While this survey does include a discussion of positive associations with self-harm, the overwhelming attitude is one of concern. One of the final questions pertains to what respondents would do if they knew that a friend was looking at Soft Grunge images online. Options include monitoring the situation by checking internet history and phone usage, encouraging a discussion with the person at risk, going to a teacher for help, ringing a helpline for advice, or taking the person at risk to a doctor (Carmichael and Gillespie 2014). These are standard responses for helping people who are at risk of suicide or self-harm, showing that many young people see engagement with Soft Grunge as a serious warning sign. Others see Soft Grunge as a dangerous way of romanticising mental illness. Sloan McLeod (2013) is adamant that this is occurring and refuses to link directly to any Soft Grunge blog because she does not wish to expose her readers to the “wildly popular” and “seriously fucked up imagery” she found in her research. Tatum agrees that Soft Grunge is a way of performing mental illness in which “[f]eelings of worthlessness or disillusionment become synonymous with and indicative of true tortured beauty, as well as intelligence and particularly psychological depth.” Emotional negativity becomes a source of glamour. Tatum repeats the common accusation that millennials are self-absorbed and suggests that new media and new technologies have the power to amplify hormonally driven teenage angst.4 She complains that existentialism is worshipped “as long as it has shiny packaging, with pretty people saying poetic things while a single tear runs down their cheek.” She deems Soft Grunge an unpleasant by-product of Tumblr’s faux-revolutionary political landscape (Tatum 2013). There is a common suspicion that Soft Grunge bloggers are part of a dangerous or disingenuous project to prove how authentic their suffering is. Gradin Franzén and Gottzén believe that aesthetics have a role to play in the establishment of who is an ‘authentic’ cutter with ‘real’ problems. For someone to gain credibility and praise, images of self-harm need to be seen as truthful and genuine. Without truth, they will lack the beauty that gives them value. This could see their creator labelled as a poser who cuts for attention rather than the communication of deep emotion (2011, p. 289). Engaging with a recognised depressive genre like Soft Grunge can help people to tap into a ‘look’ and ‘feel’ of sadness. As such, one blogger describes ‘dark’ cultures such as Soft Grunge

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as an appropriation of mental illness. She compares this to her friends dressing in black as teens in response to self-diagnosed depression or anxiety, which she sees as an activity that detracts from the experience of those suffering from serious mental illnesses such as herself (Kristen 2013). Whatever side a person falls on, Soft grunge seems to have some kind of association with authenticity. This accusation also conveys the common belief that people who really have depression would not be engaged in aesthetic posturing. Sloan McLeod agrees that most people who try to look depressed have no diagnosed mental illness. She argues that no form of depression manifests itself as “decorated cigarette boxes and artfully running mascara” (Sloan McLeod 2013). Tatum also worries that depression is appropriated by the Soft Grunge genre. She is angry with bloggers who present themselves as poster children for mental illness whilst “advertising a candy-coated placebo as their ‘authentic’ experience”. Tatum feels very suspicious that only “impossibly gorgeous people” are represented amongst the glamourous sad. This sets up a dangerous expectation that being special and being unhappy are linked and fosters this belief that emotional instability makes a person sexy and more charismatic (Tatum 2013). As Sloan McLeod (2013) summarises, treating depression as though it is trendy distracts us from the seriousness of this disease. Of course, in the complex world of internet politics, her critique has not gone without further comment. In the comments section of Sloan McLeod’s article, a reader called Janne writes about her Tumblr Soft Grunge blog and its reflection of her diagnosed depression: [W]hen I reblog something it is because I really feel that way about life, I want to take pills and end my life, I take acid, I smoke, I think life sucks and I hurt myself.You should be happy some people only reblog those pictures of killing themselves. (Sloan McLeod 2013) For Janne, sharing Soft Grunge imagery is a way of sublimating her desire to actually commit suicide. It also helps her to see her own pain reflected back at her. In her writings on the ‘Grand Unified Theory of Female Pain’, Jamison is opposed to the mythologisation of female suffering but can still see why people like Janne dwell on their wounds. She concedes that women do get hurt and wounded and do sometimes need to express their pain and explore their injuries. After going through a string of physical misfortunes such as a broken foot, a bout of self-harm with a razor, and a rapid heartbeat, she was hurt when a former boyfriend dubbed her a “wound-​dweller” who obsessed over her own pain. Although Jamison dislikes the romanticisation of suffering, she believes that women need space to talk about broken bones and broken hearts (Jamison 2014). It is not necessarily dangerous to reblog images of sadness that match one’s own feelings and experiences. Some viewers of self-harm photographs do indeed use them as a way of re-experiencing their own injuries of the past.

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For many, this alleviates the actual need to self-harm again by allowing them to take control of their own emotions and self-soothe (Sternudd 2012, p. 428). Wound-dwelling may sometimes seem frustrating to outsiders, but for those who partake in this activity, the obsession can sometimes be a path to healing. Soft Grunge and associated sub-genres are not flawless. Critics like Sloan McLeod are right to worry that beautiful and glamorous images of pain and injuries can give the wrong impression about severe mental illnesses such as depression. And it is also very important that commentators like Jamison question how female pain can be spoken of without glorification – especially when we speak within a culture that “turns female trauma into celestial constellations worthy of worship”. Jamison worries that too much discussion about female pain can make it seem integral to the character of a woman, meaning that a female needs to be in pain in order to truly be a member of her sex – an alarming idea (Jamison 2014). Nevertheless, I think these criticisms are strongest when they avoid placing undue blame on vulnerable young people. Many internet commentators specifically dislike cutters – often focusing on the cutter themselves rather than the act. Jamison is rightfully concerned that this kind of criticism dismisses a whole group of people as selfish attention-seekers without even considering the human need for attention and the deep emotional value that such an act has (Jamison 2014). Overall, I hesitate to support assumptions that Soft Grunge erases mental illness and trivialises the lived experiences of those who have extreme anxiety or depression. Because of the user-generated content core of Tumblr, Soft Grunge admirers can (and do) upload their own scars, bruises, and wounds. This is a fairly serious cry for help, not simply depression playacting. Appropriation and erasure will always occur to some degree, but I believe that many self-harmers have found a deep resonance with Soft Grunge and are producing original content that is a genuine reflection of disabling mental states. We should also consider the power that an aesthetic has to heal as well as to harm, which is a major focus of the following chapter.

Conclusion There are several factors that stand in the way of appreciating the aesthetics of self-harm as an important area of study and as a potential direction for new treatments. One problem is simply a lack of research investment. Seko and Lewis note that language-based inquiries into self-harm online have flourished whilst exploration of visual content has lagged behind. Most of the studies into the visual and multimedia expression of self-harm online have looked into potential risks and benefits, without giving much attention to the communicative nature of sharing self-harm through sites like Tumblr (2016, p. 2). There is also a general reticence to see self-harm as something that could possibly have aesthetic qualities. As one commentator states it, “we can’t look at depression as something that’s beautiful in any way” (Sloan McLeod 2013). Nevertheless,

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though not everyone likes or appreciates it, there is often a strong aesthetic dimension to presentations of self-harm online. Aesthetic features are often considered in the process of self-harm. Many people cut, burn, or bruise themselves in a way that is decorative or in a manner that seeks to accurately represent inner emotions on the external body. Gardner believes that many people struggle to verbalise their distress and often become disaffected and unable to mentally process pain in the normal manner. In this situation, cutting one’s flesh (or similar) can become a “wordless metaphor” designed to symbolise feelings like sadness, anger, and conflict (2002, pp. 97–98). When studying the motivations for self-harm, a teenager explained to Laye-Gindhu and Schonert-Reichl, “I wanted to take the pain away from my heart and put it somewhere else” (2005, p. 452). This somewhere else was her skin. Many self-harmers give some kind of form to their pain so that they can better understand it. Jamison, a former cutter, describes this process in depth. She explains, “[M]y unhappiness felt nebulous and elusive and I thought it could perhaps hold the shape of a line across my ankle” (Jamison 2014). Slicing her ankle with a razor seemed like the best way of focusing her invisible pain into a wound that could be seen and understood. While she does not see her project as a complete success and feels embarrassed that she once cut herself to show pain, she can still empathise with the reasons why other people might seek to hurt their bodies in order to make a statement about internal suffering. Jamison sees bleeding as a way of excavating one’s interior world, turning pain into proof and leaving a scar that permanently demonstrates suffering that has occurred. She also categorises the visual cues of an eating disorder in a similar way, seeing “​bone as hieroglyph, clavicle as cry”. Using this system of “bone-​ as-​language”, Jamison tried to use her eating disorder as a way of making her hidden body parts emerge (Jamison 2014). Bones, blood, and scars show that pain has happened and thus facilitate communication between the cutter and his or her witnesses. Sometimes this communication fails, as it did for people like Jamison, who could not quite manage to articulate the depth of her pain by losing excessive flesh off her body. Others have only themselves as witness. Nevertheless, failed communication does not mean that the rhetor was careless or that their work was without a kind of meaningful beauty that certain others can understand. Sharing self-harm content, albeit a problematic act, gives people the opportunity to actually achieve something: to demonstrate their existence in the community either as a participant who records his or her own suffering, a participant who gains some kind of satisfaction or release from seeing the wounds of others, or as a non-participatory connoisseur of this dramatic and enchanting imagery. The massive circulation and recognisable patterns of internet communication are very important to understand if one wishes to grasp how and why this rhetoric works. If we look at aesthetic images of self-harm without considering their “meteoric circulation”, we risk being blind to the “broader media

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ecology” that gives us so much important data about what these images represent for particular online cultures. Recognisable memes and unified online aesthetics can only exist through the contribution of multiple authors and viewers, circulating comparable images and styles in varied situations (Jenkins 2014, pp. 445–446). So what is this infectious, identifiable, aesthetic substance that lurks on the Tumblr profiles of teenagers touched by suicide and self-harm? How can we read and recognise the patterns of their media ecology? What is vital in unpicking this puzzle is a consideration of the different major aesthetics that people have used to express their sadness and anger. The are many ‘dark and brooding’ aesthetics out there, some of which have been used as an expressive device and community basis for decades (such as the Goth aesthetic movement). Nowadays, the expression of dark thoughts, depression, and anxiety also happens through a range of emerging aesthetic trends. Many of these fall under the umbrella of the New Aesthetic – a contemporary trend that explores computerised ways of seeing. Because the New Aesthetic and its subgenres tend to be a little more abstract and avant-garde, their actual emotional message can be harder for outsiders to read. But just because an artwork looks like a messy, comical bricolage shared on a 15-year-old’s Tumblr, this does not mean that it lacks a serious emotional message that is key to understanding how pain is expressed by this high-risk demographic. This chapter has presented a guide to some of the important ways that people are expressing themselves and their pain (including self-harm and disordered eating) online. The Tumblr Teen Girl Aesthetic is an important expressive zone. Also in this sphere of communications and aesthetics is the genre of Soft Grunge.This style has caused serious alarm because of its apparent romanticisation of self-harm and depressive thought. It has also raised concern because of its universalisation of the depressive experience and its rejection of traditional medical models of mental illness. Also causing alarm are the Soft Grunge subgenres of Soft Gore and Lolita.The former celebrates the distribution of violent and confronting images, while the latter stylises ephebophilia into a glamourous lifestyle for a budding young nymphet.The ethical problems with both of these Soft Grunge subsets are clear, but their popularity still deserves to be properly considered. The fact remains that there are countless people online who enjoy sharing or even creating their own images of graphic violence – often violence against their own bodies. There are also many young women whose sexuality revolves around a genuine wish to be abused by an ephebophilic. These aesthetics thus become a powerful way of exploring and expressing deviant desires and performing in a way that showcases how damaged they feel or how excited they are by the threat of damage to come. Earlier, I noted that we need to ask why so many young women have chosen to present themselves as Lolita – a character who was a vulnerable, victimised, and alienated child whose sexual autonomy was stolen by an older man. This seems like the kind of predatory tale that would frighten a teenager or conflict with her modern, feminist values. Yet the performance of isolation, grief, and

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loss all seem to appeal to a large number of young women. In order to explore why this might be, the following chapter moves into a discussion of the ‘Sad Girl’ – a complex persona who represents the struggles of youth (including self-harm) but who also helps with the articulation of a way forward: out of depression, starvation, and discontent.

Notes 1 In addition to this, deep engagement in the online world has always been limited by network connections and digital divides. Even a socially subversive online text or resource requires its author(s) to have the time and money to support it. Thus, offline hegemonies are often maintained because of the greater resources of those who support and benefit from them (Lindgren et al. 2014, pp. 9–10). 2 Eler and Durbin specify that the name of this movement does not need to be taken too literally. Not everyone who engages with it is in their teens, and not all of them are cisgendered girls. They argue that the core of the aesthetic is centred on “vulnerability and telling one[’]s own narrative” and is an attempt to articulate a new online cultural movement. Because ‘teenager-hood’ is a social construct, the aesthetic is more about exploring this notion than mandating exactly who is or is not part of the movement.This also seems to address the fact that several key players in the movement such as Molly Soda are now adults. 3 Tumblr is the place where most Soft Grunge content can be found. Other image-sharing social networks like WeHeartIt and Pintrest also house significant collections. There is a sizeable amount of Soft Grunge content on Facebook, with numerous communities dedicated to this theme. Most of these communities, however, use the Facebook interface in a manner that is as similar to Tumblr as possible. Rather than opening their groups to discussion or promotion, these communities are primarily ways of indexing and sharing Soft Grunge pictures. None seem to be especially successful in terms of typical Facebook engagement patterns. Despite having several thousand followers on average, most individual photos of posts have fewer than 30 likes. This suggests that they are not appearing on many members’ newsfeeds or that they are not evoking an enthusiastic response when they do. 4 It is worth noting that the comments left on this article almost universally disparage her suggestion that millennials are solely to blame for the fetishisation of mental illness.

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Plate 1 Jess McPhee, Self-Harm, photography, 2012. Available at www.flickr.com/ photos/jessmcpheephotography/8246961341/ under Creative Commons 2.0 licence.

Plate 2 Rosa Menkman, BLINX3, glitch art, 2011. Available at www.flickr.com/ photos/r00s/5982500792/ under Creative Commons 2.0 licence.

Plate 3 Freestocks.org, Skin and Bones, photography, 2016. Available at www.flickr. com/photos/freestocks/27179261063/ as a public domain dedication.

Plate 4 Daniela Brown, veins, photography, 2013. Available at www.flickr.com/ photos/danibrownphotography/8453296899/ under Creative Commons 2.0 licence.

Plate 5 Carolyn, Eczema and Bruising, photography 2008. Available at www.flickr. com/photos/75491103@N00/2496446670/ under Creative Commons 2.0 licence.

Plate 6 Ruby Victoria, Untitled, photography, 2010. Available at www.flickr.com/ photos/-dear-diary/5000123622/ under Creative Commons 2.0 licence.

Plate 7 Ruby Victoria, Untitled, photography, 2010. Available at www.flickr.com/ photos/52303016@N05/4942232744/ under Creative Commons 2.0 licence.

Plate 8 Ruby Victoria, i have sold my soul, traded it for hollow gold, photography, 2010. Available at www.flickr.com/photos/-dear-diary/5061604609/2/ under Creative Commons 2.0 licence. A Comment on this picture reads, “this photograph is so beautiful, the balance of the netrual [sic] colours making it feel soft, even the scars dont come arcoss [sic] harsh or aggressive”.

Plate 9 Ruby Victoria, Untitled, photography, 2012. Available at www.flickr.com/ photos/-dear-diary/7478758602/ under Creative Commons 2.0 licence.

Plate 10 Julián D. Gaitán, Bulimia, photography, 2010. Available at www.flickr.com/ photos/juliangaitan/6213098462/ under Creative Commons 2.0 licence.

Plate 11 A ndrés Nieto Porras, Pain, photography, 2016. Available at www.flickr. com/photos/anieto2k/30048895506/ under Creative Commons 2.0 licence.

Plate 12 Daniel Pasikov, Scar, photography, 2014. Available at www.flickr.com/ photos/127619962@N08/15232578749/ under Creative Commons 2.0 licence.

Plate 13 Tuan Le, Untitled, photography, 2015. Available at www.flickr.com/photos/ destinywings_veno/19046007842/ under Creative Commons 2.0 licence.

Plate 14 S tills from Christina Enrico, Sad Girl Theory (Inspired by Audrey Wollen), video, 2016. Available at www.youtube.com/watch?v=sHLa1G1kjKw, used with permission.

Plate 15 linspiration01, V.2, photography, 2014. Available at www.flickr.com/pho tos/jointcracker/15207554111/ under Creative Commons 2.0 licence.

Plate 16 S creenshot from iPhone 8 showing Tumblr, Instagram, and Facebook Messenger push notifications, author’s own.

Plate 17 Kristina Sohappy, Earth Crisis, photography, 2010. Available at www.flickr. com/photos/kristina-sohappy/4832442356 under Creative Commons 2.0 licence.

Plate 18 Gordon Tarpley, Untitled, photography, 2013. Available at www.flickr.com/ photos/gordontarpley/12495478725/ under Creative Commons 2.0 licence.

Plate 19 Richard Heaven, Edge Owl, T-shirt design, 2011. Available at www. flickr.com/photos/tenspeedphotography/5503404671/ under Creative Commons 2.0 licence.

Plate 20 Kevin Cortopassi, Shirt idea, T-shirt design, 2009. Available at www.flickr. com/photos/kevincortopassi/3836955469/ under Creative Commons 2.0 licence.

Chapter 3

Sad Girls

Sad GirlsSad Girls

The internet and the performance of mood

This strong focus on body, sadness, and self-conscious irony culminates in a newly emerging character of the Sad Girl. This girl is key to understand contemporary self-harm aesthetics, and constructive pathways out of dangerous self-harm nodes. The #sad girl tag on Tumblr takes viewers to a multitude of images of crying faces, lonely female figures, and desolate scenes. It is also home to images of self-harm and suicidal ideation. At the same time, content in this tag has a high degree of self-awareness. While the sadness is genuine, performances are often overblown or ironic. This figure of the Sad Girl brings together dramatic gothic misery, the beauty and the irony of Soft Grunge, the shock of Soft Gore, and the elegant horror of the aesthetics inspired by Lolita and The Virgin Suicides. In this way, the Sad Girl is the digital übermädchen who epitomises the creative arts and deep emotional content developed by young people online. In this chapter, I delve deeper into the Sad Girl genre of fine arts, apparel, and websites. I also investigate figures who epitomise the Sad Girl, including the singer Lana Del Rey and internet philosopher Audrey Wollen. The Sad Girl is core to a new brand of feminism and philosophy that defines the performance of mood online, revealing both why young women are so sad and how sadness can actually be a way of releasing negative affect and protesting wrongdoing rather than wallowing in non-action. Sternudd and Johannsen are some of the few researchers to focus on how young women in self-harm content are actually presented. One of their major findings is the pre-eminence of the ‘sitting girl’ trope. Appearing primarily in YouTube montages of sad imagery, this Sad Girl sits primarily on the ground but also appears on swings, piers, and railway tracks. Her main visual role is to represent suffering (2015, p. 342). The sitting Sad Girl is usually shown on the ground with her knees bent up towards her chest. Her face is generally hidden behind her hunched arms and legs or turned away from the camera/viewer (Plate 13). To represent this trope, Sternudd and Johannsen have chosen Peter Sherrard’s Woman Sitting Resting Her Head on Her Knees (2014), which is available as a stock image through Getty. It could easily be used for an article on teen depression in an online newspaper or similar medium. The photograph is in high-contrast black-and-white and shows a young woman in the ‘sitting

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girl’ position. We cannot see her face behind her limbs and her long, dark hair. But we do catch a glimpse of a hospital bracelet on one of her wrists. There is a black shadow overhanging the girl, which could be a visualisation of her depression (Sternudd and Johansson 2015, pp. 344–345). It will be fascinating to see what further insights into this trope are provided in their forthcoming The Girl in the Corner:The Aesthetics of Suffering in a Digitalized Space, which will hopefully be a useful companion text to The Aesthetics of Self-Harm. Their work is primarily about the kind of Sad Girl who is represented in the dark Tumblr aesthetic, but internet Sad Girls also reside in hyper-colour and pastel pinks. Sad Girls make art, clothing, and philosophy about the power of their emotions. As eloquently expressed by Jennings, [t]he style – the fashion of ~feelings~, the ‘sad girl’ aesthetic, angsty Tumblr Lolita, whatever you want to call it – isn’t exactly new, but despite its murky origins, it’s everywhere. Behind it are a wave of independent, internetty women artists, designers, and entrepreneurs who . . . ‘just have a lot of feelings’. (Jennings 2016) Many commentators have been drawn to the Sad Girl aesthetic due to its ability to reflect their own personalities, mental states, and places in the world. For example, Gore remembers joking with her friends about how unpopular and uncool they were for being alone on a Saturday night. They dubbed any such evening as a ‘Sad Girl Saturday’. When she moved from America to England, her sadness and isolation intensified, and she became a recluse who sharply missed her home comforts. At this point, she became so sad that she had no idea how to deal with her feelings and had a great fear towards expressing them to others and causing some kind of confrontation. Gore finally found companionship and compassion in the world of Twitter, where she and other Sad Girls connected with each other, shared stories, and taught each other that negative feelings are valid feelings too. This was a watershed discovery for Gore, who now has the mantra of ‘live every day like it’s Sad Girl Saturday’. By making sadness part of her personal identity, she was able to learn that it is okay to have sad feelings and to express them. Although the Sad Girl “rides on the struggle bus, she has a group of women behind her to keep her company the whole way” (Gore 2014). Part of this Sad Girl story is simply good humour and the ability to share self-deprecating jokes with others. But it also reflects the social pressure felt by young, single women to be out on the town and dating, never home without a beau on a date night. It shows the pressure that women feel to be happy all the time and to keep ‘bad’ emotions to themselves. The Sad Girl aesthetic provides a much-needed outlet for expressing the pressures and difficulties faced by young women in a world that gives them strict rules for conduct and tells them to look happy no matter what they feel on the inside.

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Sad Girl websites While sites like Tumblr allow for Sad Girl culture to develop via a folksonomy, there are also websites entirely devoted to projects of performing sadness. A major website for the Sad Girl is the Sad Girls Guide, a magazine-style publication with a logo consisting of a sad face with love heart eyes. Sad Girls Guide publishes articles to help “young women to gain their footing while navigating through all the obstacles growing up throws in their direction”. Combining pop culture references with blunt advice, this website aims to give thoughtful guidance while simultaneously having fun and conceding that “not everything is #thatserious” (Sad Girls Guide 2015). Recent topics include a guide for hustling for a new career move and a guide for effectively complaining about boys. This is the same semi-ironic semi-serious discourse that has spawned the @sosadtoday Twitter account with its constant broadcast of messages like “studies show that i’m the worst” (2016a). These tweets are written by Melissa Broder who later composed a book of the same name, containing her essays and thoughts about life with anxiety (Broder 2016b). Her sad tweets have been retweeted by a host of celebrities, “but mostly just Tumblr-addicted teen girls” who enjoy the discussion of anxiety with a focus on digital interactions, such as boys ignoring Snapchats (Pelly 2014). The account had an impressive 559,000 followers as of the end of 2017. One of the appeals of this Twitter account is that it normalises the fact that people really do get depressed. Pelly argues that sadness is often presented as an illness or “an outward mark of failure” in Western culture, which is focused on the idea of procuring and performing happiness. She believes that the present stigma against sadness has not always existed and that the “sad culture” of Tumblr and Twitter is aiming to remove it through popular accounts like @sosadtoday (Pelly 2014). Gaynor argues that @sosadtoday “enacts a feminine position of weakness so crippling she is no longer a functional human, but a yearning machine”. This not only shows how destructive this notion of weakness can be but also shows the power of having an active persona of sadness that can help process these emotions through cathartic satire (2015). There is certainly something compelling in this Twitter feed, which is both confronting and entertaining. The low-fi, home-made dimension of the Teen Girl Tumblr Aesthetic also emerges in some Sad Girl material. Dora Moutot’s Webcam Tears (2012 –) project is a blog dedicated to cataloguing videos of people (male or female) crying. All the videos must be taken via webcam and show the recorder’s face crying in from of their computer. Moutot explains that computers have become the witness and spectators to our lives: there while we eat, sleep, dance, laugh, masturbate, and cry. Because seeing genitals online is no longer shocking, “tears are a new form of pornography”. Webcam Tears is labelled as an “emotional porn channel” that explores both exhibitionism and loneliness in a world where computers are our closest companions (Moutot 2012).Through this site, people

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have the ability to search a large catalogue of strangers sobbing and exorcising their emotions. It is also a rare opportunity for the genuine expression of sadness, as any kind of professional production values are rejected in favour of dark or grainy webcam footage, shot in people’s bedrooms and basements. The endless parade of submissions suggests that there is real appeal in recording oneself for a forum where overblown melancholy and total submission to tears are valued and admired.

Lana Del Rey Beyond clothing brands and forums for the presentation of sad actions and ideas, there are also sad celebrities. Some of these individuals are the aforementioned visual artists, and others are performers of other kinds. A pre-eminent feature of the #sad girl tag is the singer Lana Del Rey. Born Elizabeth ‘Lizzy’ Grant in 1985, Del Rey and her songs are powerfully evocative of the contemporary female experience. One of her main themes is loneliness and lost love. Del Rey became a singer in order to summon together a commune of like-minded souls. Her music career was “half-inspired because I didn’t have many friends, and I was hoping that I would meet people and fall in love and start a community around me, the way they used to do in the ’60s” (Del Rey in Simpson 2012). She was to receive her wish and is now a seminal part of the melodramatic expression of sadness, love, and loss. She has been dubbed “the queen of pop melancholy who has inspired a million #PrettyWhenYouCry selfies”, based on her song of the same name (Hines 2015). Del Rey has a magnificently well-constructed aesthetic persona, which echoes through her songs, her live performances, and her music videos. Zoladz believes that her album Ultraviolence (2014) “seemed to emerge fully formed” from the Tumblr Teen Girl Aesthetic. It is impossible to tell if her persona is real or if it is a comical exaggeration, but this is irrelevant in the half-joke, halfdeadly-serious world of Tumblr pain (Zoladz 2014). Ultraviolence was developed out of a strong foundation of music about pain. Suicide is also a theme in her film clips, especially “Summertime Sadness” (2012). Described as “a visual ode to Instagram” (Bell 2012), Del Rey’s sad narrative is conveyed in grainy, badly ‘colorised’ film with light leaks, dirt, and jumping frames. The story in the clip involves Del Rey and her lover, who are both suicidal. In the opening scenes, Dey Rey throws herself off a precipice. Her girlfriend then stands dangerously on the edge of a bridge. Other scenes include dangerous driving, and the two women crying. At one point, Del Rey poses like a statue of Christ before jumping into a valley. With content such as this, it is not entirely surprising that Del Rey has been criticised for her depressive themes and her performances of melodramatic sexuality. Some critics feel that her genre of music normalises a discourse of suicidal ideation as part of everyday life. Soft Grunge heroes Del Rey and Marina & The Diamonds have been linked to negative feelings about life (Sloan McLeod

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2013). As with elements of the Lolita aesthetic, Del Rey has been criticised for her acquiescent and non-feminist character. Vigier feels that “[s]ubmissiveness, nostalgia and a tendency to indulge in self-destructive behavior are the hallmarks of Del Rey’s persona” (2012, p. 4). The majority of her songs are indeed about devotion to cruel, dismissive, and thrilling men who reel her in and cast her off with ease. Zoladz agrees that her oeuvre is an arguable glorification of “feminine passivity, weakness, and empty titillation”. But rather than fight these claims, she believes Del Rey has intensified her embodiment of these qualities to the point that “there’s something unsettling and even brazen about it” by the time she releases Ultraviolence (Zoladz 2014). Adding to this is the fact that many of her fans act out similar personas. Del Rey has been described, in a negative way, as “basically the human embodiment” of Soft Grunge (Sloan McLeod 2013). Cleaver is concerned by the kind of femineity played out by fans of Del Rey, Lolita, and the submissive nymphet lifestyle. She feels as though blogs on this theme are a documentation of tragedy and doom, fetishising youth as some kind of collectable item (Cleaver 2014). There is certainly something complicated about Del Rey. She is not merely a mindless, crying siren as some would label her. Vigier argues that Del Rey represents and speaks to “a contradiction facing thousands of young women today, women who have followed mainstream society’s prescriptions for success in what has been called a post-feminist world, but who find that real liberation and genuine satisfaction elude them” (2012, p. 1). For example, her 2014 Ultraviolence song ‘Sad Girl’ is sung from the perspective of a mistress who is keen to be a “bad bitch on the side” and watch her paramour get high because he is so deeply intoxicating to her.Yet the chorus erupts into a confession that being on the sidelines of his primary relationship makes her deeply miserable and lonesome. Her sexual freedom makes her feel accomplished and depressed simultaneously. Zoladz believes that this is a big part of the contemporary female condition. Women are expected to be strong, brave, and bold. Speaking about unresolved depression and feelings of inadequacy is not encouraged, as they form a crack of sadness or failure in the façade of a successful woman. Zoladz is frustrated by recurrent requests from men to ‘smile’ while she is at work or on the street, concluding that “society would still prefer women to lacquer on a happy face” than to show what they are really feeling (Zoladz 2014). Instead, Del Rey’s music focuses on sad faces and the pains of courtship with ill-chosen men. A relevant assumption underlying criticism of Del Rey is that feminism and displays of power are inextricably linked. Vigier notes that in the 1990s, feminism started putting a large degree of emphasis on power, for example, the Spice Girls’ ‘girl power’ mantra. Women were expected to make public displays of their power, and, through that, achieve equality. This meant that a ‘real’ feminist should have unwavering confidence in her sexual expression and authority in her sexual exploits (2012, p. 5). Del Rey does not. While she confidently expresses her desires and experiences, this is done through a lens of

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regret, sadness, and loving obsessions with men who have wronged her. Zoladz contrasts her oeuvre to other contemporary pop acts like Kelly Clarkson, Pink, and Ke$ha who carry on the 1990s’ ‘girl power’ mantra into the present day. She feels that this theme of empowerment is most evident in Katy Perry’s song “Roar” (2013), where the strong female singer tells a story of being held down, then discovering her voice and sharing its power with the world in an aggressive roar. This song came out in the same year as Sheryl Sandberg’s neo-capitalist ‘Lean In’ mantra, which told women that they can have all the financial and workplace power they want if they push hard enough. Zoladz calls Ultraviolence the anti-“Roar”.With songs like “Fucked My Way Up to the Top”, Del Rey sings about success through sexual favours, not through hard work and demanding respect. The universe that she paints is a sad, shadowy, romantic world in which women get high, dress up, and chase handsome men rather than excelling in their careers (Zoladz 2014). An easy conclusion to come to is that Del Rey is not a feminist and her ideals are not in keeping with feminist goals. Indeed, in an interview, she notoriously declared that she found feminism boring and was more interested in space travel and Tesla. Many felt that she was missing the point of the movement and doing a disservice to less privileged women who are still fighting hard for recognition (Bell 2015). In the wake of Del Rey’s comments, Ms Magazine published an article stating that she was not a feminist and lamenting her “disempowered form of femininity” and her arguable promotion of domestic abuse. The article in question criticises Del Rey for her romanticisation of the Lolita story and her persona of a “powerless victim who depends on men for validation and support” (Shugerman 2014). There is real validity in this argument, and I think we do need to be cautious about the influence of ideals of womanhood presented through art. But this kind of discourse stems from the problematic action of repeatedly asking female celebrities what they think of feminism in order to bait them into giving the ‘wrong’ response. Salek argues that this is a good way to get clicks on an article but a terrible way of advancing the feminist cause (2014a). A badly phrased answer to a question is not necessarily a reflection of a person’s political and moral beliefs. What I would suggest, instead, is that Del Rey represents narratives of female weakness, sadness, and failure. She also speaks to a generation who feel cut out of their forebears’ market economy. Admitting that we are depressed or hurt should not make us less of a feminist. Natural human desires for those who hurt us, or for ill-conceived romances, should not make us feel as though we have betrayed our gender or let down the feminist cause. Instead, these emotions and experiences are all part of a full human life. Del Rey’s music is about an expression of this richness, even if it makes her seem weak and depressing as a result. This is very appealing to a whole range of young women who feel that they are either letting down feminism or being betrayed by it, because they are not living proactive lives of success and happiness at all times. Ideologies targeted at women often neglect to leave space for emotional nuances. Del Rey’s music

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fills a gap that seems to appeal to a great number of Sad Girls on their own romantic journeys.

Sad Girls and feminism This leads to broader questions on the intersection of sadness and gender politics. Gore believes that the Sad Girl movement is a deeply feminist one. Sad Girls use the internet to support each other and are “assertive women who respect themselves”. They are creative people who are in touch with their emotions and explore them through a variety of art forms. Sad Girls know that ignoring their own experiences and feelings would be a disservice to themselves (Gore 2014). But this does not mean that the experience is easy. As one commentator confessed during a therapy session, “[b]eing a woman is the saddest thing”. She bases this sadness on the fact that women are attacked on a daily basis as people treat their bodies as public property; as they face legal, professional, economic, and social inequities; and as they are fed media that seems more focused on shaming women than accurately representing them (Gaynor 2015). These are all feminist issues. By being publicly distressed by them, Sad Girls force others to confront wrongdoing and inequality. Sad Girls have also created a sophisticated space for the discussion of what a girl needs to be able to do in order to claim a space as a feminist. Cleaver (2014) explains, “Western young women today arguably have more options than ever before, but there’s a pressure that arises from that to accomplish more. When you never quite feel like you’re getting enough right it makes sense to fetishise the wrong”. This can involve an obsession with sadness, pain, and selfdestruction. Indeed, Stobbe’s opinion piece on Sad Girls starts with a confession of failure. As she entered her 20s, she found herself assailed by media telling her what a young woman should be able to do in order to call herself a powerful and functional adult. Such directives included the ability to parallel park, cook a healthy meal, and apply eyeliner with finesse. As a child, she had assumed that her adulthood would bring with it the ability to be not only a successful career woman with a good position but also a great mother and wife who could cook organic meals, grow her own vegetables, and see the children off to school. She would make enough time to stay skinny, sexy, and beautiful and be able to keep up to date with cultural events (Strobbe 2015). Approaching her adult years, Strobbe maintains that the desire to do all of these things simultaneously is a feminist pursuit and a good way to celebrate the freedom of a generation whose mothers were criticised if they wanted to hold down a job after marriage. But she also notes that “do-it-all feminism” can be an uncomfortable ideal where women are told that they can still aim to be beautiful, should still be good homemakers with practical skills, but should also be confident with masculine skills and social roles and should be successful in society and in the workplace. These requirements all amount up into a long list of what women must do in order to be modern feminists (Strobbe

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2015). As Gaynor explains, women are often made to feel guilty for not being strong enough and having to rely on support from other people. In this situation, “[v]ulnerability becomes conflated with weakness”, and many women are left feeling that they are not contributing to the feminist cause. Gaynor notes a sense of guilt that she and her friends feel when they act in a subordinate way in a relationship, or if they fail to be brash and outspoken about equality. She worries that she will be seen as “a regressive 1950s housewife” who holds “the symbolic martini of servitude” for her husband if she ever slips up and looks weak or needy (Gaynor 2015). By being open about failure and the anxiety to be a ‘prefect’ woman and empowered feminist, commentators like Strobbe and Gaynor are allowing other women to come to terms with the fact that they have been sold an impossible dream.

Sad Girl theory Girls’ sadness is not passive, self-involved or shallow; it is a gesture of liberation, it is articulate and informed, it is a way of reclaiming agency over our bodies, identities, and lives. – Wollen (in Watson 2015)

In researching the Sad Girl trope of Del Rey, I came across the prodigious work of Audrey Wollen – a contemporary artist and philosopher. I was pleased to find that Wollen directly echoed my sentiment on Del Rey being one of history’s most recent Sad Girls (Barron 2014),1 going so far as to dub Del Rey 2014’s Queen of the Sad Girls (Salek 2014b).2 She also gives many answers for what the performance of sadness really means for the young women who execute it in online spaces. Wollen’s ‘Sad Girl theory’ is a complex philosophical discourse that spreads across her art, political activism, and social media presence. She initially developed her theory in response to the alienation she felt when faced with contemporary feminism. She felt that feminism in this form demanded that she love herself, have great sex, and achieve economic success. Instead, she felt depressed (Watson 2015). Sad Girl theory addresses some of the lacunae in contemporary feminism by proposing that the internalised suffering experienced by women is an act of protest. While externalised resistance in the form of violence and public dissent is acknowledged as a ‘real’ kind of protest, Wollen aims to draw attention to quieter and less masculinised forms of powerful resistance. Her Sad Girls are women who have “consciously disrupted the status quo through enacting their own sorrow”. This quiet but visible demonstration of sadness is “a strategy for subverting those systems, for making the implicit violence visceral and visible, for implicating us all in her devastation” (Wollen in Barron 2014). By forcing us to witness her despair, the Sad Girl makes us ask ourselves what we have done to cause her tears.

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I think this gives us a clear answer as to why so many online self-harmers create and share visual representations of their wounds, and why so many young women draw words or tears on their faces that represent hurt, rejection, and depression. They are asking us to bear witness to their grief and their suffering. While there is no evidence that Wollen is a self-harmer or that she even has an interest in this kind of gory imagery, she certainly has an interest in the expression of female pain. Wollen wishes to show that many manifestations of female madness and sickness are actually manifestations of female liberation and resistance. She feels that acts like starvation are not narcissism (Salek 2014b). Instead, she argues that sadness, tears, and self-harm have been associated with women for centuries and have all been viewed as symptoms of some other problem rather than autonomous acts of protest. She wants us to see this manifestations of female ‘sickness’ as part of an anti-patriarchal battle that has been ranging, obscured in the history books, for centuries (Watson 2015). Rather than advocating the hegemonic idea of suicidal behaviour as an illness, she states that self-hate, sorrow, and suffering are all “scenes of protest”, which should be re-categorised as political resistance rather than neurosis, narcissism, or neglect (Wollen in Martinez 2015). While she agrees that many of these acts can be physically and emotionally devastating, Wollen wants us to remember that they are also active, autonomous, political statements from people who are often voiceless in other ways (Salek 2014b). She asks us to look at the “long history of girls who have used their own anguish, their own suffering, as tools for resistance and political agency”. In doing so,Wollen hopes that we can consider that which “mass culture wants to stay invisible”, such as the fact that suicide is the number one cause of death for girls between 11 and 19 years of age (Wollen in Tunnicliffe 2015). One major way in which Wollen advances her Sad Girl theory, and the visibility of female sadness, is through Instagram. She selected this medium because it was “already catering to and feeding off of girls representing themselves”. As such, she found it to be the perfect place for a discussion about images, objectification, and the politics of representation (Wollen in Barron 2014). Her Instagram account explores a wide range of themes within this broader discussion of representation. In born crying (2014a) she shows her own face in soft focus with tears streaming from her eyes. Her followers are kind, giving her advice like “You’ll be fine it’s ok don’t worry” and other comforting statements. Others balance darkness with humour. She also gives a ‘PSA’ to male artists, which reads, “BEWARE MALE ARTISTS MAKING ARTWORK ABOUT EMPTINESS. NOTHING DOES NOT BELONG TO YOU. GIRLS OWN THE VOID. BACK OFF FUCKERS!!!!” (Wollen 2015a). Perhaps the darkest of all her posts is her Instagram message mourning the sentencing of Purvi Patel, who was sent to gaol after a lack of abortion facilities led her to terminate her pregnancy by herself in an alleyway. She was subsequently charged with feticide. Wollen implores that “this is the start of something horrific, and it’s

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important for every girl to witness, mourn, and rage against it” (Wollen 2015b). This mass mourning was taken up by other women. For example, a screenshot of her Instagram post was put on Tumblr by ‘growinggirl’ – a ‘sad girls guide’ in the city of Los Angeles. To date, it has been shared and liked 106,206 times (growinggirl 2015). Wollen’s Instagram art has also become a kind of rallying call. One of her clearest and most comprehensive statements on the Sad Girl is also one of her most popular. In 2014, Wollen enunciated the multifaceted nature of the Sad Girl through a set of sentences, share on Instagram in red capital letters: THE SAD GIRL HAS ‘DADDY ISSUES’, A BRUISED SEXUALITY THE SAD GIRL FALLS IN LOVE EASILY, BUT COMMITS RARELY THE SAD GIRL ESCHEWS THE RESPONSIBILITIES OF DOMESTICITY THE SAD GIRL AVOIDS THE DOMESTIC NOT OUT OF DEFIANCE BUT A SELF-DESIGNATED INCOMPETENCE THE SAD GIRL HAS A HISTORY OF DISORDERED EATING, IF NOT TOTAL ANOREXIA THE SAD GIRL CONSISTENTLY STRUGGLES WITH HER WEIGHT, DESPITE BEING TOLD HER SIZE IS ACCEPTABLE THE SAD GIRL SETS TRENDS THE SAD GIRL HAS AN OBVIOUS INVESTMENT IN INDIVIDUAL STYLE AND PERSONA THE SAD GIRL MAINTAINS A NONCHALANCE THAT ANTICIPATES BEING STOLEN FROM (Wollen 2014b) This manifesto of the Sad Girl reveals many important elements of this theory and elucidates the experiences of many young women who gravitate towards the label of ‘sad’. A Sad Girl is unlikely to be a housewife. She will fall in romantic love with you but will not be chained to the kitchen. In part, this is because she feels as though she would fail at being a housewife, not simply because she is opposed to the concept of domestic labour. A Sad Girl is also likely to have serious emotional trauma based on a lifetime of bad interactions with men. She has disordered eating patterns and an inability to be content with her body, even if she is at a healthy and socially acceptable weight. She may even have diagnosed anorexia. Finally, a Sad Girl cares about the way she presents herself to the world and always attempts to innovate something new. In this way, she not only sets trends but also needs to fear theft of her original content because of a lack of autonomy and respect in the professional world. In response to the question of whether “being sad is trendy right now”, Wollen argues that it has always been part of the human experience and has always motivated a variety of subcultures – not just today’s Sad Girl community. Interestingly, what varies in terms of the specific Sad Girl articulated earlier

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is the dimension of wit and jesting it contains. Wollen argues that “right now being depressed is having a moment as part of our vernacular and humor, for sure”. She feels that “expressing that sadness has just become more quippy”, because we can now do so in short and vernacular fora like Twitter rather than writing a sonnet in iambic pentameter (Wollen in Salek 2014b). There is also presently more opportunity to find witness for our suffering. If @sosadtoday tweets something, a large portion of her followers are likely to see it and bear witness to her inability to leave the house, fear of gaining weight, and constant need to sleep. By being open about this sadness, Wollen also hopes that women can group together and pay attention to each other’s sadness and the sadness at the heart of the female condition. At the moment, she is happy that people are expressing these thoughts through Twitter or Instagram but also wants more of this behaviour to filter into ‘real life’. She laments, “We spend a lot of time talking about how we want to kill ourselves over social media, but when was the last time all of your friends got together and cried?” Wollen is concerned that groups of female friends are still overly concerned with the idea that happiness is a goal we should all seek and which we can earn through good behaviour. She wants to create a world in which groups of women can support each other by abandoning happiness as a pursuit and instead dedicate time to “just chill with our misery” (Wollen in Salek 2014b). This is not because she wants friends to make each other feel glum but, rather, because she is worried that young women have been socialised into suffering alone and presenting an image of dynamism and success when in public. She argues that “Sad girls have been kept invisible for literally thousands of years”. In our present era, suicide is a leading cause of death for young women, yet these same people are told that their sadness is an individual failure rather than a broader group issue.Young women are strongly encouraged to suffer alone and to put on a happy face in public; otherwise, they are seen as narcissists who burden others with their own faults. By suffering with our friends and sharing real emotions with the people around us, we can tell people that their sadness is “a very appropriate and informed reaction” to stressors rather than advocating that young women just keep quiet and practice positivity (Wollen in Tunnicliffe 2015). This may see young women dismissed as narcissists, but at least they can know that their burden of depression should not always be a private affair. Because of the power and originality of this message, Wollen has a strong fanbase of her own. Strobbe found her Sad Girl theory to be a way out of the labyrinth of modern ‘do it all’ feminism. As she failed to be a Powerful Woman who could walk in six-inch heels with a smile on her face and hit goals in academic, social, and physical contests, she found herself drawn to Wollen and the “beautiful power of sadness”.Through Sad Girl theory, Strobbe learned that it is all right to feel that the world is flawed and that women are placed under immense pressure and frequent condemnation. Sad Girl theory gives a voice to women who find themselves unable to do everything required of them

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(Strobbe 2015). Wollen has also provided a creative language through which women can express themselves and their experiences of social pressure without putting on a happy façade. Artist Christina Enrico uses Wollen as a muse for her video “Sad Girl Theory” (2016). In this video, Enrico opens with quotations from Wollen’s philosophy about suicide, sadness, and suffering in silence. Cherry Glazerr’s twee anthem ‘Teenage Girl’ (2013) ramps up the tempo and breaks the silence with an appropriate hymn to the Sad Girl aesthetic that celebrates junk food and make-up as much as it provides a deep rumination on the sadness and silence of the teenage girl. Enrico includes a variety of scenes that draw from female culture and a deep, suicidal sadness (Plate 14). Her first shot shows ‘GIRLS OWN THE VOID’ scribbled in pink lipstick on a bathroom mirror. The bathroom vanity becomes central to the action, featuring a single white rose. She also shoots a flushing toilet, filled with what could be a bath bomb or pink, glittery vomit from a purge. Enrico films her own body with her collarbones covered in glitter and tongue adorned by diamond gems. She shows her torso in white underwear with a bouquet of pink roses and baby’s breath.This sweet image is soon distorted by quick jump cuts in time to the frantic beat of the music. Enrico contorts her waist in a tape measure, blood falls on her hands clasping a rose, the toilet cannot hold all the pink puke, Enrico violently scratches her chest, and blood drops into the white sink. She arranges flowers in her underwear and rubs blood over her skin. The tape measure becomes barbed wire that she pulls around her body. As the beat slows, we see a poesy and a letter addressed to ‘Mom & Dad’. More blood flows, suggesting that the letter is her suicidal farewell.The final scenes of Enrico show her still alive, smearing blood off her face and washing off the sink basin. The camera cuts between images of her clean and images of her bloody.The film ends with Wollen’s words on the validity of sadness in the face of being a girl.

White art: the ethnicity of sadness Aside from questions over the presentation of the female body, the nowstereotypical Sad Girl has also been critiqued because of the over-reliance on White bodies as a way of presenting depressive themes and exploring girlhood. Even Dictionary.com defines the ‘Tumblr girl’ as fashionable, attractive, and generally White (Tumblr girl 2017). In agreement, Hines describes the typical Sad Girl as a young woman, likely from an affluent Western nation, who has free time to spend online. Although Sad Aesthetics are geared towards the expression of deep, unique, personal feelings, Hines believes that they are ironically formulaic. She notes “waifish frames” and “cursive tattoos” as examples of repeated motifs. The bodies in question tend to be White, have a flat stomach (Plate 15), and are youthful, blonde, and full-lipped – looking beautiful even when in pain. While Hines argues people of various ethnicities and appearances enjoy and share these images, they represent “a collective desire to prune one’s online aesthetic to fit narrow, and thus exclusionary, beauty ideals” (Hines 2015). In the

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process of creating Sad Girl icons and articulating a Soft Grunge culture, a very specific kind of frail, sweet, and vulnerable body has been articulated. In 2015, a Tumblr blog called ‘okaywork’ published a list of ‘white art’ including 1 plants 2 veins 3 socks with jelly sandals 4 bathtubs 5 hickeys 6 chapped lips 7 snapchat picture of the sky (okaywork 2015) Although the list was to some degree sarcastic, it captures the fact that expressive modalities like Soft Grunge and the Sad Girl are closely connected to White women. Bodily images on sites like Tumblr – including veins, hickeys, and chapped lips – tend to appear on White skin. ‘Cute’ imagery like plants, jelly sandals, and quirky screenshots of photographs of the sky are also associated most commonly with White creators. This has left many non-White women exploring what it means to be sad outside of this overpowering, contemporary aesthetic. A critic of many of the aesthetics mentioned in this chapter is Tumblr user Brianna Fletcher, who posted a list of what she deems “trendy faux white feminism”.This list includes Audrey Wollen, Sylvia Plath, and Etsy stores featuring White girls with Jenny Holzer quotes on their shirts. She is also exasperated by the saturation of a singular body type, exclaiming, “i don’t wanna see your instagram post of your malnourished white body with your a-cups out screaming about freeing the nipple”. Fletcher is tired of Polaroid shots featuring naked women with messy hair and bored expressions. She categorises bodies like this as faux-radical because they show one supposed flaw like a flat chest, thick eyebrows, or body hair.Yet all other aspects of the people they depict are conventionally attractive and give them social privilege, for example, White skin and a thin figure. Fletcher argues that this kind of aesthetic is damaging because it sells itself as feminism yet creates body image issues and erases plussize women and women of colour. She believes that “this shit is only mediocre white women looking for ways to force themselves upon you while also being hailed as brave and radical” (Fletcher 2016). Roca Payne agrees that depression is presented to us in a very narrow way. She sees the ‘typical’ depressed person as a thin White woman with hair that is a little dirty and clothes that are a little loose. She lies in bed, feels tired, keeps quiet, and loses her passions. This depressed caricature is repeated again and again in the media as a representation of who is depressed and what symptoms they might express. This image is simple and easy to understand, but it is also dishonest (Roca Payne 2016).

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Such an image also requires a fair amount of privilege to carry off. Jennings notes that the “internet-cool sad girl” trope can be paradoxical, as it sets up performative sadness as a “trait that also signifies coolness”. Wearing a shirt that reads ‘UGLY’ or implies that the wearer has a bad personality or bad social life takes courage. This confidence is less likely to manifest in a person who is seen as weak, vulnerable, or visually unpleasant. She connects this with the ‘normcore’ look – an undistinguished, unpretentious, casual clothing style. Normcore is most successful with wearers who are “rich, cool, and skinny enough to pull off tacky, unflattering clothes without people taking them at face value”. Portwood-Stacer agrees that the semiotics of an ‘UGLY’ shirt are influenced by the wearer. A risky sentiment will not ruin the reputation of someone who is generally seen as pretty and popular (Jennings 2016). While it is likely such wearers may have very genuine anxieties about their looks and their social status, it takes a certain amount of privilege and a particular kind of ‘good’ body for a shirt reading ‘UGLY’ to work on all intended levels of humour and honesty. To point out such underlying body politics, some of the artists mentioned in this chapter are actively addressing the image of sadness as a White girl’s pursuit. The Coven art collective, for example, is dedicated to respecting people’s boundaries and differences. One of their major aims is to promote justice for marginalised women including women of colour and Indigenous women (Philomène in Neave 2015). One of the major ways they do this is by exploring the emotional life and power of women through the eyes of artists from a variety of ethnicities who showcase bodies that deviate from the thin, White, cisgendered ideal. There are also art movements specifically exploring the nonWhite selfie, such as Art Hoe. This movement appears under the #art hoe, #arthoe, or #artho tag on sites like Tumblr, Instagram, and Twitter. It is open to all young people of colour around the world who are interested in writing themselves back into the tradition of Western art that has often excluded them. Founded by two genderqueer young Black people, Mars and Jam, who were aged 15 when the movement began, #art hoe selfies are devoted to the idea of re-contextualising art and beauty in a trend that is both aesthetic and political. Jam explains the power that comes from “a disabled trans black woman superimposing herself over a white man’s painting saying ‘I am here, I have worth, and my existence and art matters!’ is so wildly radical and revolutionary” (Jam in Blay 2015). Similarly, Mars aims for a stable platform where non-binary people of colour can explore their artistic passion and personal expression without being questioned about their identity or being hampered by stereotypes (Mars in Sisley 2015). Perhaps the most important instigators of the Sad Girl movement – ‘Sad Girls y Qué’ – must not be forgotten. At present, this group consists of five Chicana-identifying women: Anna Bon, Maite Soleno, Ariana Bon-Hodoyán, Pau Lia, and Ana Laura Camarena. They were the first to have ever used the phrase ‘Sad Girl’ as part of a broader philosophical statement. Despite this, they

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are rarely credited outside of their immediate circle. The Sad Girls y Qué collective launched an eponymous Facebook page in October 2013, which gained tens of thousands of followers (Calderón-Douglass 2014). Founding member Bon explains that the Sad Girl archetype was drawn from seminal “Chicana chola culture” and its discussions on the place of women. A major text that inspired the movement is Mi Vida Loca (1994), a film based in the Los Angeles neighbourhood of Echo Park. In this movie, the character Sad Girl is given this name by her fellow gang members. After living through a series of tragic events, she ends up growing into this nickname, which initially caused her discomfort. Bon finds this movie deeply relatable because of the narrative of the women who are repeatedly taken advantage of and treated poorly. She finds it a believable image of what Chicana women “go through as second class citizens to the necessities of men”. Bon also draws the Sad Girl archetype from a typical tattoo style in Los Angeles, which depicts a crying gangster woman. This woman is often dressed in a gritty Pachuca aesthetic and shows the complex strength and resilience of a Mexican woman (Calderón-Douglass 2014). Based in Tijuana, Mexico, Sad Girls y Qué have been dubbed “a glittering, internet feminist group who are taking down Mexico’s ‘bullshit macho culture’ one kitten meme at a time” (Eden 2015), and “glittery, girl power gang” who retaliate against local and global machismo with a powerful form of femininity (Calderón-Douglass 2014). In some ways, their content is the traditional Sad Girl fare. Calderón-Douglass notes that their Facebook platform has been used to publish “heartbreak poems and notes on depression and solitude” (2014). Bon explains that it started simply as a forum to vent, discuss heartbreak, and share sex-positive views (Eden 2015). It is also a place containing a humorous contrast of the super-deep with the superficial. Lia, one of the founding members, explains that followers can expect rants on “bullshit in the world” followed by “a picture of a cat with glitter” (Eden 2015). Nevertheless, such images are far from superficial when viewed in the broader context of the movement. As Bon explains, the pink and feminised aesthetic of Sad Girls y Qué brings to the forefront images that have been devalued in a culture where corporate women dress like men to gain respect and a taste for cute images and kittens makes a women seem stupid and shallow (Calderón-Douglass 2014). They ask that their viewers revaluate the actual quality of feminised images, and celebrate that which has been denied as foolish because it is female-oriented. Importantly, Sad Girls y Qué is dedicated to providing an alternative to White feminism. Bon sees White feminism as a hegemonic reduction of a very complex movement. Soleno defines it as a kind of feminism that is more just a skin colour but, rather, a combination of privilege and ignorant mentalities (Calderón-Douglass 2014). Although they admire some White women, such as Britney Spears during her head-shaving period of 2007, women of colour have been core to the foundation of their feminist philosophy. The group are especially fond of bell hooks and Audre Lorde, whose work they found by searching for open-source academic. pdfs (Eden 2015). Soleno criticises White feminism as a

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system by which a ruling section of women appropriate other cultures in order to find new ways of empowering themselves. This is despite being in a more privileged position than women from these cultures. Bon agrees that a wellrounded feminist should be someone who looks out for oppressed groups and seeks to address their dehumanisation rather than taking part in it (CalderónDouglass 2014). While the Sad Girls y Qué are interested in hair, make-up, cartoons, and other ‘cute’ or ‘girly’ items, they also have a much broader political aim. As Hines (2015) argues, the Sad Girls y Qué collective is opposing patriarchal norms, “not just reblogging bruise pics because its members are in a bad mood” (Hines 2015). There is an additional depth to its movement, which reflects the additional suffering caused to them by both sexism and racism. Because of their clear prominence in the movement, it is tempting to conclude that White girls (especially exceedingly pale individuals) are the social subset with the biggest self-harm problem and the most interested in sharing aesthetic representations of their pain online. In terms of official figures of who self-harms, differences in race are murkier and harder to statistically analyse than other differentials like gender and age. Yet, it tends to be White females who identify with the self-harm label and contribute to studies on this topic. For example, one survey of English adolescents logged 82% of students as White (Hawton et al. 2002, p. 1208). On another survey of online self-harm communities, 90.3% described White as their race (Harris and Roberts 2013, p. e285). In the Kapur investigation of self-poisoning in the UK, the authors noted that 93% of patients were “white British” (Kapur et al. 2004, p. 38). These numbers seem improbable as genuine reflections of the ethnic diversity in self-harm, but they do match the statistics of self-harm images shared online. In the Seko and Lewis survey of ‘indirect SI images’ (i.e., images accompanied by keywords and tags pertaining to self-injury that do not directly portray self-injury), 97.1% depicted White persons. Interestingly, three-quarters of the images studied also showed female adolescents and young adults (2016, p. 7). Unwilling to conclude that White people are therefore the more likely to harm themselves, Seko and Lewis explore some other rational possibilities.They suggest that the sharing of memes online is a mixed blessing. On the positive side, reblogging portrayals of sadness or self-harm can help people who identify with them to convey and explore these feelings through a “shared template”. But because the shared template is relatively narrow in terms of who is represented, it skews perceptions of sadness and beautiful suffering as the domains of White people, in general, and young White female, in particular. This kind of person is seen as both photogenic and vulnerable, while people who do not match the cultural perception of a self-harmer often have their experiences and images excluded (Seko and Lewis 2016, p. 14). This exclusion is exacerbated by the fact that there are also some skin practices that seem to be ethically specific because of working better and being more visible on one skin colour than another. Colourful tattoos show up more clearly on pale skin, while darker skin reacts better to scarification because of its propensity for forming keloid scars

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(Favazza 2011, p. 133). Arguably, bruises and blood from self-harm show most clearly on the whitest of skin. Nevertheless, I think it is also evident from the study of the earlier aesthetic genres that the cultural connotations of extreme paleness, such as delicate beauty and vulnerability, also have a large role to play in the valorisation of this skin type. So, too, is the media over-representation of White people and White pain, which often overshadows other people and experiences. It is important that we realise this and help address the absence of other bodies when promoting more healthful and constructive aesthetic communities, as discussed in the final chapter.

Conclusion Although the Sad Girl trend is only a few years old, it has made waves by tapping into pre-existing feelings and archetypes. Already, the Sad Girl is appearing in fine art in galleries and in popular art online. She has her own clothing brands. She expresses herself online through specialist websites and Twitter feeds. There are Sad Girl superstars like Del Rey and Sad Girl philosophers like Wollen. Their brand of ‘sad’ feminism addresses some of the gaps in the ‘girl power’ movements that many young women grew up with as the acceptable face of feminism and empowerment. They make room for exploring weakness and failure as female conditions – something that has been met with mixed reviews. There are valid criticisms that the Sad Girl movement is too reductive, too patriarchal, and too obsessed with the typical pale, White, skinny, female body. Whatever one’s personal take on this movement is, it is still a very important expressive device for many people. It can also help outsiders to gain a better grasp on what young, vulnerable people are feeling and why. Aesthetic movements like Soft Grunge and Sad Girl are ways of moulding beauty to express suffering and sometimes to even find a way to heal. As one Tumblr user outlines, “constructed identity as self-care. performance as self-care. aesthetic as self-care. these things are so valuable, constructing a self you like and cherish is so valuable, choosing to be a person you enjoy is so valuable” (condesces 2014). The importance of expressing emotion and unpacking the motivation to damage oneself is also part of modern self-harm treatment. For example, Lehman recommends developing the symbolism of self-injury as a way of helping sufferers to understand their underlying urges and to allow them to articulate the way in which self-injury functions as a coping skill (2013, p. 2). This cannot happen without guided self-reflection and a better understanding of one’s personality and needs. So do the aesthetics outlined in this chapter and the one before it do something that might be truly deemed socially dangerous? I believe that they provide both motivation and sites of contagion for self-harm and a language through which aggressive and anxious desires can be successfully quelled through reflection and re-augmentation of the dynamic teenage selfhood. Because people

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are invited to lampoon themselves, their aesthetics, and their interests, they are given a healthy opportunity to consider feelings of anxiety and the desire to self-harm from multiple perspectives. This can actually help with a more sophisticated expression of complex emotions and needs to other people in their lives. Talking about self-harm online is not a guarantee that self-harm practices will become more severe. They certainly may, but many people find that they benefit from an open discussion of negative feelings and actually hurt themselves less as a result. The same happens with images. While some people will use them to trigger self-harm, others will use them as a cathartic release that stops them from turning on their bodies. Broad censorship efforts and uneducated disgust are not helpful. Instead, case-by-case guidance is the only real way to manage a person’s relationship with ‘dark’ material. What we can conclude about these aesthetic movements is that they allow space for confession of deviant emotion, which can be a very constructive way to heal and find perspective. There is also a very powerful community basis for these aesthetics, which provide a safe space and empathetic companionship. Artistic expression is also very powerful and cathartic. We should spend more time asking why people are sad as opposed to censoring their sad art or telling them to stop making it. Researchers into self-harm will also benefit from paying more attention to the aesthetic dimensions of this behaviour. Even in the act of cutting or bruising, many people are acutely aware of their body as an expressive vehicle and see pain and physical destruction as a good metaphor for their inner suffering. This also provides motivation for capturing evidence of this destruction, sometimes in keeping with the aesthetic values of a self-harm genre like Soft Gore. Finally, we also need to appreciate the broader communities that form around the sharing of these images and which provide them with even greater context and new dimensions of meaning. Without an appreciation for this complex and multilayered system of visual rhetoric, the actual meaning of these rhetorical choices can be lost. This is also a way that we can work towards new and radical treatment methods based on visual data and aesthetic behaviours. In the following chapters, I outline some suggestions for aesthetic communities that are more inclusive and healing-oriented and that may become a key to solving the conundrum of treating self-harm in the internet age.

Notes 1 Wollen is a huge fan of Del Rey, dubbing her radical and important because of her conflation of the artificial and the emotional. Wollen is impressed by her Warholian ability to present herself as an icon and as a myth. She notes that Del Rey is not just inspired by Marilyn Munroe – she is also a proliferation of the Marilyn icon. Del Rey “lives in that highly eroticized, highly commodified position of the already-dead”. Another of her avatars is the seemingly contradictory Jackie O, yet Del Rey balances the two with the kind of perfection that gives women permission to be limitless (Wollen in Salek 2014b). 2 In terms of the title of this theory, Wollen uses the diminutive ‘girl’ purposefully. She feels as though she is not considered to be a woman in the eyes of the patriarchy who

Sad Girls 113 are “constantly infantilizing” her. Thus, she has decided to accept this label as a way of using it to her advantage and weaving the discourse of her oppression into her political stance (Wollen in Tongco 2015). This is similar to Gevinson’s reading of Collins’s Babe. She believes that the book is an attempt to de-infantalise or redefine the term babe by reclaiming this diminutive for their own original, powerful projects on female life and iconography (Gevinson 2014, p. 6).

References Barron, B., 2014. Richard Prince, Audrey Wollen, and the Sad Girl Theory [online]. i-D. Available from: https://i-d.vice.com/en_gb/article/richard-prince-audrey-wollen-andthe-sad-girl-theory [Accessed 21 July 2016]. Bell, C., 2012. Lana Del Rey ‘Summertime Sadness’Video: Jaime King Is Lana’s Suicidal Lesbian Lover [online]. Huffington Post. Available from: www.huffingtonpost.com.au/entry/ lana-del-rey-summertime-sadness-video_n_1688899 [Accessed 5 Jan 2017]. Bell, G., 2015. Lana Del Rey Addresses Her ‘Anti-Feminist’ Quotes [online]. Nylon. Available from: www.nylon.com/articles/lana-del-rey-interview-james-franco [Accessed 27 July 2016]. Blay, Z., 2015. How The ‘Art Hoe’ Movement Is Redefining The Selfie for Black Teens [online]. Huffington Post. Available from: www.huffingtonpost.com.au/entry/art-hoemovement-redefining-selfie_us_55df300ce4b08dc09486a020 [Accessed 3 Aug 2016]. Broder, M., 2016a. Studies Show That I’m the Worst [online]. sosadtoday. Available from: https://twitter.com/sosadtoday/status/755996286889844736 [Accessed 21 July 2016]. Broder, M., 2016b. So sad today: Personal essays. New York: Grand Central Publishing. Calderón-Douglass, B., 2014. Sad Girls y Qué Are Breaking Down Machismo With Internet Art [online]. VICE. Available from: www.vice.com/en_ca/article/sad-girls-y-queis-breaking-down-machismo-and-offering-an-alternative-to-white-feminism-456 [Accessed 5 Jan 2017]. Cleaver, S.K., 2014. Essay: Lolita [online]. Girly. Available from: http://showstudio.com/pro ject/girly/essay_lolita [Accessed 8 Feb 2017]. condesces, 2014. Self-Care [online]. Tumblr. Available from: http://condesces.tumblr.com/ post/99364443555/constructed-identity-as-self-care-performance-as [Accessed 20 Nov 2014]. Eden, N., 2015. Sad Girls y Qué [online]. Wonderland Magazine. Available from: www.won derlandmagazine.com/2015/03/sad-girls-y-que/ [Accessed 5 Jan 2017]. Enrico, C., 2016. Sad Girl Theory (Inspired by Audrey Wollen) [online]. YouTube. Available from: www.youtube.com/watch?v=sHLa1G1kjKw [Accessed 26 July 2016]. Favazza, A.R., 2011. Bodies under siege: Self-mutilation, nonsuicidal self-injury, and body modification in culture and psychiatry. 3rd ed. Baltimore: Johns Hopkins University Press. Fletcher, B., 2016. I’m So God Damn Fucking Tired of This Trendy Faux White Feminism Going Around [online]. Tumblr.Available from: http://2007sucked.tumblr.com/post/144901414063/ im-so-god-damn-fucking-tired-of-this-trendy-faux [Accessed 22 July 2016]. Gaynor, E., 2015. In Defense of Sorrow:The Sad Girl Internet Aesthetic [online]. Weird Sister. Available from: http://weird-sister.com/2015/09/24/in-defense-of-sorrow-the-sad-girlinternet-aesthetic/ [Accessed 5 Jan 2017]. Gevinson, T., 2014. Foreword. In: Discharge. 6–7. Brooklyn: Capricious LLC. Gore, S., 2014. The Rise of the Sad Girl [online]. The Toast. Available from: http://the-toast. net/2014/07/14/rise-sad-girl/ [Accessed 26 July 2016].

114  Sad Girls growinggirl, 2015. ate colleen [online]. Tumblr. Available from: http://growinggirl.tumblr. com/post/115163878244 [Accessed 21 July 2016]. Harris, I.M. and Roberts, L.M., 2013. Exploring the Use and Effects of Deliberate SelfHarm Websites: An Internet-Based Study. Journal of Medical Internet Research, 15 (12), e285. Hawton, K., Rodham, K., Evans, E., and Weatherall, R., 2002. Deliberate Self Harm in Adolescents: Self Report Survey in Schools in England. BMJ, 325, 1207–1211. Hines, A., 2015. A Taxonomy of the Sad Girl [online]. i-D. Available from: https://i-d.vice. com/en_gb/article/a-taxonomy-of-the-sad-girl [Accessed 9 Feb 2017]. Jennings, R., 2016. Wearing Your Emotions on Your Sleeve [online]. Racked. Available from: www.racked.com/2016/7/1/11956536/sad-girl-fashion [Accessed 26 July 2016]. Kapur, N., Cooper, J., Hiroeh, U., May, C., Appleby, L., and House, A., 2004. Emergency Department Management and Outcome for Self-Poisoning: A Cohort Study. General Hospital Psychiatry, 26 (1), 36–41. Lehman, K.M., 2013. Assuaging the Dark Gods: Non-Suicidal Self-Injury and the Symbolism of Sacrifice and Redemption. Master of Arts in Counseling Psychology. Pacifica Graduate Institute. Martinez, R., 2015. Audrey Wollen On Art, Sadness & Internet Girl Culture [online]. Oyster. Available from: www.oystermag.com/audrey-wollen-on-art-sadness-internet-girl-culture [Accessed 27 July 2016]. Moutot, D., 2012. Webcam Tears – About [online]. Webcam Tears. Available from: http://web camtears.tumblr.com/about [Accessed 22 July 2016]. Neave, K., 2015. The Coven: Practical Magick [online]. Dazed. Available from: www.dazed digital.com/artsandculture/article/25682/1/the-coven-practical-magick [Accessed 3 Aug 2016]. okaywork, 2015. White Art [online]. Tumblr. Available from: http://okaywork.co.vu/ post/88530576098/white-art. Pelly, L., 2014. The Sad Girls of Twitter [online]. The Media. Available from: www.fvckthe media.com/issue28/the-sad-girls [Accessed 27 July 2016]. Roca Payne, S., 2016. Social Media as a Coping Mechanism [online]. Hooligan. Available from: www.hooliganmagazine.com/blog/2016/3/12/y2fzvkimpwhkteqkbysrhoo5vjnz4x [Accessed 4 July 2016]. Sad Girls Guide, 2015. About [online]. Sad Girls Guide. Available from: http://sadgirlsguide. com/about/ [Accessed 27 July 2016]. Salek, Y., 2014a. Lana Del Rey’s Take On Feminism Isn’t Wrong [online]. Cultist. Available from: www.cultistzine.com/2014/06/05/bra-burning-lana-del-reys-take-on-femi nism-isnt-wrong/ [Accessed 27 July 2016]. Salek, Y., 2014b. Audrey Wollen on Sad Girl Theory [online]. Cultist. Available from: www. cultistzine.com/2014/06/19/cult-talk-audrey-wollen-on-sad-girl-theory/ [Accessed 22 July 2016]. Seko,Y. and Lewis, S.P., 2016. The Self – Harmed,Visualized, and Reblogged: Remaking of Self-Injury Narratives on Tumblr. New Media & Society, 1–19. Shugerman, E., 2014. Lana Del Rey: Not a Feminist [online]. Ms Magazine. Available from: http://msmagazine.com/blog/2014/06/12/lana-del-rey-not-a-feminist/ [Accessed 27 July 2016]. Simpson, L., 2012. Lana Del Rey Used Music to Make Friends [online]. Digital Spy. Available from: www.digitalspy.com/music/news/a362711/lana-del-rey-hoped-music-industrywould-make-her-more-friends/ [Accessed 12 Dec 2016].

Sad Girls 115 Sisley, D., 2015. What the Hell Is an ‘art hoe’? [online]. Dazed. Available from: www.dazed digital.com/artsandculture/article/25862/1/the-new-art-movement-empowering-poc [Accessed 3 Aug 2016]. Sloan McLeod, S., 2013. On Tumblr’s Romanticization of Depression [online]. Available from: http://astrorice.com/romanticization-of-depression/ [Accessed 3 Feb 2014]. Sternudd, H.T. and Johansson, A., 2015. Iconography of Suffering in Social Media: Images of Sitting Girls. In: R.E. Anderson, ed. World suffering and quality of life. The Netherlands, 341–355. Strobbe, E., 2015. Why Modern Feminism Needs to Embrace Sadness [online]. Odyssey. Available from: www.theodysseyonline.com/modern-feminism-embrace-sadness [Accessed 22 July 2016]. Tongco, T., 2015. Meet Audrey Wollen, the Feminist Art Star Staging a Revolution on Instagram [online]. The Huffington Post. Available from: www.huffingtonpost.com.au/entry/ audrey-wollen-the-feminist-art-star-staging-a-revolution-on-instagram_us_5660dddde4 b079b2818e0993?section=australia [Accessed 27 July 2016]. Tumblr girl, 2017. Dictionary.com. Tunnicliffe, A., 2015. Audrey Wollen on the Power of Sadness [online]. Nylon. Available from: www.nylon.com/articles/audrey-wollen-sad-girl-theory [Accessed 27 July 2016]. Vigier, C., 2012. The Meaning of Lana Del Ray: Pop Culture, Feminism and the Choices Facing Young Women Today. Zeteo:The Journal of Interdisciplinary Writing, 1–16. Watson, L., 2015. How Girls Are Finding Empowerment Through Being Sad Online [online]. Dazed. Available from: www.dazeddigital.com/photography/article/28463/1/ girls-are-finding-empowerment-through-internet-sadness [Accessed 21 July 2016]. Wollen, A., 2014a. Born Crying [online]. Instagram. Available from: www.instagram.com/p/ klh1ggMzWD/ [Accessed 27 July 2016]. Wollen, A., 2014b. The Sad Girl [online]. Instagram. Available from: www.instagram.com/p/ oeNBzcMzTa/ [Accessed 13 Feb 2017]. Wollen, A., 2015a. A PSA Brought to U By Ur Local Chapter of Female Nothingness [online]. Instagram. Available from: www.instagram.com/p/830V1EszbT/ [Accessed 27 July 2016]. Wollen, A., 2015b. Yesterday We Sent a Woman to Jail for Having a Miscarriage and Then Seeking Medical Help [online]. Instagram. Available from: www.instagram.com/ p/06QFtyszfg/ [Accessed 27 July 2016]. Zoladz, L., 2014. Pretty When You Cry [online]. Pitchfork. Available from: http://pitchfork. com/features/ordinary-machines/9440-pretty-when-you-cry/ [Accessed 21 July 2016].

Chapter 4

Suggestions for clinical practitioners Suggestions for clinical practitionersSuggestions for clinical practitioners

Developing tools for managing visually oriented self-harmers

The internet has an increasingly powerful role to play in the discussion – and even dissemination – of self-harm, disordered eating, and suicidal ideation. It has also led to the rise of the aesthetics of self-harm, causing many people to revel in the beauty of their wounds, bruises, or emaciation. While individuals in the past may have enjoyed the look or feel of their self-inflicted injuries, this appreciation is now happening en masse.This growing fascination with the selfharm aesthetic is not necessarily reflected in clinical practice, as it is both new and obscure. In this chapter, I propose some practical responses that take into account the neglected aspects of visual rhetoric in the self-harm process, and consider ways in which pre-existing online communities can be used in a constructive manner. Because self-harm is a very complex issue and its sufferers are so varied, there will never be a clear answer to suit them all. Nevertheless, there are still a range of new tools that can be considered in professional practice. A major part of what the internet offers to self-harmers is a sense of community. Online community has a large role to play in the expression of negative affect. Communities encourage their members to respond differently to pain. Some encourage them to dwell on it and cultivate unhappiness; others provide a safe space to analyse bad feelings and work through them constructively. In this chapter, I summarise the various ways in which the internet can be a positive or negative force for healing. Rather than simply fearing the impact of dangerous communities like pro-ana cults, we also need to appreciate the fact that online social networks can help vulnerable people to feel more loved, respected, and connected than they do in their immediate offline social sphere. Communities can model illness, or they can model recovery. Rather than the impossible task of banning self-harmers from the online world, it is possible to offer them educated guidance that can help them differentiate help from harm. When this happens, the huge benefits of online communities open up. They become a space where a need for the expression of darkness is respected, and a space where stereotypes of suffering – such as the ‘delicate self-mutilator’ can be critiqued and expanded on. The internet can be a sinister force that negatives clinical treatment and stands against medical advice, or it can be something genuinely helpful and a real path to recovery and healthy, authentic expression. This chapter shows how the latter can be cultivated.

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Community and self-harm Self-harmers often change their approach and re-evaluate their choices when faced with new communities, friends, and situations. This could mean rejecting self-harm because their associates look upon it in a negative way, or escalating their behaviour because it wins them attention or praise. Consequently, if people’s lifestyles and associates change, then their self-harm behaviours are likely to change as well. Turner et al. found that the negative emotional, physical, and social consequences of self-harm are a major motivating factor to stop (2014, p. 83). This change tends to occur if people actively resolves to change their life for the better and focus on bodily health or become aware of the negative emotional consequences of self-harm for themselves or for their loved ones. This is because such conceptual changes lead to new “psychological and social constructs”, which are the keys to better coping skills and new behavioural adaptations (Turner et al. 2014, p. 93). In the Han et al. study, which explores recovery from suicidal ideation, many of the participants outline new ways of engaging with the world that they discovered in the process of their recovery. After surviving a suicide attempt, several participants came to the realisation that they would never change their parents or their family dynamics. Instead, they now aimed to change themselves in order to seek contentment. This constructive change involves techniques such as ignoring unfair expectations, valuing one’s own emotions and interests above family pressures, and being braver in terms of expressing one’s true nature and passions (2014, p. 93). It is also ideal if family and friends can assist with these changes. Recovery tends to occur when people are supported in making changes that suit their needs, for example, when bullied children are allowed to change schools or when isolated seniors are helped to reconnect with community (Gupta et al. 1987, p. 47). I believe that these techniques work because for many sufferers, self-harm is a lifestyle. Many self-harmers see it as a personal choice, and as one option (of many) which they favour as the best way to express and deal with emotion (see, e.g., Adler and Adler 2011, p. 178ff). In the following, I outline some major ways in which people have given up self-harm lifestyles in response to the behaviour of their family, friends, and community. Fear of social rejection

The majority of people who self-harm do confide in someone, and the Heath study indicates that they are most likely to tell their friends (Heath et al. 2009, p. 182). If their friends do not like this behaviour, people are likely to stop and choose other communication styles instead. For example, In the Buser and Pitchko study, one participant expected that her friends would be impressed by her self-harm and take her seriously as a result. In reality, her friends were surprised and judgemental. This made her re-evaluate her approach and her style of communication with her peers. Another stopped self-harming when a valued friend threatened to ignore him if he ever hurt himself again (2014, p.

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441). An interviewee in the Alders’ study stopped cutting herself for a similar reason. Her best friend told her that she would stop speaking to her if she ever cut herself again. This made her realise that she was hurting someone very important, which became a very powerful motivator for change (2011, p. 191). Similarly, one of Bine’s interviewees left self-harm Tumblr communities after her ‘real-life’ friends convinced her to stop doing “mildly masochistic” things to her body such as going hungry in response to the eating disorder blog PrettyThin. She now uses Tumblr to search for positive, inspirational images that are more in line with what her offline friends value (Bine 2013). All these threats of social rejection had a powerful impact in the short term, but it seems possible that these people would harm themselves again if they were presented with different friends who were more supportive of self-harm and this style of online communication. Indeed, even the researchers involved harboured suspicions that some of the participants had not fully recovered and might start again soon (Buser and Pitchko 2014, p. 441). A few of the Adler’s interviewees who said they had stopped cutting for their spouses also made it clear that they would immediately start again if they ever got divorced. The likelihood of this was echoed in the words of another woman they interviewed who explained that stopping for other people is really just postposing the inevitable. Instead, she argues, you have to stop for yourself if you wish to see lasting change (2011, p. 191). Lifestyle changes

If people move into a new lifestyle, for example, if they leave home for tertiary studies, then this becomes a good opportunity to case self-harming. In the Buser and Pitchko study, one woman was encouraged by a close friend to embrace healthy choices, which they would enact together. For example, the two friends would go on long walks to relieve stress (2014, p. 441). Even more impactful were substantial lifestyle changes that involved totally new surroundings, responsibilities, or people. A third of the participants in this study reported that they had stopped self-harming when they left their family homes and old neighbourhoods and moved away to college. This allowed them to escape from stresses in their old lives, such as tense relationships with their family, bad friends, or a lack of agency. These participants ceased self-harm when they were able to have control of their lives, finances, and surroundings. Many also enjoyed how calm and peaceful their lives were without having to mediate in family disputes or socialise with aggressive or unpredictable childhood friends (2014, p. 442). Adler and Adler came to similar conclusions based on their interviews. Many informants ‘grew out’ of their self-harm in their 20s – partially in response to conventional online wisdom that this was a natural end point to behaviour that was more appropriate for impulsive teens. Their 20s were also a time during which their lifestyles started to change; many of them made positive life choices and moved

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away from bad family dynamics. Some learned to express their anger without turning it inwards, and others took up healthy activities like competitive cycling, ballet, and soccer (2011, pp. 184–185).1 Loving attachment

The Han study recommends the development of “loving attachments” to people or community groups that provide a sense of support. In this category, they include mentors, family members, pets, and protective environments. Some participants explained that they had recovered from their suicidal ideation because they were able to engage with good-quality psychiatrists or counsellors who gave them productive support. Others gained support and comradery from close friends who showed them love, listened to their problems, and gave them practical advice. Some learned to focus on their family and to remind themselves that they were loved and should not hurt the people who cared for them the most. Others who felt rejected by their parents or their partners gained a similar sense of love from their pets. One woman explained that her cat saved her by licking away her tears and loving her unconditionally. In addition to these important people and animals, a protective environment is also needed. By this, Han et al. mean a place where those who are at risk of suicide or self-harm can be insulated from the external pressures that cause them to react in this way. This might mean protecting them from bullies or ensuring that they were kept safe from damaging external pressures and expectations until they had a chance to recover and improve their abilities for healthy emotional regulation (2014, pp. 93–94). So from these interviews, we can see the importance of both kind people (and pets) plus broader supportive environments.

Benefits of online communities A major question that readers of this book may be asking is whether self-harm websites should be encouraged, tolerated, or discouraged amongst patients or those at risk.This is a very complex question and should be evaluated on a caseby-case basis after discussion with a patient. For some users, online communities can be a constructive and friendly environment that encourages healing and connectivity. For others, they can inspire competitiveness and be used as an inspirational encyclopaedia of new injurious behaviour. There is no singular lifestyle or set of actions that is espoused across all sites, meaning that positive outcomes are just as likely as an increase in damaging behaviours. But despite this risk, censoring self-harm sites is not the best approach. Instead, it is more constructive to be honest about the appeal of these sites and why they can be more intimate and supportive environments than the therapeutic relationship offered by medical professionals. By being aware of their persuasive qualities, self-harmers can be guided towards expressing their negative feelings in

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healthier and more productive ways. They can also develop healthy attachment relationships, social acceptance, and positive lifestyle changes. Professionally run mental health websites

Professional websites about mental health issues have been available since the early days of the internet.These sites are put together by people who are trained in issues like self-harm and eating disorders, and offer information to those suffering from this behaviour, their families, and their friends. Professionally run self-harm websites like S.A.F.E. Alternatives are distinguishable from peer-run sites because they provide informational resources, clearly delineate NSSI from suicidal behaviour and avoid any visual or graphic representations of self-harm (Duggan et al. 2012, p. 62). A peer-run site is more likely to conflate NSSI, suicidal ideation, and disordered eating – thus giving less focus to Diagnostic and Statistical Manual of Mental Disorders (DSM) definitions. Such a site is also more likely to advocate self-harm, although many are run as support networks for those who wish to recover. Talking about self-harm

One of the appealing factors about self-harm discussions in peer-run communities is the opportunity for people to talk about their feelings and impulses. To some critics, this kind of discussion may seem problematic. Yet, we know that talking about harmful behaviour amongst high-risk groups helps. Shared jokes and stories about suicidal impulses and self-harm can be a powerful factor in reducing loneliness and opening up discussions that lead to better outcomes for the people involved. In the offline world, this can be seen in action when looking at the discourse of female factory workers within Sri Lanka who frequently discuss their desire to kill themselves.They often share metaphorical and imaginative stories about suicide with each other during the course of their day (Hewamanne 2010). Yet this seems to lower the rates of actual suicide activity amongst this group.Widger explains that the shift towards a symbolic discussion of suicidal behaviour is actually a way of avoiding suicide because it allows the female factory workers to respond to stress and redress negative events in their lives without actually harming themselves (2014, p. 806). The suicide threats and gestures that have made their way into factory floor culture have made suicidal acts less relevant and compelling for the women involved. Thus, we should not assume that vivid discussions about harmful behaviour are always destructive and dangerous for those concerned. Sometimes these discussions are the only way to purge tensions or speak honestly about deviant compulsions. Discussing self-harm online is also a great way of connecting with other people in order to feel less alone. Social and geographical isolation are known risk factors for self-harm (McCleave and Latham 1998, p. 14). If people are able to make connections with new friends who understand their behaviour, they

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may be more willing to cease it in the future. While this may seem counterintuitive, there is evidence to show to genuine friendship has been key to many recoveries. The Harris and Roberts study revealed many positive aspects of self-harm forums, including a sense of connectivity as a result of the friendships and support networks developed online. Their informants frequently described self-harm as a lonely and isolating act. Many were able to offset these feelings by sharing them with those who were suffering in a similar way (Harris and Roberts 2013, p. e285). For website users, this sphere can become the only place to express their authentic self (Peebles et al. 2012, p. s62). Because of this, feelings of intimacy build quickly, and participants often describe feeling deeply accepted in online communities and nowhere else. Help and advice can be received quickly, and deep trust is commonplace (Adler and Adler 2011, pp. 146–147). Self-harm communities allow for self-disclosure of sensitive information, which is received and reciprocated by people who are likely to empathise and provide similar disclosures of their own. In the Peebles study, many of the users surveyed claimed that they felt “like a freak” and were generally isolated. Several noted that they had no social support beyond pro-ED websites, and many described their friends and family as distant or unable to understand them (Peebles et al. 2012, p. s62). Feeling more connected to other people leads to strong bonds and close, meaningful interpersonal relationships. This communication style also allows for ‘masspersonal’ communication – the broadcasting of intimate self-disclosures to large numbers of like-minded people. Thus empathetic reciprocation can happen on a substantial scale, which is highly uncommon in offline communication (Tong et al. 2013, pp. 410–411). Masspersonal communication also tends to be international, meaning that there is always someone awake to talk to. One of the Adlers’ American informants explained how she never felt alone, despite bouts of insomnia, because self-harmers in Australia and New Zealand would be awake and talking to her on one of the community message boards every time she was unable to sleep (2011, p. 113). Sites like Tumblr are excellent for this kind of mass-sharing and acceptance. Plastic Pony explains that Tumblr is a place where you can post almost anything – no matter how dark or embarrassing it might be. She describes the Tumblr community as “A LOT more forgiving than every other website I can think of, and of course, real life”. As such, she feels the freedom to express herself honestly without stigma. She also gains genuine happiness from people looking at her Tumblr and liking it, as her Tumblr is a reflection of her true mind. For this reason, she feels that “[i]f I can be accepted on Tumblr, maybe I can also accept myself ” (Plastic Pony in Eler and Durbin 2013). This possibility of true acceptance is deeply appealing for those who struggle to find support from those around them in their everyday lives. Online spaces can be a useful place to practice relationship-building and social interaction skills. Many users of these sites see them as a place to retreat to when life is difficult or when socialisation seems impossible. They then become a zone where people

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can recover, find acceptance, then feel buoyed and ready to engage with their offline lives and relationships again (Adler and Adler 2011, p. 160). The Harris and Roberts study found that 65.6% of users visited self-harm sites at least twice per week. The majority of participants used these sites as a source of information (78.2%), with many also enjoying the presence of forums as a place to chat (68.4%). Benefits indicated by these participants include a sense of help and support and a reduction in feelings of isolation. When asked to evaluate the impact of these websites, many participants were able to list a variety of positive psychological effects including better self-esteem, reduced isolation, and improved coping mechanisms because of these connections and friendships. One participant praised the websites for helping her to “realize how much others do care,” whilst another felt that self-harm forums “allowed me to feel I belonged somewhere, and have the social interaction that I was desperate for” (Harris and Roberts 2013, p. e285). Considering the prevalence of selfharm in bullied and isolated adolescents, this may have been the first time that many participants were able to feel valued, wanted, or included in a social circle. Sharing ideas and experiences by blogging to an understanding audience has also been proved to have positive effects. Many pro-ED bloggers describe the process of writing about their feelings as massively cathartic. The blogging process helps to release them from their anxieties, view their situation more objectively, and receive helpful advice from people who empathise. These same feelings were shared by community members in recovery who felt that the people who read their blogs were happy to support both unhealthy eating and efforts made in the move towards a healthier lifestyle. Whether positive or negative, blogs are a space to share thoughts, release tension, and connect with readers who can truly understand the struggle (Yeshua-Katz and Martins 2013, p. 504). This makes them a valuable resource. Tong et al. believe that individual blogs help support the pro-ED community as a whole. When authors cathartically express their personal stories, anxieties, or relationship issues, they can receive caring support from people who empathise with them – especially with issues pertaining to sensitive and divisive topics like eating disorders. At the same time, friendships can be validated by a sense of shared feelings and experiences (2013, p. 419). Communicating with other people in such a deep and meaningful manner can actually be a good way of distracting oneself from an impulse to self-harm, starve, or purge. A 30-year-old woman interviewed as part of the Harris and Roberts study described online forums as “good distractions from self-harm thoughts, and games especially are helpful with that” (2013, p. e285). By playing with each other, people at risk of self-harm can soothe themselves and build positive friendships. All these benefits can be part of the path to recovery. Turner et al. found that people who stop engaging in NSSI tend to do so because they gain a strong sense of social support, have increased feelings of hope, and feel more of a reason to live. Recovery comes through better coping skills for dealing with unwanted problems and emotions (Turner et al. 2014, p. 83). Talking to other people can also help self-harmers reflect on the true nature of their behaviour.

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For many self-harmers interviewed by the Adlers, deeply engaging in online communities was the point at which they realised that they had a long-term, ongoing problem as opposed to a private, eccentric, but ultimately controllable stress-relief method (2013, p. 30). This developing self-awareness and acknowledgement of the severity of their actions led many to admit that they had a problem and to start to consider what the ramifications of that problem might be. For many, this was the first step towards their recovery. Harris and Roberts interviewed an 18-year-old woman who explained that the websites she visited reduced my self-harm – I’ve learned other ways to cope, and these websites have taught me to think rationally about what I’m doing to myself. They’ve given me a new perspective on my self-injury, to view it as a coping mechanism and something I need help for. (Harris and Roberts 2013, p. e285) Although the websites she engaged with may have contained active selfharmers, this did not normalise the behaviour. Instead, many of the Harris and Roberts informants found useful coping techniques espoused on the forums they frequented. One describes the website she uses as a place of support for daily problems and a place to express feelings. She notes that the website “keeps me focused on recovery, placing importance on good mental health strategies.” As a result of these positive coping strategies, 40% of participants reported that they have experienced a decrease in self-harm, with many stopping altogether. Although not everyone interviewed had stopped, several indicated a feeling that recovery was possible after engaging with positive role models and success stories shared online (Harris and Roberts 2013, p. e825). Even after recovery, many people still frequent self-harm communities and comment on self-harm blogs in order to help themselves by helping others. As Adler and Adler note, former self-harmers visit active self-harm communities so that they can assist others with open-minded and empathetic advice. In doing so, they often strengthen their own resolve to stay away from this behaviour or give meaning to their lives when they feel a lack of value or purpose (Adler and Adler 2011, p. 132). Similarly, in the Harris and Roberts study, some participants noted that they no longer self-harmed but still frequented self-harm forums in order to help others by sharing experiences and tips for recovery. One woman explained that the forums had once helped her by providing advice that she felt unable to ask for in person. Despite identifying as a recovered self-harmer, she continues to use the site “because I like to give back and give advice to those who post threads and are struggling just as I used to” (2013, p. e285). The Adlers see this as a common part of self-help communities more broadly, citing examples of ex-alcoholics gaining professional certification and helping others to gain sobriety through organisations like Alcoholics Anonymous. This process allows the reformed addicts to capitalise on their former deviance and to simultaneously reinforce their abstinence by helping others to attain this goal (2013, p. 30). For members of the online self-harm

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community, reformed harmers can be a supportive presence who can be relied on to genuinely understand and empathise with the temptation. This is a solid indication of a thriving and altruistic community in which advice and support from former harmers are treasured. For people without community support, the long-term prognosis is dire. Turner et al. also offer a list of reasons why people do not recover from NSSI. Individuals can easily become entrenched in a mind-set where they cope with emotion in dysfunctional ways, feel hopeless about ever recovering, and get stuck in long-term self-harm patterns. Many people fall into this mind-set because they are afraid that their self-harm will be discovered and that they will be stigmatised as a result. They also tend to fear disappointing others by disclosing what they have done and being further ostracised as a result. Repeated experiences of stigma, rejection, and disappointment are common amongst those with more severe cases of NSSI. Finding support groups who can empathise is a way of avoiding this outright rejection of self-harm and those who take part in it. Without the help of positive role models who have recovered, many self-harmers believe that their addiction to this behaviour will only grow. They also tend to feel that the only reaction they will get from disclosing their behaviour to other people is horror or stigmatisation (Turner et al. 2014, p. 83). Although talking about self-harm with other people who understand and empathise does have the potential to encourage this behaviour, it also seems to be one of the few ways to help a person recover. We know that one of the rare ways recovery can happen is through seeing self-harm behaviour in a more realistic context and working through difficult issues with friends who care and understand. For this reason, cutting off self-harmers from an empathetic community base is a very bad idea. Better than therapy?

Many self-harmers describe talking to other people online as better for them than therapy and counselling programs. This deep friendship and empathetic connection with other self-harmers is something that therapeutic relationships with doctors cannot provide. Traditional therapy, although clinically useful, can sometimes cause stress to patients who feel as though their doctors are somehow ‘missing the point’ of their struggles. This is expressed evocatively be Podvoll, who explains some of the problems that clinicians run into when they focus on the anxieties and impulses that lead to self-harm rather than any individual injury that a patient might show to them. Although this is best practice and helps to treat the cause rather than the symptoms, it can lead patients to feel that even a severe self-injury “is still not enough to affect or move other people”. He recalls, A self-mutilating patient of mine once said, ‘If I came through your office door covered with blood and still bleeding, you’d probably just sit there and ask me what I was thinking about before I cut’. (Podvoll 1969, p. 215)

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Although this paper was written many decades ago, these problems are not yet resolved in newer therapeutic methods. In the Peebles survey of pro-ED sites, the researchers uncovered a very negative image of physicians and therapists. Users described their experience with “faceless doctors” and complained that their health care providers “did not understand them and imparted messages in a non-empathetic way without trying to connect” (Peebles et al. 2012, p. s62). Although there is value in keeping calm and trying to avoid an emotional reaction to patients’ wounds, this can often frustrate patients and make them feel as though the strength of their anguish is ignored. Conversely, talking to other self-harmers online who appreciate their wounds and what these injuries seek to communicate can be an appealing way of gaining much-needed sympathy or evoking the desired horror at their condition. There is also an important sense of immediacy in online communities, which allows for emotions to be discussed and exorcised at an appropriate moment. This immediacy is not always available in clinical treatments. Considering the impulsivity associated with self-harm behaviours, it is likely that patients will not always be in a dangerous mental state when treatment is made available for them. Filling this void, online self-harm groups are ever present and easily accessible. This dilemma is summed up by a popular Tumblr post from 2014 where a mentally ill patient sums up some of the problems of waiting for a doctor’s appointment.When her appointment with her therapist is weeks away, she finds herself “suffering severely, mentally and physically . . . ready to speak out about the agony i go through everyday, have the courage to ask for help”.When her appointment rolls around, she is generally in a good mood, feels happy and finds it hard to remember what she even wanted to say (bakura 2014). This means she misses out on expressing the severity of her condition, possibly leading to a misdiagnosis or a lack of appropriate support. This issue of timing is hugely important. This is an area that is not often researched, but it does come up in the work of Adler and Adler, who asked their subjects to explain what time of day they cut and why. Most selected the evening, generally because they started the day feeling positive but ended it with a sense of anger or frustration. Some were very busy and distracted during work or school, which stopped them reflecting too much on bad feelings until the quiet of the evening. Obsessive thoughts did not start looping in their minds until then. Others selected the evening because this was usually a time where they were left alone in their bedrooms and could predict when family members were unlikely to interrupt them. Some had trouble sleeping and would cut to calm themselves down or to fill in the time. For many, self-harm simply became part of their evening routine (Adler and Adler 2011, pp. 78–79). Thus, in the daytime when most self-harm counselling services are available, many prospective patients feel well and in control or too busy to properly process their pain. They are most prone to intrusive thoughts and dangerous behaviours outside of typical consultation hours. Because online communities have no closing hours, they are often what people will seek when alone in their bedrooms at night and in need of help or companionship.

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Websites that play the role of therapist are not necessarily as dangerous and destructive as a trained professional in this field might imagine. Many websites contain a medicalised discourse on self-harm, which may often be complimentary to psychiatric treatments and open up a dialogue between participants and mental health professionals. This is a good starting point for people who are scared to talk about their problems face-to-face or who are uncertain whether their behaviour and impulses are serious enough to need professional attention. Many self-harmers feel embarrassed or cautious about reporting their behaviour, which can mean they miss out on helpful treatment or fail to realise that they may need and deserve help. As Whitlock et al. note, many self-harmers express guilt for burdening others with their problems or frequently apologise for sharing their thoughts and actions online (2006, p. 413). A good, safe space online can allow freedom from such negative perceptions and teach users that their feelings are neither humiliating nor invalid. Online resources are a good way of minimising a sense of embarrassment associated with the disclosure of self-harm. In the McManus and Bebbington study of English households, self-harmers were far more likely to disclose their behaviour when they entered answers into a computer survey as opposed to when they answered the same questions in a face-to-face discussion (2009, p. 73).This embarrassment seems especially powerful for children, who often miss out on proper diagnosis and treatment as a result. Interestingly, the Stallard et al. study revealed that many parents support the anonymity afforded by online spaces as it allows their children to explore and discuss their mental health issues without feeling awkward or embarrassed about addressing them with people who they know (2010, p. 82). Children who might struggle with full disclosure to their parents or a health care professional are more likely to be open and honest when they are not obliged to look a person in the eyes. While a child in this position will probably need to start face-to-face treatment, online resources can help them to process their initial fears and develop a sense of trust. Online spaces are also immensely important for members of marginalised communities who may not feel as though their therapist fully appreciates the pressures they are under or the discrimination they face on a daily basis. For example, transgender youth are often isolated from gender-affirming mental health services, which could help address the high rates of self-harm amongst this group if they were provided (Reisner et al. 2015, p. 278). By talking about their issues with other transgender self-harmers online, or sympathetic professionals with experience in gender issues, they can find an audience who empathises with the additional pressures that this identity brings. The internet is a good space for finding resources and support with regard to stigmatised topics such as self-harm and sexuality. This can be especially beneficial for marginalised youth who may be uncomfortable looking for this kind of support in their everyday lives (Whitlock et al. 2006, p. 408). For example, the ‘Transgender Teen Survival Guide’ is a Tumblr devoted to helping young trans people and their families with specific advice. Some

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of this advice pertains to self-harm scenarios that are unique to the trans community. For example, one reader wrote in to explain that he uses his binder (a garment to flatten breasts) as a form of self-harm and as a replacement for cutting (Transgender Teen Survival Guide 2014). Others have asked if hospitals allow long-sleeved shirts during surgery to hide embarrassing unbound chests and self-harm scars (Transgender Teen Survival Guide 2016), or have sought out tools for stopping the painful misgendering that triggers them to hurt themselves (Transgender Teen Survival Guide 2015). Only people who appreciate the deep anxiety evoked by unwanted sexual characteristics, or the pain of misgendering, can give the empathetic responses that these teenagers require. To dismiss the need of a person to wear a binder in the hospital is to greatly decrease the likelihood of him or her seeking treatment at all. Obviously online resources are not a replacement for professional, face-toface mental health treatment. There is no guarantee that an online self-harm community will be run by people who are qualified in this field or that the material it contains will be constructive and up to date. Nevertheless, these communities can be very important companions to therapy or can motivate users to seek help and feel more confident describing their symptoms to doctors and taking the first steps towards getting help.Talking to other self-harmers or sympathetic online strangers can be a good way of gaining sympathy and support in the exact moment when it is most needed. Professionals cannot always participate in the deep emotive relationships that their clients crave and are not always there when a true crisis hits. Many self-harmers do not even seek medical help because they are too embarrassed or worried that they are being a burden on others. For them, an online community can be an important first step in realising that they have a valid problem and learning how it might be addressed if they were to share their symptoms with a doctor.

Risks of online communities In addition to these clear benefits, it is also important to respect the risks of online self-harm communities. Professionally run self-harm websites have a consistent message about the dangers of the behaviour and the necessity of seeking help. As such, there is nothing about them that poses a serious risk for users. Instead, risk lies with online communities that are peer-driven and unsupervised by medical professionals.This risk is substantial because these peer-run sites tend to be far more appealing and persuasive. Their informal, triggering content is accessed more often than professional sites (Duggan et al. 2012, p. 56). For example, when comparing pro-ana sites versus pro-recovery sites and professional online resources, the former are consistently the most popular. Proana sites are flourishing. They are better organised, have more comprehensive content, and are more numerous than recovery sites or professional services (Chesley et al. 2003, p. 124). If people are looking for self-harm content, they

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are likely to find a variety of websites and online communities that contain problematic content and risky advice of various kinds. Triggering content

Many people visit self-harm websites in order to find triggering stimuli. In psychiatric literature, it is understood that trauma – and subsequent reminders of that trauma – can trigger an unpleasant nervous system response such as hyperarousal. This can be seen in sufferers of post-traumatic stress disorder (PTSD) and in victims of chronic interpersonal trauma (van der Kolk et al. 2005, p. 389).This idea of ‘triggering’ content has been taken up within more colloquial online discourses. Many people use online ‘trigger warnings’ to censor difficult content, but, importantly, triggering content is not always unwanted. Many people actively seek it out, often looking for images of self-harm or narratives about the self-harm experience in order to strengthen their resolve and increase their temptation to cut. Harris and Roberts found that about 10% of their participants used selfharm websites as a way of finding triggering material (text and images) to increase the severity of their impulses or to add to their inventory of damaging acts. This allowed for the experiences of other people to worsen their own condition. A 19-year-old female in this study confessed, “I wanted triggering. That sounds weird but I felt the harm I was doing was not bad enough and I needed to make it worse” (Harris and Roberts 2013, p. e285). Because many of pro-self-harm websites contain very graphic and detailed texts – both visual and verbal – they can easily function as sources of inspiration if viewers wish to learn new ways of hurting themselves. Self-harmers often share explicit tips and techniques online, such as outlining the difference between Stanley blades and box cutters and explaining how to use tourniquets to change the rate of blood flow from a wound (Whitlock et al. 2006, p. 412). Many sites also contain detailed narratives from people who have been through harrowing journeys of self-harm and disordered eating. These stories are usually presented as material to aide others in their recovery.Yet Boyd et al. have noted that they are also very popular in anti-recovery communities. Many people use stories and pictures from people who have been very ill and have now prioritised health in order to explore what severe cuts, starvation, and so on look and feel like. This is so the initial severity of their illness can be imitated, not the recovery (Boyd et al. 2011, p. 25). Competitive behaviours

Similarly, the Adlers argue that many self-harm sites are competitive and reinforce the need to cut. This is especially common on sites where people share vivid images and use visceral language to showcase their self-harm (such as photos of blood dripping on their keyboards). One of their informants likened

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this material to a commercial that reminded them of their urges. Others cut or injured more because they felt as though it was the rule for being part of the group (Adler and Adler 2011, p. 164). Just fewer a third of users surveyed by Harris and Roberts felt that self-harm websites encouraged them to increase their injurious activities. Increased severity and frequency, and new ways of harming were common experiences. A sense of competitiveness was also expressed by many of the users, trigged in particular by images of injuries and scars. A 19-year-old woman explained to the researchers, “I see other’s scars, look at my own and think ‘I’m not like them, I’m not ill’ and it makes the whole situation worse” (Harris and Roberts 2013, p. e285). By having these inaccurate benchmarks for ‘genuine’ sickness, many people who need clinical help feel as though they are not ill or damaged enough to deserve it. While many communities ban any competitive discussion, it is very easy to find groups that encourage it. Adler and Adler stumbled across many instances in which unmoderated forums degenerated into a meritocracy based on the severity of damage inflicted. One example they give is a forum without an official creator/moderator in which a young girl posted photos of cuts under her breasts as a result of the despair she felt over her boyfriend breaking up with her. The responses on the site were fairly disparaging, with some users claiming that cuts under the breast tissue do not hurt very much and others criticising how shallow the cuts were and asking if she really used a razor to make them as she had claimed (Adler and Adler 2013, p. 24). The girl’s response to this criticism was not logged, but it is fairly easy to predict. She would need to either impress the community members by cutting in sensitive places more deeply or accept that she would not be receiving care or support from the other sufferers because of her apparently lacklustre efforts. Competition on such forums can lead to a sense of failure, inadequacy, or group rejection. Feeling rejected by self-harm communities can have very damaging consequences. Harris and Roberts noted that many subjects who experienced negative moods and opinions because of online community use felt this way because they were shunned by other users or because they were left with a sense of personal inadequacy from their interactions (2013, p. e285). We also need to remember that many self-harmers are the victims of childhood maltreatment, which is likely to have created a very negative view of the self and mistrust towards others.Yates explains that negative beliefs such as these need to be challenged, and positive representations need to be fostered in order to undo some of this damage (2009, p. 130). In many communities, the opposite is happening. For example, Tumblr allows what Bell deems a “combination of naked exposure and online depersonalization,” which can quickly turn toxic (2013, p. 31). People are often asked to present their self-harm wounds or starved physiques to a panel of judgemental community members whose anonymity makes them feel free to unleash an acerbic critique. This can make a vulnerable person feel rejected from what they saw as a safe space or encourage them to hurt themselves more in order to gain acceptance.

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Some websites explicitly ban this kind of content due to an understanding of what it can trigger. When praising a positive and successful website, one of the participants interviewed by Harris and Roberts specified that “[m]oderators are watchful to make sure that people aren’t ‘comparing’ self-harm stories, and photos/images of self-harm aren’t allowed”. Many people who are trying to recover will purposefully avoid this kind of material, knowing the kind of impact it may have. One participant praised her community of choice by specifying that “it’s NOT a teenage community where we egg each other on and share tips and photos” (Harris and Roberts 2013, p. e285).This style of community is increasingly popular.The Adlers have noted that increased moderation of self-harm sites occurred after many of the major un-moderated communities spiralled out of control and were consumed by open hostility. In the wake of this implosion, groups now tend to have heavy moderation, clear statements of purpose, and rules to stop competition and unhelpful dialogues (2013, p. 25). Still, this kind of moderation does require leaders to step forward and take control of a space, which is certainly not guaranteed to occur. Self-harm lifestyles

Finally, one of the biggest dangers of online communities is their ability to support a self-harm lifestyle by suggesting that harmful behaviours and pain that cause them are permanent or by leading people to identify strongly with a label such as ‘cutter’ or ‘purger’.The Adlers and Adler note that collective group identity in these online spaces can lead to individuals developing stronger personal identities as self-injurers. In contrast, they noted that people who avoided online self-harm groups were less interested in these labels (2013, p. 28). Explaining why this might be so, the Hawton et al. study found that self-harm can be symptomatic of either “a transient period of distress” or indicate longterm mental health issues and high suicide risk (2002, p. 1211). Some intensive communities help mutate this short-term distress as a source of identity, thus diminishing its transient nature and making long-term mental health issues more probable. It is very likely that users of pro-self-harm sites have been heavily exposed to what Lewis and Baker dub ‘NSSI scripts’. They are very likely to have engaged with other people who have discussed why self-harm works for them or why it is a reasonable response to their sadness or turmoil. As such, they are likely to have picked up on ideas that reinforce their own desire to self-harm (2011, p. 390). This seems especially likely when a self-harm identity is tied to an aesthetic identity like Soft Grunge. Chapman and Dixon-Gordon noted that many of their subjects felt angry or bored before self-harm, then relief in the aftermath. They are concerned that these emotional shifts might be recalled in a positive manner if prompted, thus leading to self-harm as a standard response for the regulation of negative emotions (Chapman and Dixon-Gordon 2007, p. 549). If a person also gains positive reinforcement by creating something beautiful

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or attention-grabbing, this could further add to the feedback loop. In a survey run by Carmichael and Gillespie, non-academic internet users with an interest in Soft Grunge content, members of the public were asked for their thoughts on this aesthetic movement. Possible negative responses included “I think it romanticises depression, self harm and self hate” or “I think it turns young people into attention seekers”. More positive responses included “I think it creates a space for young people to express their pain” (Carmichael and Gillespie 2014). Unfortunately, the full results of this survey were not made public. Nevertheless, Carmichael and Gillespie suggest that there are various factors associated with Soft Grunge that can either help or harm young people at risk. On the positive side, they suggest it may be a way for young people to express their pain. Pragmatically, they also propose that prohibitions on this form of expression will “drive it underground” rather than solving the problem. Nevertheless, many of the perspectives explored in their survey are damning towards the genre. They share the view that Soft Grunge romanticises depression and self-destructive behaviours, encourages attention seeking acts, and stigmatises mental illness (Carmichael and Gillespie 2014). This mirrors the attitude of Bine who sees Tumblr as an outlet for the “glorification of self-pity,” which is detrimental to the diagnosis of ‘real’ clinical depression (2013). The suggestion here is that taking part in a Soft Grunge lifestyle is more likely to encourage a person to also adopt a persona of romantic depression. Gore’s analysis of the ‘glamourisation’ of self-harm and suicide on Tumblr and Instagram has led her to conclude that teens on these social media websites gain “an incorrect perspective of the seriousness of these disorders, as well as the desire to ‘fit in’, which is then triggering these tendencies in many suspectable [sic] users.” She argues that “it is clear that the line between a healthy, non-judgmental community of peers who understand your pain, and something much worse, have been crossed” (Gore 2014). She is certainly not alone in these accusations. Sloan McLeod is equally concerned by the impact that Soft Grunge has on vulnerable viewers. Although she concedes that some Soft Grunge fans have been diagnosed with depression or similar illnesses and feels that support is an important part of healing, she is also very critical about the real impact of this genre. She believes that this subculture “doesn’t support the ‘Sad Girls’ it idolizes, it enables them”. She argues that “[e]very time you reblog pictures of a computer screen that says ‘stupid sad girl’ or Marlboro cigarettes with sticky notes pasted on them saying ‘because you broke my heart’ ”, you are contributing to a culture that makes depression seem like a personal quirk rather than a serious mental illness (Sloan McLeod 2013). This summarises the very common criticism that sad communities enable sad cultures where people are encouraged to wallow in mental illness rather than seeking help or where healthy individuals pretend to be sick for the attention it brings. Another dangerous facet of self-harm lifestyles as supported by self-harm communities is the lack of interest in recovery. While many sites do support

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people receiving medical care, Lewis et al. are concerned that many self-harm websites lack an important “recovery-oriented message about prognosis” – instead presenting this behaviour as a justifiable way of coping with problems in life. Some sites discuss self-harm as a largely unproblematic behaviour with minimal pain, whilst others present it as a chronic and incurable disease. Either of these understandings of self-harm is dangerous as neither encourages participants to seek professional help (2012, p. e2). Indeed, anti-recovery communities often orient themselves as spaces where people can gain new insights into conditions like anorexia without the scrutiny of family members or the medical profession (Fox et al. 2005, p. 945). While there are some benefits to sharing discussions of one’s mental health with an empathetic community, many of these communities can turn anticlinical. It is easy to find tips and tricks for hiding the symptoms of self-harm and disordered eating. For example, the Chesley et al. study noted a large portion of pro-ana websites that list the diagnostic criteria for anorexia nervosa. By understanding these criteria, users are able to lie and pretend not to meet them. For example, some lists remind readers to tell their doctors that they have regular periods or encourage them to drink large amounts of water before their appointment in order to seem several pounds heavier than they are. Of the sites surveyed, 75% contained this kind of information, whilst only 5% explored troubling issues such as the mortality rates for anorexia (2003, pp. 123–124). Clinical information is not included to warn people of symptoms and consequences but, rather, to help them evade detection. Many pro-ana participants express some desire to recover but have a deep suspicion of the treatment options available to them. Online communities can foster these suspicions and reinforce the idea that medical practitioners are the enemy or that their programs are superficial and ineffective. For example, many users with eating disorders are very anxious about weight gain and feel as though treatment programs are focused on changing BMI rather than on addressing the core of one’s psychological torment. Pro-ana member ‘Taylor’ explains why she and her companions dislike in-patient programs. She claims that they “really only serve to fatten you up so that they can collect their exorbitant fees based on you ‘looking healthier’ while inside you’re still a mess” (Williams and Reid 2010, p. 563). This is a fairly common attitude in more problematic communities and can easily impact the perspectives of others. Selfharmers who share tips online are more likely to discourage disclosure of selfharm to caregivers or mental health professionals (Whitlock et al. 2006, p. 415). Many who work in this industry are categorised as doing their job just for the money and not because of a genuine desire to help their patients. This makes potential patients feel very suspicious of their aims. It also gives them moral permission to lie about symptoms and recovery, as they are misleading someone who is disingenuous to begin with (Williams and Reid 2010, p. 563). Intensive communities can also lead to a diminished perspective of risk within the group. For example, in the Peebles study, most website users noted

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dangers inherent in eating disorders but chose to minimise or ignore these risks. Many users realised that eating disorders were dangerous for their bodies and overall health, but this feeling was diminished when online and talking with people who were dismissive of health risks. Recognised dangers were diminished in this space. Peebles et al. believe that this mind-set was encouraged by the feeling that the only real connections that existed for the users were online, and the ‘real life’ was somehow less real (2012, p. s62). Much of this is achieved through niche language choice. Lyons et al. note that pro-ana websites tend to have linguistic tropes that show a sense of positivity, reduced cognitive processing, and reduced preoccupation with selfhood. They see this as a possible coping strategy through which language patterns create some degree of emotional stability that sustains the immunity of these participants against professional psychological treatment. By creating a feeling of control over their illness and suspending in-depth reflection that might force them to confront the risks they are taking, community members can avoid addressing the severity of their illness and the depth of their self-harm (2006, p. 256). Farber et al. note an interesting perception of death in patients who selfharm. Despite the fact that conditions like anorexia nervosa have a very high fatality rate, self-harmers tend to feel very low levels of anxiety towards their life-threatening behaviour and often have very underdeveloped self-care capacities. Interestingly, this is often experienced in tandem with a high level of anxiety about death and annihilation in a more abstract sense. Patients can often become preoccupied with ideas to do with being annihilated by a predator, losing one’s sense of self, being abandoned, or falling into an abyss (Farber et al. 2007, p. 290). There is less concern over more real dangers like septic wounds. This kind of preoccupation can be seen in online communities. For example, the Whitlock study found a young user who explained, I think my greatest fear is to be forgotten. A teacher I had last year doesn’t even remember my name – it makes me think that no one remembers me. How do I know I exist? At least I know I exist when I cut. (Whitlock et al. 2006, p. 407) Causing pain, especially when that pain is shared and discussed online, can help validate one’s own sense of existence and importance in a community. Gardner has noted similar feelings in her patients, who often cut or burned themselves in order to feel real or alive. She also believes that self-harm creates “fearful excitement”, which is longed for afterwards. She correlates this excitement with risk-taking behaviours and masochism. By taking part in dangerous activities or cultivating opportunities for pain, people are given a feeling of control and the sense that they can decide if they live or die. In younger patients, this can sometimes manifest in a desire to kill off the painful and unbearable parts of oneself while somehow allowing the happier parts to keep living. This autonomy in the face of death can be both exciting and unpredictable, whilst

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also giving a person a much-desired sense of control (Gardner 2002, p. 26).This cocktail of emotions can lead to communities where members lack a realistic perspective on death and danger and in which they reaffirm autonomy or existence through risky behaviours. Membership in such communities often leads to shallower connections with people outside of their boundaries. Some of the respondents surveyed by Adler and Adler were concerned that their online lives are so filled with fantasy and intense emotion that they pay less attention and devote less time to their reallife relationships and responsibilities. One respondent was worried that her time spent on pro-ana sites took away from time spent with her husband and daughter. Another saw the grandeur of these online relationships as desensitising her to activities and feelings in her daily life (Adler and Adler 2011, p. 163). Whitlock et al. warn that active participation in online spaces can reduce a sense of isolation and loneliness on some patients but runs the risk of replacing the “real work” required to develop healthy relationships and coping strategies in broader society (2007, p. 1135). A woman who was once a part of such a community explains, [I]n retrospect I can see that it made my self-harming worse because the only thing the users had in common was self-harm. It’s good to talk about it, but it was all that we talked about. I do not believe that surrounding myself with other self-harmers was good for me. (Harris and Roberts 2013, p. e285) This intensive community seems to have made things worse for her by taking her attention away from other themes and life experiences that may have aided her recovery and taken up her time. Redolent with NSSI scripts, such communities teach members that self-harm and starvation are lifelong identities – often supported by complex aesthetic trends. They also express anti-recovery sentiments, encourage patients to lie to their doctors, and downplay the actual risk inherent in hurting one’s body. When whole communities support these ideologies and alternative lifestyles, they can be more powerful and persuasive than any other source of ideology and behaviour.

Recommendations for safe and impactful online spaces With both these benefits and risks in mind, it is possible to create online communities dealing with self-harm themes that can help inspire recovery and model healthier behaviour. Of course, there is no ‘one size fits all’ website that will satisfy the needs of every person. Multiple online communities of varying natures would be needed. For example, it is important that the age of users be considered. When the Adlers asked their subjects what the major drawbacks of online self-harm communities were, many mentioned feeling alienated by the

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prevalence of teenagers and their specific concerns. Many younger users were not interested in recovery and were not keen on censoring their discussions about cutting and life crises. In contrast, older users were often frustrated by their problems and concerns, such as their parents not letting them go shopping. Users in their 30s gained very little from this kind of discourse, which made them feel like the typical self-harmer was a spoilt teenage Goth (2011, p. 115). The content and aesthetic style that appeals to one demographic will be entirely off-putting to another. Triggers and contests

Negotiating triggering content is one of the biggest challenges in creating helpful communities, as people tend to react to explicit discussions of self-harm in different ways. Research suggests that some vulnerable young people have been assisted by media discussions of self-harm, which have led them to stop dangerous behaviour or realise that help is available. Nevertheless, many others are triggered into self-harm episodes by the same material and have reported learning new techniques through public discussions about self-harm or through fictional representations (Zahl and Hawton 2004, p. 189).This makes it difficult to predict if an honest and evocative story of recovery would inspire others to see a life without self-harm as a possibility or if it would be used as inspiration for doing more damage by acting out the ‘low points’ of the story. Again, it is important to respect the fact that different people have different needs and motivations. It is also important for online safe spaces to remove opportunities for unsafe competition such as comparing cuts or low-BMI figures. This necessity has already been noted by recovery programs, including S.A.F.E., which runs intensive therapy groups. S.A.F.E. patients receive attention if they do not injure themselves and are not allowed to show their scars to others or explain how they got them.This is to prevent feelings of competition.They are also discouraged from identifying with terms like cutter or burner, which are eliminated from the vocabulary of the group (Favazza 2011, pp. 264–265). The Grove Street residential program has similar rules, forbidding participants from discussing their self-harm or showing wounds and scars when in the presence of their peers. This has successfully led to an at-risk community that shows no clusters of self-harm behaviour (Walsh and Doerfler 2009, p. 287). Online spaces would benefit from similar restrictions, especially for those in the early stages of recovery. Of course, this does not mean that all competitions should be ceased or that participants should be discouraged from friendly contests or trying to better their own achievements. Distracting games, chats, and healthy challenges could be very useful community tools for maintaining the interest of the more competitive members. A good way of stopping competition over wounds or body weight is to encourage people to expand their spheres of interest and learn to value other

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things. Widening the focus of community discussions is a useful tool for gently broadening the interests of suffers, and encouraging them to form friendships based on a variety of hobbies and topics. When praising self-harm websites for assistance in his recovery, a 16-year-old subject of Harris and Roberts’s study described his favourite self-harm site as one that also allowed discussion of other topics and contained a variety of engaging media. Similarly, a 24-year-old informant praised her favourite community for the variety of ages, professions, and lifestyles represented by the members. Although she describes them as sharing “a common pain,” she also notes that they generally “play games, have fun and make lifelong friends” rather than forcing anyone to behave under a strict set of guidelines or discuss set themes pertaining to their illness (Harris and Roberts 2013, p. e285). Another tool for helping people to broaden their interests is to help them articulate ambitions for their future that do not pertain to harmful behaviours. In Tatz’s recommendations for dealing with suicide and self-harm in at-risk communities, he advocates programmes in which children are encouraged to express their life goals – for example, the desire to be an elite athlete. These children are then helped to express problems that are getting in the way of their dreams.This might include being unable to afford equipment or uniforms that would allow them to join local sporting teams. Breaking down seemingly impossible dreams into small obstacles is a good way of helping them to overcome frustrations and to articulate more precisely what they want from life (Health Report 2001). These programmes are generally for marginalised communities and are administered in face-to-face meetings. Not all self-harmers have such serious financial limitations, and many are more socially privileged and mobile. But there are elements of these programmes that can easily be transferred to websites and online discussion forums. An important aspect of the programmes that Tatz mentions is the focus on having goals and dreams and learning how to articulate frustrations and limitations in life (2005, p. xii). This can apply to anyone. Medical advice

A controversial part of many self-harm communities is the willingness of untrained members to give out medical advice. Obviously, this is not recommended and often leads to very dangerous folktales about illness and its treatment. Nevertheless, there are important reasons why medical advice from sources other than doctors is desired. In part, this is because many self-harmers have received bad treatment that was dismissive of their needs, or too minimal to properly address complex problems. Many are left with questions about their treatment and prognosis. Patients should be allowed to vent frustrations about the medical care they are receiving, and learn how their experiences fit within a broader context. Adler and Adler have noted many situations in which selfharmers have used their online spaces to talk about bad doctors or treatment,

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uncomfortable medications, and problems with associated industries such as medical insurance (Adler and Adler 2013, p. 33). Nevertheless, if representatives from the medical world do not step in and help disenfranchised and disillusioned patients, these discussions can quickly turn toxic. By sharing bad experiences, many users feel validated in their suspicions and start to turn against medical diagnoses and treatment programs. Many decide that their behaviour is normal and that the medical world is aiming to profit off them or cast their valid lifestyle choices as irrational (Adler and Adler 2013, p. 33). If medical professionals seem to view self-harmers as deviants and refuse to properly engage with problems such as unpleasant side effects or the cost of drugs, patients are likely to feel rejected by the entire medical establishment. Conversely, if doctors engage with angry or confused patients and offer helpful and compassionate advice to self-harmers online, this can change negative perceptions of their profession. Many users will be under professional medical guidance and may have been prescribed medications to help ease their symptoms. New medications can cause confusing problems, which are not always explained in detail by the people who prescribe them. It is useful to have databases of side-effects and other problems with medications – especially when these are phrased in a vernacular and assessable way that communicates more clearly than the fine-print booklets distributed with drugs. Medications for treating mental illness, such as SSRIs, are known to be problematic to many people, and it is valuable to share tips for dealing with common side effects such as stomach upsets or dizziness. While this does not replace professional medical advice, it can help users to find comfort in empathising with others and learning how or when the negative effects of drugs ceased for them. There are already countless online forums in which users of all classes of medication discuss side effects and share experiences. Targeted forums for those taking mental health drugs could help bring this information together and allow users to share experiences under supervision from doctors or pharmacists. This would help offset the danger of unqualified medical advice. Many forum users suggest home remedies such as ‘drink more water to ease stomach cramps from SSRIs’. Unless it is done to an excessive degree, this advice is likely to lead to overall better health and may indeed sooth the complaint. Other advice is more dangerous and could lead to serious injury or death. Some users suggest techniques that can only be done under strict medical supervision such as drastically changing drug dosages or the process of administration.This is obviously not advice that should be circulating online, especially not on websites used by people with a history of harmful or addictive behaviour. A useful compromise would be a moderated medical forum in which qualified health professionals can dispense advice on common medications or therapies and answer questions that users may be unable to ask a professional face-to-face because of embarrassment or financial limitations. Medical professionals could also help in these online spaces by providing advice on how to attend to wounds and what the

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signs and symptoms of a serious infection might be. Although this could be read as encouraging actions like cutting, the alternative is to mention nothing and wait until cutters present at the hospital with wounds that are septic. This kind of advice would help forge better and more productive relationships between online self-harm communities and the medical field. Because many people without formal medical training have already taken a leadership role in solving medical problems for others, it would be a bad idea to cut them out completely. Instead, with the help of some basic training, enthusiastic community members could easily work in support of doctors and medical services. This has already happened in offline communities. For example, in order to address the high rate of suicide and self-harm in Australian Indigenous populations, especially remote populations, there is government funding and training available for the procurement of community gatekeepers. These gatekeepers are individuals who can be relied on to note the signs of mental illness and a propensity for self-harm and who are instructed on ways of referring distressed individuals to trusted services that can help them (Silburn et al. 2014, p. 98). This is particularly important in Australia, as many Indigenous people who are at risk live in very remote communities with limited health care facilities. A similar gatekeeping process could also benefit self-harmers who present online. Trusted users could be trained to note serious signs of mental distress and be educated in ways of addressing these problems and passing on approved advice or details of mental health services. Coping skills

In addition to advice about medication and problems with the body, it is also a good idea to involve medical professionals who can assist with emotional problems.There have been numerous studies that highlight the denuded coping skills of self-harmers and emphasise the need for better emotional regulation as a pathway to recovery. Because many self-harmers experience a greater unwillingness to deal with emotional pain when undergoing exposure to interpersonal distress and other life problems, their limited emotional strength needs to be considered. When emotional reserves are depleted, a person is more likely to turn to physical pain as a way of coping with emotional stressors. For this reason, Gratz et al. believe that it would be useful to teach self-harmers a set of useful skills for dealing with emerging problems while in a high-stress period (Gratz et al. 2011, p. 72). Most self-harm communities show an awareness of their members’ highstress lives. Some recommend self-harm as a coping mechanism, which is obviously not to be encouraged. Others advocate short-term distractions like holding ice cubes or doing star jumps when stress reaches peak level. These can stop a person from fixating on a stressor, but they are not in-depth therapeutic methods that can impart coping skills and foster the long-term amelioration of anxiety. This kind of assistance needs to come from people who have devoted

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their lives to the study of therapeutic methods for self-harmers and who can help translate their knowledge into new skills and constructive online discussions. So what might these skills and learning activities entail? Most therapists will have a repertoire of behavioural training ideas to help patients deal with stress and communicate their needs when they reach a ‘breaking point’. I would also like to recommend an expansion of these programmes into the domain of the internet in order to gain advantage from the aforementioned benefits of online communities and resources. A major coping skill that people require help with is working through the bumpy journey of recovery and learning that success will not be immediate. It is also very important to be honest about the possibility of relapse and provide specific resources for those who need to repeatedly try to quit before they permanently achieve this outcome. Many online posters have expressed frustration that their parents and teachers do not understand the addictive nature of selfharm (Whitlock et al. 2006, p. 412). By dealing with this behaviour as an addiction, professionals can show that they understand how it feels and how difficult the recovery process can be. Adler and Adler argue that quitting self-harm is a similar process to quitting cigarettes. While some people are able to quit ‘cold turkey’, most will go through relapses. Quitting should be seen as an active stage rather than a sudden, schismatic act. The Adlers note the usefulness of websites where people share stories of their relapses and give words of encouragement to others who are on a similar journey. This helps to absolve those who have ‘slipped up’ from feelings of shame and the desire to stop trying (2011, p. 195). Even though this kind of honesty and support might look as though it encourages or celebrates stories of failure, these narratives are actually a vital part of building a healthy and productive community atmosphere that supports the long-term journey towards abstinence. It is also useful to teach people how to cultivate positivity and aim for a happier, healthier life. Newman encourages the use of a ‘hope kit’ in the treatment of self-harm. He describes a hope kit as a container that holds reminders of reasons not to hurt oneself. These reminders can include treasured cards and letters from loved ones, photos of important people, mementos of success and achievements, and lists of future goals. Patients are encouraged to look through their hope kits when they feel self-hate or pessimism about life. The contents will remind them of positive worldly ties such as certificates that they are proud of or brochures for travel destinations they wish to visit one day. Through help from a therapist, they can then realise that self-harm is incompatible with these positive elements of their lives and dreams for the future (Newman 2009, p. 213). Similarly, the Buser study recommends counselling for self-harm that helps young people plan for a happier and more autonomous future. This can include discussions about establishing financial independence or education and career goals. These clearly articulated goals can make a young person more likely to recover in the future by helping them to shift out of uncontrollable or damaging environments and helping them to view the future with optimism

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and focus on good things to come.These discussions can be straightforward and logistical, or they can be more creative. Buser et al. recommend activities such as creative art projects that help young people to dream about the future and their aspirations (2014, pp. 444–445). With guidance, sites like Pinterest and Tumblr can work in a similar way.They can be storage spaces for hopes and dreams for the future, such as images of palm trees and paradisiacal holidays, or complex craft activities that can showcase technical skill and decorate the home.Tumblr is also viable as a diary where a user can post happy memories or positive events in order to be reminded of good things when they are feeling gloomy.The accessibility of these sites means that they can travel anywhere with the person who has created them. If they feel distressed on a bus, for example, they can get out their phone and access their blogs to receive a positive stimulus or distract themselves by finding new happy images and quotations to buoy their mood. This technique is also reflective of the fact that many people harm themselves because there are negative things happening in their lives, because they have bad relationships with others, or because they have a lack of hope in the future. By helping them regain hope and practice techniques for more constructive expression of needs, they are less likely to express themselves via bodily damage. As Jarvis points out, recent clinical literature has been focused on the idea of self-harmers as lacking control, being weak, and needing to be adjusted via clinical treatment. These approaches de-emphasise the environmental causes of self-harm. This style of treatment focuses on techniques such as dialectical behaviour therapy, which places control in the hands of the clinical practitioner and removes a great deal of patient autonomy (Jarvis 2012, p. 21). By allowing patients to have a degree of autonomy over explaining their actions and emotions and acting out these feelings in a safe online space, they are more likely to respond positively to treatment. As Boyd et al. argue, “[t]he key to addressing self-harm is not to address the coping strategy, but to address the underlying issues that require coping” (2011, p. 27). Websites like Tumblr can be used as a way of guiding environmental change and encouraging positive thoughts about the future. An online ‘hope kit’, or similar, can give patients back their autonomy and voice. Modelling recovery

A powerful way that peer-run sites have helped in the recovery journey is by modelling what recovery can look like. This involves self-harmers showing ways that they have overcome the compulsion to cut and showing how their scars have healed after years of hard work and productive lifestyle changes that have taken away the urge to cut. The most popular pro-recovery groups for former sufferers of eating disorders seem to have a fairly set pattern. They tend to be run by people who identify as having recovered and who wish to help others. They are often administered with the help of former patients from

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treatment facilities who are happy to share their advice about what to expect from certain styles of counselling, therapy, or support groups. These recovery communities are often visited by women who are anxious to learn more about treatment facilities before their admission dates (Juarascio et al. 2010, p. 403). The divide between pro- and anti-ED material is not, however, perfectly clear. Many members discuss how much they disliked their clinics, how they avoid going back there, and how they still feel misunderstood outside of the pro-ED community (Tong et al. 2013, pp. 416–417). Followers and composers of recovery blogs often remain connected to pro-ED material because they feel sad or guilty about abandoning these spaces and friendships (Yeshua-Katz and Martins 2013, p. 504). Nevertheless, this ongoing connection can function as a lifeline to those still embroiled in harmful behaviours. There are several online resources run by self-harmers and former selfharmers in recovery, not mental health professionals. Some talented users have even published their thoughts on the recovery journey, such as Julia Grimaldi whose Tumblr ‘scarredconversations’ shares her musings on self-harm. She has also released her poems in an anthology called Recovering (2016). A popular blog is http://find-a-voice-and-shout-out-loud.tumblr.com, run by an anonymous female in her 20s who is also in recovery from self-harm. She still suffers from depression, anxiety, and PTSD from domestic abuse. She is yet to recover from her eating disorder and sees herself as being on a journey towards recovery rather than totally cured. Nevertheless, she is a popular advocate for honest and realistic self-harm recovery and has kept a thriving motivational blog since 2012. Her blog contains an appealing, glittery background in warm colours. She also shares motivational images with phrases such as “trust your soul”, “stay positive even when it feels like your life is falling apart” and “you don’t need a reason to help people”. The author answers questions from her readers in a caring and non-judgemental way. She also fosters a safe space with her site clearly stating, “This is a Trigger-Free certified blog – no negativity allowed here” (anon. 2012). The anonymous author has composed several feature articles explaining how to heal. In her main article on this topic, “Self Harm, Alternatives and How to Quit”, the author explains that she started self-harming because she loathed herself but argues that this kind of behaviour can be appealing to anyone feeling stress or strong emotions. She also discusses the fact that many self-harmers will naturally decide that they need to stop.This might be because they start to feel a need to harm in public or while under the influence of alcohol and drugs (very confronting and alarming compulsions), because they no longer get a feeling of release or happiness from their behaviour, or because they realise that they are hurting themselves and others. In order to stop permanently, the author advocates slowly weaning oneself from self-harm whilst still allowing small feelings of pain and replicating the visual effects of acts like cutting. When triggered into self-harm, the author suggests twanging an elastic band against the wrist instead of reaching for a razor. This is best achieved if the band is twanged with

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the hand you would normally use to cut with.This allows you to do something with your active hand and feel a satisfying “painful snap” on the passive wrist that usually receives the injury. To replicate the visual impact of self-harm, she recommends drawing or painting on one’s body. For example, a person could take a red pen and draw a line where he or she wants to cut. She also suggests drawing words or pictures on one’s flesh to express feelings. If a person enjoys watching injuries heal and fade, he or she can watch the ink do the same. The author also suggests more common clinical recommendations such as taking a shower, speaking to a friend, exercising, or writing a poem, among others. But her primary advice is to combat the need for a sensation of pain and the dramatic visuals of blood (anon. 2012). The kind of advice she provides can only be given by someone who had harmed themselves and has an empathetic rapport with her audience. She also shares her concerns about the way in which the general population misunderstands the motivations for self-harm and wrongly considers it an attention seeking act. She thinks that this classification happens when family members, friends, and associates find out that a person is hurting him- or herself without actually appreciating the true reasons why (anon. 2012). Indeed, many people who feel confronted by self-harm misread it as an attention-seeking activity or as a form of emotional blackmail. The empathetic perspectives shown in ‘Find a Voice and Shout Out Loud’ are very important for self-harmers who are looking for a supportive recovery-oriented community where they will be helped rather than judged or humiliated. This kind of empathetic discussion is also likely to be helpful for the anonymous author herself. Han et al. note that an important part of recovery is helping others on a similar journey. Some of their interviewees gained a sense of accomplishment by participating in volunteer work, caring for their family members and friends, and seeking out peers who were self-harming. These actions brought them joy and helped them to feel as though they were advancing their own lives by supporting other people (2014, p. 95). There are also some professionally run sites where peers are invited to share their own stories and give each other support. Tong et al. mention the website proud2bme.org, where people with eating disorders, or who are in recovery, can share their thoughts and experiences. This site is run in conjunction with health care professionals to ensure that it promotes correct treatment for eating disorders. They consider this site to be a good compromise between pro-ED blogs and prevailing mental health literature, which can sometimes ignore the importance of self-disclosure amongst sufferers as part of the healing journey (2013, pp. 419–420). Proud2bme.org offers readers the ability to ask questions about eating disorders and body image to medical professionals, chat on a helpline, and read stories about people who have recovered. There is also the opportunity to share positive stories with people who may be considering recovery or feeling uncertain as to how it can be approached. Popular story tropes include a discussion of body-positive role models and ‘recovery heroes’.

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There are tips for cooking nutritious meals and stories about exploring fashion in a body-positive way. Proud2bme.org also encourages activism against unrealistic body image and body-shaming with tips from people who have started petitions at college or used social media to spread their ideas. The internet provides a significant opportunity for locating and connecting with other people who are looking for help. In providing peer support, individuals also provide themselves with more reasons to carry on their recovery journey. It is very important for people in the midst of a mental health crisis to see constructive and effective ways that other people have freed themselves from bad thoughts and destructive actions. Han et al. note that those who have successfully recovered from suicidal behaviours are those who learned how to utilise “non-destructive methods” for dealing with emotional pressure and negative thoughts. These methods varied across their interviewees but often included some kind of venting such as writing, listening to music, crying, hugging, having a nap, or talking to other people. This allowed them to reconnect with positive feelings and activities or distracted them from intense emotions by allowing them to relax and ‘tune out’. Of course, this venting and relaxation need to be supervised, as not all of the techniques suggested by their interview subjects are entirely safe. For example, some let out their sadness and anger through excessive eating and drinking alcohol (2014, pp. 94–95). Nevertheless, learning from those who have recovered, or who have started a recovery journey, is a good way of developing new coping skills that are constructive and bring happiness. Leaving room for darkness

Of course, one of the big risks of providing structured help and positive community spaces is that they will be rejected by people who are in pain.This is not because they have nothing constructive to offer. Rather, it is because this helpful material is presented in a way that feels reductive, boring, or irrelevant to people who are in the midst of a mental health crisis. A deep engagement with the opinions of people suffering from mental illness is important, including a consideration as to what they find patronising or overly simplistic. Bloggers such as Rowe ruminate on this topic with frequency. In the wake of the death by suicide of Robin Williams, Rowe shared his experience of walking through town and being confronted by a religious woman handing out pamphlets providing reasons to keep living. He realised that she meant well but notes that anyone suicidal is suffering from a very complex range of problems that a single pamphlet about why life is worth living cannot solve. He also pondered why she would think that the most alienated and impersonal form of social interaction – shoving a leaflet into someone’s hand – is going to decisively alter their relationship to society? As if depression is just the result of ignorance or stupidity: of never

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having been told, or never having thought, of things about life that are good. (Rowe 2014) This is a not a mistake that needs to be repeated in online spaces. Rowe complains about the endlessly repeated simplistic catchphrases about seeking help and loving life – uttered by “happy-clappy do-gooders in brightly coloured clothes baking cupcakes and putting up balloons and smiling rather too earnestly” (Rowe 2014). Kicking back against the candy-coated mental health initiatives run by his university, Rowe notes that “this mode of expression simply doesn’t inhabit the same world” as his experiences of depression and anxiety. The rhetorical delivery of these campaigns closes off communication rather than encouraging it.This brand of ‘zest for life’ mental health campaign also detracts from broader social issues that cause or exacerbate mental illness such as social isolation, poverty, and unemployment. Rowe suspects that these mental health campaigns are a way of presenting mental illness as an individual problem rather than as a social problem that requires broader political solutions (Rowe 2014). Self-harm and suicidal behaviours tend to be exacerbated by stressors like violence in the home, bullying in schools, incarceration, or financial strain. Simply talking about these issues will not make them immediately better. We require broader systems encouraging parity in fundamental services like health care and education, changes in the treatment given to Indigenous peoples in colonised countries, and revised attitudes towards transgender youth to name but a few. Until society is able to provide a fairer life for those who are disadvantaged and voiceless in whatever capacity, we need to be honest about the very real presence of sadness, stress, and darkness in the human experience. This darkness cannot be obliterated by an upbeat and happy campaign, no matter how good the intentions of this campaign might be. There is also a very real risk that people who feel unhappy will also feel fundamentally disconnected from the idea of health and wellness.Website creators and online community leaders need to be careful with the way that they present mental illness and the connotations that they ascribe to health. This is shown clearly in Thompson’s study of HealthyPlace.com. This website brings together resources for dealing with mental illness and has a strong focus on community and the sharing of experiences. In its present form, HealthyPlace. com presents mental illness as an everyday concern that is shared by many people. Wellness is presented as an ideal end state that can be reached through “online sociality” (Thompson 2012, p. 398). This is all good in theory, but this kind of happy and healthy aesthetic has a real potential to alienate those who see themselves as fundamentally represented by darkness or despair. If negative feelings are not presented as part of the pathway to health, many people will see health as a totally unobtainable ideal that is a long way away from their present state.

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In the older mental health communities (ca. 1999) examined by Thompson, there were more downcast or troubled figures featured. These figures would often be posed with their head in their hands, looking away from the camera. Other hyper-stylised figures were used to represent specific disorders. In her research, Thompson includes an old screenshot of ‘chronic pain’ represented by melting, skeletal female figure and ‘OCD’ represented by a pair of ice-blue hands under a running tap. Information for survivors of abuse was often represented through stock images of troubled children who signified a loss of innocence and safety (2012, pp. 404, 407–408). Although they are now aesthetically outdated and look old, these images still have a certain power that seems to be missing from the idealised health images presented on the newer incarnation of the site. People can see their pain reflected in a twisted, suffering figure. There is something honest about it, and this aesthetic has parallels with the aesthetic choices common to peer-run self-harm sites. In its present incarnation, the website focuses on selling mental health and bodily well-being as a product. HealthyPlace.com is run by a for-profit company that earns money through selling advertising space on the site. As such, it also needs to provide something of value to its audience in order to ensure that the right users find the site and keep returning. Thompson notes that a large portion of the newer website features stylised, generic stock images of happy people enjoying life. These figures are captured spending time with friends, enjoying the outdoors, and smiling. Importantly, they are also smiling at the viewer, inviting a degree of engagement. Their happiness implies that they are free from disorder and have embraced a life of wellness. Much of the site is written in the second person, helping readers to feel personally addressed and connected to the material as a result. The stock figures used vary in their age, gender, and sex so that people from different demographics can find an image of a better future self to connect to. The more recent inclusion of YouTube videos on the site also encourages this sense of personal connection with ‘real people’. Thompson concludes that this mode of communication with the website viewer is “blurring the lines between health and sociality” (2012, pp. 399–402). Health is presented as something deeply connected to leisure, hospitality, and family togetherness. It is also presented as a commodity that can be earned through proper action. Healthy people are happy, connected to others, and socially functional. They have adventures in the outdoors, share smiles, and overcome adversity. Of course, this is something that not everybody will resonate with. Many people gravitate towards dark forms of expression because they are appealing and expressive. Describing the appeal of Soft Grunge and self-harm content, Bine explains that this genre provides users with an appealing sense of being set apart from the norm: This sense of being different, of understanding the world for what it truly is, is the gratification these teenagers seek. If they are part of this community,

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they are part of something dark and beautiful, something misunderstood by the rest of their peers. (Bine 2013) This darkness may take a form that is disgusting according to normative aesthetic standards, such as the sharing of photos of skinned knees or emaciated flesh. But there is room in our society to accommodate horror and discuss what it represents for those who find it appealing. As Tarr discusses in her appraisal of the self-harm movie Dans ma Peau, the horror film genre has been a longstanding way of displaying and processing revolting occurrences to do with death, bodily violation, and psychic perversion. In Dans ma Peau, the protagonist, Esther, moves from a clean and whole body into a blood-soaked and violated body that is close to death. The aesthetic representation of this process is horrific and confronting, but it opens a constructive discussion about the connection (and disconnection) of a woman with her skin. Esther eroticises and disfigures her own flesh in a manner that allows her to sensualise and fetishise her increasingly mutated physical form. This allows her to be both a masochist and an artist whose body becomes a monstrous representation of the social pressures of normative womanhood (Tarr 2006, pp. 81, 86). If we address only the masochism and ignore the artistry, an important communicative device is lost: We ignore the way in which the human body can be manipulated in a search for meaning and connection and focus only on the negative and distasteful dimensions of pain. To properly understand and treat self-harm, we need to examine why mutilation helps to express the relationships among body, self, and community. This may be dark and horrific, but it is very revealing and it is core to understanding motivations that a patient may have for dangerous and destructive behaviour. Behind the obvious masochism in Dans ma Peau, Esther is suffering from relationship anxieties, works through the night to advance her career, and feels required to flirt with men in higher positions in order secure a more permanent job. During the duration of the film, she also loses important friendships and develops a self-destructive desire to sabotage her business connections and her promotion (Tarr 2006, p. 88). Any of these stressors could precipitate self-harm, and many are tied into the social pressures of a woman trying to succeed in male-dominated workplaces and intimate relationships within a patriarchal sphere.To look only at the grotesque and horrific dimensions of her actions is to ignore the way in which her mutilation communicates her anxiety. There are also several moments in the film where figures of influence pretend not to see the mutilation that Esther is performing. Her boyfriend accepts obvious lies about her wounds, her colleagues pretend not to notice the blood she leaves behind at work, and even a pharmacist fails to connect her facial scarring with her odd request for chemicals that will tan a piece of human flesh. Tarr argues that society has failed to acknowledge either the pressures placed on Esther and people like her or the kind of violent reactions that

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individuals might have to their social failure (2006, p. 90). Although Esther’s story is clearly fictional, this blindness to self-harm is very real. So, too, is her method of controlling her body through monstrous pain and mutilation as a reaction to social burdens and as a means of escaping restrictive societal norms. We do not give young women many opportunities to express their weaknesses in public. This lack of public discourse drives discussions of weakness and sadness underground. Self-harm communities give people an opportunity to say, ‘I do feel fat’, ‘I do hate my body’, ‘I do wish I was dead’. It also gives them an audience of empathetic listeners who can process these dark thoughts with them. People need to be allowed to explore negative themes such as ugliness, death, and pain. These facets of life do not go away, even if a person chooses to be happy and healthy. ‘Darker’ websites and aesthetics can help people to work through troubling times and emotions without hampering their expression. For example, a Tumblr user explains: One thing about soft grunge is that, for me, it helped me find my voice, my hurt, and it allowed me to look at what I experienced. It was very important (for me) in dealing with the ugliness I couldn’t let myself “be about”. (Meredith in Kristen 2013) Even though the imagery she was dealing with was ugly, depressing, and painful, it helped her to come to terms with her emotions and express them in a way that enabled her to achieve catharsis. Gardner is adamant that words can come to replace wounds, and the symbolic dimension of self-harm can be fixed with better communication, better ways to relieve tension, and being in touch with emotions like anger. If feelings can be expressed and dealt with in a direct fashion, there will be less need for them to be metaphorically rendered in attacks on the body (2002, p. 151). Because emotions can be dark and violent, an aesthetic expression may need to be similar. This is not inherently bad, and it should not be completely discouraged. Demographic specificity

Recovery content can also be broadened and made more sophisticated via the appreciation of different needs had by different demographics. There are different kinds of stress experienced by different kinds of people who have different social roles and expectations. It is important for people to see themselves represented in recovery, or they will not believe that health is possible for them. It is also very common that people do not even realise they have an eating disorder or clinically recognisable NSSI behaviours because they do not see other people like them represented in discussions of these diseases. This is another area in which we need to move past the idea that self-harm and eating disorders are the exclusive domain of young, White females. In recognition of this problem, there are now recommendations that males, especially males with

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eating disorders, be given their own gender-specific treatment programs. These programs would need to have a greater focus on body dysmorphia, especially muscle dysmorphia, as this is more relevant to common concerns that men have about their physiques.The ultimate aim of a group such as this would be to create a healthier version of masculinity. It would also create a safe space for men to disclose symptoms, such as food restriction, which they may worry is only a ‘woman’s disease’ (Strother et al. 2012, p. 352). While these recommendations are for in-person support groups, I do not see why similar spaces could not be made available online. Some male-specific groups already exist. The Boys Action Self-Harm (or, BASH) MySpace page was created by the Wish Centre in North London, which also runs a range of offline mental health programmes. This page aims to support boys from age 13 to 19 who self-harm, focusing on tacking isolation and boosting self-esteem through peer support and creative activities. The young men are invited to share their creative output such as photography and poetry. Jones describes the MySpace interface as safe and familiar, noting that many young people will more easily connect with this kind of content than they will with clinical websites. She also notes the appeal of the ‘friends only’ model that BASH nominated. To join, a young man has to send a message introducing himself and a friend request. Parents are allowed to receive information about BASH but cannot become a ‘friend’ of the site. Thus the content within is more anonymous (Jones 2009).2 Not much remains of the site today, and it is too locked up for archive websites to be of much help, but I did find a profile picture used by the site, which shows a heavily contrasted image of a young man – possibly of African descent. He is surrounded by white and red text reading, “Scars both inside & out. At first I felt more powerful. . . . . . The pain. . . . . . gave me something 2 focus on. Support made me feel stronger. It was hard 2 stop but now I have hope”. The Wish Centre also ran a similar program for young women of the same age called ‘Girls Xpress!’, where young females had the opportunity to produce music and video clips and even a documentary (Girls XPress – Documentary 2004). Both these groups still exist offline and meet weekly. We also need spaces for non-heterosexual, non-White people to discuss their struggles with self-harm. Falling outside of gender expectations can mean that a person becomes invisible in the eyes of public health campaigns or general concepts of well-being and disease. Because of some of the representational biases mentioned in previous chapters, many people feel as though self-harm and starvation are things that only White people do. Musing on their own experiences with anorexia, Balasubramanian notes that the bodies presented to them as examples of these diseases were always White, skinny, and cisgendered. As a result, they feels “an internalized sense that it’s a condition of straight white cis women, and there is no reason to bring this ‘white girl disease’ into conversation with my friends or queer of color communities” (Balasubramanian 2014).

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Writing from the perspective of a trans woman of colour, Balasubramanian explains: My anorexia had everything to do with affluent white womanhood, something not available to me, but that I was systemically surrounded by. It had everything to do with heterosexuality: an aspiration for ‘proper and dignified’ white womanhood – that is ultimately desirable to white masculinity. (Balasubramanian 2014) This means that people like Balasubramanian are missing out on the treatment they need and deserve because disclosure is so difficult for them. As such, people like this need more opportunities to articulate their struggles – ideally to other people who can empathise and offer advice relevant to a person’s financial status, sexuality, gender, and ethnicity. It is also beneficial to engage with the ethnic and cultural background of a patient if it seems likely that they have been disenfranchised by the erosion of traditional culture through colonisation and geographical displacement. In studying the Canadian Aboriginal population, MacNeil (2008) draws attention to the cultural disconnection and associated disadvantages that have led to increased suicide rates amongst this group. In a context where Aboriginal people tend to have poor self-image and suffer hopelessness as a result of fractured cultural image, it is important for therapeutic tools to address this disconnect and help the patient to heal this sense of instability and loss. This is a specialist requirement, which is generally absent from self-harm recovery initiatives. MacNeil is concerned that Canadian mental health policies suppress Aboriginal belief systems and show a lack of acceptance for Native spirituality. She feels that self-destructive behaviours, especially amongst young Aborigines, could be addressed by discussing opportunities for empowerment in the context of their own culture rather than hegemonic solutions designed by people of other ethnicities and backgrounds. Communities with higher degrees of autonomy tend to have lower suicide rates. MacNeil recommends the development of a clear understanding of how youths in this culture understand life and death and a consideration of how communities can support the development of resilience and strength in times of stress or suicidal thought (2008, pp. 6–7). I think an ideal situation would be the funding and encouragement of Indigenous groups in making mental health sites based on their lived experiences and cultural views, rather than having non-Indigenous Canadians (or Australians, etc.) driving the content and setting the tone.This would address MacNeil’s concerns about the impact that different cultural perspectives on life and death might have on suicidal behaviour. By allowing different demographics to articulate their own specific needs we can create a variety of useful resources and supportive communities that target a variety of problems and offer nuanced, realistic solutions.

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Media hybridity

Another important factor to consider is that a standalone website is no longer a viable way of capturing the hearts and minds of self-harmers. It is here that we need to return to Lindgren et al.’s theory of media hybridity. They argue that viewing online and offline spaces as separate is fallacious and does not account for the manner in which the two are deeply connected and continuously influence and develop each other (2014, p. 2). This means that a person’s online behaviours can influence the appearance of their offline body, and their offline body can shape online cultural trends.We have seen this functioning in a concerning manner in pro-ED groups and the like, but there are many ways in which this process of hybridity can manifest differently and help make recovery resources appealing, immediate, and able to compete with problematic or triggering content. While some of the seminal sites like S.A.F.E. Alternatives have been online for decades, there is still a need for more research into functional online spaces. Professionally driven self-harm sites are increasingly part of the therapeutic process. Many self-harmers who see therapists have been asked to visit informative sites as part of what they call their ‘homework’. This is often seen as a positive experience (Zahl and Hawton 2004, p. 195). Yet current models for therapeutic websites are limited. In 2010, major problems with treatment-based websites were noted in a UK study of children and adolescents who used a local mental health centre. The young people and their parents were polled on their usage of online materials. Parents tended to like the idea of their children using computers and websites as a means of addressing mental health concerns and learning coping skills. The young people themselves were less convinced, with many describing websites about mental health as unhelpful and computerised therapy programs as unsuccessful (Stallard et al. 2010, p. 80). Many of the children and teenagers interviewed for this study had used the internet to search for information about their diagnosed or suspected mental health problems. While some found useful sources, the majority (53%) reported that it only helped a little, with a following 24% claiming the information they found had not helped at all or had confused them. Many of these young people had also used social networking to engage with information about their mental health but found sites of this nature to be similarly unhelpful (Stallard et al. 2010, p. 81). Many medical practitioners and mental health advocates are aware that there are serious problems in the way that doctors communicate with their patients – especially younger generations. For example, McGorry sees communication with young people as key to solving Australia’s mental health problems. He is pleased about the emergence of web-based mental health programmes and feels that these can reach out to younger Australians by “communicating with them in their language”. McGorry also praises ‘real life’ services such as Headspace Centres, which are “one-stop shops where stigma-free expert care is available in a youth-friendly environment”. Nevertheless, he laments that we have less than

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half the amount of Headspace Centres needed to accommodate disparate communities (McGorry 2012). Online material and communities can help address this issue, bringing “stigma-free expert care” to people’s home environment while they await better funding and more in-person services. McGorry specifically mentions the importance of language choices when it comes to forming youth-appropriate mental health resources. The means of delivery is also very important, as younger generations tend to view the internet as something more immersive and ever present than it may be for their parents and health care practitioners. Unfortunately, there is a dearth of studies actually exploring how children and adolescents feel about the mental health services available to them, which seems to suggest a lack of interest in young patient perception. The studies that do exist very rarely mention any kind of change in practice or recommend future changes as a result of their findings. Conversely, older patients are often asked for their opinions on adult mental health services, with this feedback being used to create meaningful change (Worrall-Davies and Marino-Francis 2008, pp. 9, 11). Without actual observation of the way that young people use the internet or investigation into what they want from a mental health service and why, the product they are delivered is unlikely to actually target their needs or appeal to their desires. We also lack any centralised database that indicates whether or not an online service is safe and free of triggering material or inaccurate/outdated medical advice. The 2016 Orygen Report recommends the development of ‘e-mental health’ recourses in order to provide access to websites that contain reputable and evidence-based programs for discussing self-harm and responding to selfharm crises. It is hoped that websites can become an important part of mental health service delivery, ideally structured around a centralised registry that will check content and ensure that best practice is followed. Under these recommendations, websites could be accredited as an e-mental health programme if they have accurate information, are developed by people with relevant expertise, and are accessible and effective for high-risk populations. It is also recommended that websites can be accessed by young people, their families, and their clinicians (Robinson et al. 2016, p. 56). Without a reliable list of sites that contain these necessary features, it is hard for clinicians to make sound recommendations for their patients and ensure that their specific needs are met. Medical professionals also need to be properly introduced to the kind of resources that exist – both those that can work in their favour and those that may be perpetuating any clinical or otherwise problematic advice. Many professionals who deal with self-harmers are unaware of online communities that can help or harm their patients. As such, Lewis et al. recommend that clinical practitioners be educated about the different types of online activities that their patients may be engaging with. In order to help a patient who seems to have a concerning relationship with online material, these researchers recommend a basic functional assessment approach where the patient is asked to keep a log of their online activities. This log should keep in mind thoughts, feelings, or

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events that precipitated their visit to self-harm sites; interactions and feelings during online activity in the self-harm sphere; and thoughts, feelings, or events after the online activity is completed. This will allow for a reasonable diagnosis of triggers and an understanding of how deeply their online activity impacts upon their everyday life (including school, sleep, and eating; 2012, p. e4). This also leaves open the possibility of a patient being able to demonstrate that their community interactions are largely positive and constructive, or can open up a discussion about negative and positive elements within self-harm communities. The other vital thing for the medical profession to understand, especially those who are involved in the creation of self-harm resources, is that using the internet is now far more complex than the process of reading a book or a leaflet. A successful website needs to be far more than a digital pamphlet that communicates the basics of self-harm and how it is treated. This may have been the reality of the internet back when self-harm material first went live. But the internet has quickly become far more than a discrete digital realm that people purposefully access by sitting down at their desktop computer, dialling up their modem, and searching key terms like ‘help for cutters’ with the specific intention of changing their behaviour in the ‘real world’. It is now a deeply hybrid space where online and offline feed into each other in a constant, intertwining loop. While some original adopters of the internet may still sit at their computer and access certain websites for specific reasons – primarily to do with supporting their offline lives, questions, and interests – this is increasingly uncommon and quite old-fashioned. Web 1.0 and dial-up internet have now morphed into the constant connectivity of smartphones, 4G, and social media that is a very real and embodied experience. In a world where our online friends can receive a thumping facsimile of our heartbeats delivered from our Apple Watch to theirs, a static website with the facts and figures of NSSI is unlikely to capture the attention of many young users. Many clinical websites and other resources seem to assume that ‘going on the internet’ is a set activity that one plans to do in order to address a particular need or desire. But this neglects the super-saturation of the internet in the lives of many people – especially the generation of digital natives who seem to be causing the most concern for clinicians. Nowadays, the internet is so omnipresent that some users are never really disconnected.They might own, for example, an iPhone that keeps them connected to online apps like Facebook without having to specifically sit down in front of a computer and open an internet browser. Push notifications also bring the internet to a person, letting them know when a program or a friend needs their attention (Plate 16).This removes even more personal autonomy and means that a person might get in touch with a problematic community space without actively trying. Some medical researchers have observed that online communities and friendship groups are more powerful and persuasive than early internet theorists may have anticipated. Whitlock et al. noted in 2007 that ‘digital natives’, born in the 1980s, had different expectations and experiences with the internet than their

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elders.They warn that the internet can become a surrogate for ‘real-life’ friends or family members (2007, p. 1138). Online spaces are no longer seen as sites of exceptional interaction or as places where one’s identity is necessarily significantly different from what it is offline. For many participants, they are simply part of daily communication and connection with a network of friends and acquaintances. Online technologies tend to extend offline relationships rather than replace them (Leander and McKim 2003, pp. 218–219). These relationships with people in the virtual space seem to grow easier with each passing year and each new technological advancement.These relationships can become very intense and important when they help people to participate in niche lifestyles. Presently, many pro-ED bloggers phone, text, and Skype each other. They also commonly add their online friends on Facebook and even meet each other in person. These friendships are deep and often involve discussions about non-ED matters like exams or dating (Yeshua-Katz and Martins 2013, p. 504). These are not mere ‘internet friends’. The bonds that are formed are very real and should not be underestimated by people whose main circle of companions are offline friends. In accounting for media hybridity, Lindgren et al. explain where these different attitudes about internet relationships have come from. In the earlier days of internet theory, online and offline were seen as two clearly demarcated spaces. Some theorists saw the internet as a utopic space where freedom from the corporeal could lead to equality and international understanding. Others read it in a more dystopic way, leading to moral panic over the kind of services and ideas that could be freely accessed online. Either way, there was a distinction between online and offline – one was virtual, and one was material. The divide was also quite hierarchical. The offline world was always that which was more real and authentic. The online world was a space that people could choose to access for specific purposes (2014, p. 6). For example, people could access a website about cutting if they were curious as to what this phenomenon was. A ‘good’ website would be one where visitors would learn techniques for preventing or recovering from this behaviour, which they could then implement in the real world. This is a similar process of information-seeking to reading a book but faster, more up to date, and more dynamic thanks to the advanced technological properties of the internet. In this context, recovery websites run by medical professionals are a great idea. Nevertheless, they have now become outmoded. While such websites are probably quite useful for parents, teachers, or individuals who are looking to learn more about self-harm and how it can be stopped, they do not contain the actual mechanisms for cessation. While proED and pro-self-harm pages often contain comparable stand-alone advice for how to hurt oneself more secretly or more effectively, this is not the real source of their power.They have such prominence because they recognise the fact that people (especially younger people) use the internet as a source of friendship, aesthetic identity, and community that is as powerful and as ever present as the friends and community members they meet in their offline engagements. In

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contrast, most self-help and information sites have a very outdated understanding of the online spaces that host them and do not use this online world to any degree near its full potential. There is a real problem of technological solutions being quickly outpaced. In Stallard et al.’s 2010 paper, the primary discussion was about the feasibility and likeability of therapeutic computer programs, such as CD ROMs containing cognitive behavioural therapy (CBT) activities. Because technology has developed quickly, the suggestion about CD ROMs is already past any point of viability. Nowadays, a teenage audience is far more likely to engage with therapeutic tools in the form of mobile technology, such as apps for phones and tablets. If this can be done, the associated initiative is more likely to be successful. Seko et al. note that therapeutic interventions and tools delivered through mobile phones have been praised for their ability to provide rapid and timely communication. The researchers’ survey of mobile phone apps found that they were a good device for logging trends, such as mood and behaviour, and seemed to have better completion rates than mood logging on paper or in a diary. This is primarily because mobile phones are ubiquitous and very popular amongst youth.The vast majority of the target demographic own them and use them frequently. They are also accustomed to the use of apps, with many of the health apps surveyed described as user-friendly and easy to engage with. This system is cost effective, because the expensive technology (the phone itself) is already owned by the target demographic, and these users require little to no training for the use of this device. Phone apps and texting services have also been praised for their flexibility, allowing services to be structured around the needs and lifestyle of the patient. Because phones are generally respected as personal spaces, many people have reported feeling confident entering sensitive information and logging details like low mood or alcohol intake, which they might generally view as private or secret (Seko et al. 2014, pp. 598–599).3 Mobile technology has already been used as a tool of lifestyle intervention and monitoring, with apps helping users to quit smoking, to manage their diabetes and asthma, and to deter behaviour that leads to obesity. In terms of mental health, apps and texting services have recently been used for the aftercare of eating disorder patients, to help people track moods, and to support cognitive behavioural therapy. Research into the efficacy of these programs is still an emergent field, but it seems promising (Seko et al. 2014, p. 591). Nevertheless, some potential faults and areas of concern have also been noted. The Orygen Report mentions the importance of creating a formal registry for apps, similar to its ideas for website registration. There are concerns that selfharm prevention apps have not been evaluated in a manner that shows who developed them and what expertise they have in mental health. This means that users could be subject to inaccurate, unhelpful, or even dangerous advice (Robinson et al. 2016, p. 46). Seko et al. recommend that all apps be used with a degree of caution. For example, if health practitioners are forced to review

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every piece of input that their patient provides to an app, they will be faced with a deluge of data and be under pressure to provide constant monitoring. There is the danger that many health apps fail to follow the sort of guidelines that practitioners advocate.There is also a possibility that failing to achieve goals within health apps could lead users to feel ashamed or dejected. Finally, Seko et al. raise a concern that the individual focus of health apps, coupled with a lack of apps for those who provide support to them, can lead a mentally ill person to feel that their struggles are individual. This leads to a disconnection from the role that society plays in mental illness and recovery (2014, p. 600). None of these concerns invalidate the emerging use of apps and mobile technology, but they do need to be taken into account when recommending services to patients or as part of the development of new programs. Social media sites can also be good locations for the hosting of recoveryoriented programs. Some efforts to this end have been made already. The 2013 ‘OK2TALK’ initiative was created in the wake of gun-related violence, specifically the Sandy Hook massacre. The Ogilvy Public Relations firm was given the job of creating a public service announcement that would connect with young people and encourage them to talk about their mental health issues.They used Tumblr (rather than Facebook) as a platform to direct young people to the website OK2TALK.org, and enlisted young people to create user-generated content pertaining to “personal stories of recovery, tragedy, struggle, and hope”. By the end of the project, they ended up with more than 6,900 content submissions for the site and increased traffic for associated help resources. Summing up how and why the project worked, the team noted the importance of Tumblr as a space for anonymous communication that encourages conversations about sensitive topics. This ability to differentiate between social media platforms is very important. The team also came up with three major points for future research and practice. First, a good campaign must be authentic and should prioritise “peer-to-peer storytelling to open the lines of communication”.They recommend unscripted testimonials as a good way of doing so. Second, a good site should inspire action by encouraging users to contribute their own content rather than just consuming static information written by others. Third, a campaign needs to be located in an appropriate space that young people already frequent, such as Tumblr or Facebook. If an environment already fosters behaviours like sharing and conversation, it will be suitable for eliciting these responses (Geisler et al. 2014). There are many lessons to be learned from pro-self-harm sites, which tend to have a firm grasp on media hybridity because of their peer-driven content and structure. While, for many patients, these sites may be detrimental or will need to be carefully managed, this does not make them uniformly bad. On many levels, they are more successful and more popular than professionally run sites.This is because they tend to have a better grasp on many important aspects of self-harm as a community expression and the power of media hybridity via new technologies. Peer-run sites tend to be honest about the pain and

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darkness of mental illness and the seeming impossibility of health from the perspective of someone in the midst of a crisis. They also tend to support niche or marginalised demographics with empathetic care. Professionally driven sites will be better if they can learn from some of these successful aspects of their supposed rivals. They will be more appealing if they can include appropriate peer-produced content, benefitting from the positives of this communication style while diverting people away from the more dangerous sides of these communities and resources. To stop a person from gaining all of their information and ideals from peer-run sites, professionals need to be open-minded and offer good, tempting, technologically current alternatives. They also need to understand some of the deeper benefits that come from intensive pro-selfharm communities. The most successful and persuasive of these groups have a real dedication to ritualistic behaviour or to a unifying aesthetic code. This is something that most professional sites are lacking – much to their detriment.

Conclusion: healing online Self-harm and community are deeply interlinked in a process that can denude or exacerbate the urge to injure or starve.This becomes abundantly clear online. One of the best opportunities for changing cultural approaches to self-harm is the internet.The online world is a new first line of treatment and a place where medical professionals have a special opportunity to make a difference before people are admitted to an emergency room or cause irreversible damage to their body. At present, communities dedicated to self-harm often contain material that does more damage than good. Peer-run self-harm sites can be a curse or a blessing. Significant work needs to go into the development of constructive spaces where healing can occur, supervised by professionals and inspired by the many positive aspects of peer-run content. Professionally run mental health websites exist in decent numbers, and many have excellent resources that are backed up with cutting-edge research.Their content is accurate and free of risk. Nevertheless, they remain less popular and less impactful than peer-run communities and resources. There are ways of addressing this, which start with an appreciation of how peer-run communities operate and what they offer. Many peer-run self-harm communities are actually beneficial or have beneficial elements. They can be friendly environments where users can discuss their feelings and symptoms without harsh judgement, talking to people who are guaranteed to empathise and understand.This sense of community prevents feelings of loneliness, and allows for deep friendships to emerge and authentic self-expression to take place. This stigma-free environment is very important for healing and coping with feelings of fear and shame. These spaces can offer advice and community at any time of the day or night. Specialist groups can also address important issues that lead to harmful behaviour such as prejudice based on gender, race, or class.

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To be able to appreciate and employ these positive elements, it is also important to understand the risky or damaging elements of peer-run communities. Many contain triggering content that can inspire people to harm themselves more severely or in new ways. There is also a large deal of competitive behaviour, including competitions to see who can cut the deepest or who can lose the most weight in a week. These activities lead to an escalation of symptoms or feelings of failure and rejection if targets are not met. Communities are often anti-clinical and contain ways to trick doctors, fix wounds at home, and evade diagnosis for deadly conditions like anorexia. With this kind of community ethos, it is common for self-harm to be presented as a lifestyle choice. This can be especially persuasive and problematic when it is supported by a self-harm aesthetic like Soft Grunge. An absorbing self-harm lifestyle can turn a temporary defective coping mechanism into a lifelong struggle and part of a person’s understanding of their selfhood. It can also isolate them from other people and other world views. In such communities, people come together to convince each other that they are not sick, not mortal, or not able to recover – all of which are untrue. The advice given and the general mood of a community can also be deeply unpredictable and even quite conflicting. Rouleau and von Ranson note that pro-ED websites do not necessarily operate on a rational framework. Some may be anti-recovery and pro-illness whilst still providing explicit support to members who want to go down conventional pathways of healing such as inpatient treatment in medical clinics. It is difficult to predict the level of support for recovery that can be found on ostensibly anti-recovery sites (2011, p. 529). Many users of pro-self-harm sites find themselves torn between the idea that self-harm is a normal and functional coping mechanism or a punishment that they deserve and the idea that the process is flawed, dangerous, or unpleasant. Even within single posts, users will often be unsure if they are weak or strong and unsure if they should stop or carry on. This deep ambivalence is a result of conflicting discourses about self-harm and the impact these discourses have on personal identity (Gradin Franzén and Gottzén 2011, p. 287). Even those who are totally absorbed in a self-harm lifestyle seem to occasionally entertain the idea of recovery. Generally speaking, many self-harmers are ambivalent about their behaviour and can think of some reasons why it would be reasonable or beneficial to stop. By reducing factors that make self-harm seem positive or functional, it is likely that a person will be less at risk of repeating this behaviour. Cessation is also more likely when an individual can access different behaviours that have a similar function. By reinforcing healthier coping mechanisms, helping people to avoid unwanted experiences, and praising them for avoiding self-harm, it is believed that this behaviour can be resolved and replaced (Turner et al. 2014, p. 72). This can also apply to online scenarios. Ambivalence opens up a space for discussing why ceasing dangerous behaviour is possible and beneficial. Many

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users of more ambivalent sites have already made it clear what has helped them to get better. For example, one participant in the Harris and Roberts study favours a site “aimed at supporting people who self-harm, aiming to help find ‘healthier’ ways of coping”. What makes these new lessons and ideas appealing is that “[s]elf-harm isn’t ‘forbidden’, and there isn’t a timescale in which you ‘have’ to stop self-harming, but the ultimate aim is that help and support helps people to stop” (Harris and Roberts 2013, p. e285). Clearly, her ultimate aim and the ultimate aim of the website as a whole is recovery. Support and companionship are provided, along with advice for healthier ways of coping with emotional distress. Importantly, a sense of judgement is absent. Self-harm and self-harmers are not made to feel bad or deviant, and recovery is not presented as something that needs happen quickly or without occasional relapse. These positive attributes are excellent points of consideration in the construction of online spaces by medical professionals. The positive elements of online self-harm communities should be considered alongside the risks in order to create new resources that support genuine and absorbing recovery efforts. We need to balance the good with the bad in order to help foster communities that are healthy and productive without being either insulting or dull. There is, of course, no one model for this. Instead, different people need different linguistic styles, different content, and different aesthetic underpinnings. A functional online community or resource is one that can help people to see beyond their illness as a source of identity, and embrace other interests and healthier coping skills. In the following chapter, I build on these possibilities by showing how a strong aesthetic core can be used to give vitality and meaning to recovery-oriented spaces.

Notes 1 Unfortunately, if people miss this opportunity to change at the end of their teen years, they are less likely to ever abandon self-harm or find solace in other lifestyle pursuits. Alarmingly, the older self-harmers become without quitting, the more likely they are to see self-harm as a lifelong ‘treatment’ for their problems (Adler and Adler 2011, p. 187). While many young people in normative Western cultures experience a powerful lifestyle shift as they become independent and move out of home in their late teens or early 20s, those who miss out on this positive transition or start harming at a more advanced age, often skip the most common transitional period that allows self-harm to end for good. This also opens a dangerous opportunity for self-harm to become part of their adult problem-management repertoire. 2 Although the page was heavily monitored by BASH staff to prevent any negative comments or unhelpful behaviour, Jones (2009) is concerned that it did share similarities with the discussion platforms used by pro-self-harm sites, and thus private communication between users did have the potential to be problematic 3 The biggest problem here is, of course, income level and accessibility to technology.Without a modern smartphone and a fast, reliable internet connection, these apps cannot be used (Seko et al. 2014, p. 600).

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References Adler, P.A. and Adler, P., 2011. The Tender Cut: Inside the Hidden World of Self-Injury. New York: New York University Press. Adler, P.A. and Adler, P., 2013. Self-Injury and the Internet: Reconfiguring the Therapeutic Community. Reset, 2, 16–40. anon., 2012. Feature #1: Self Harm, Alternatives and How to Quit [online]. Find the Strength to Fight for your Future. Available from: http://find-a-voice-and-shout-out-loud.tumblr.com/ post/27187722520/feature-1-self-harm-alternatives-and-how-to [Accessed 9 June 2016]. bakura, 2014. Tumblr. Available from: www.bakura.co.uk/post/104704948503/me-whenmy-therapist-appointment-is-several-weeks#_=_ [Accessed 19 Jan 2015]. Balasubramanian, J., 2014. #EatingDisordersAreForWhiteWomen [online]. Black Girl Dangerous. Available from: www.blackgirldangerous.org/2014/02/eatingdisordersareforwhite women/ [Accessed 21 Apr 2015]. Bell, L., 2013. Trigger Warnings: Sex, Lies and Social Justice Utopia on Tumblr. Networking Knowledge: Journal of the MeCCSA Postgraduate Network, 6 (1), 31–47. Bine, A.-S., 2013. Social Media Is Redefining ‘Depression’ [online]. The Atlantic. Available from: www.theatlantic.com/health/archive/2013/10/social-media-is-redefining-depres sion/280818/ [Accessed 2 Feb 2015]. Boyd, D., Leavitt, A., and Ryan, J., 2011. Pro-Self-Harm and the Visibility of Youth-Generated Problematic Material. I/S: A Journal of Law and Policy for the Information Society, 7 (1), 1–32. Buser,T.J. and Pitchko, A., 2014. Naturalistic Recovery from Nonsuicidal Self-Injury: A Phenomenological Inquiry. Journal of Counseling & Development, 92 (4), 438–446. Carmichael, L. and Gillespie, J., 2014. #SoftGrunge: Harming or Helping Young People? Chapman, A.L. and Dixon-Gordon, K.L., 2007. Emotional Antecedents and Consequences of Deliberate Self-Harm and Suicide Attempts. Suicide and Life-Threatening Behavior, 37 (5), 543–552. Chesley, E., Alberts, J., Klein, J., and Kreipe, R., 2003. Pro or Con? Anorexia Nervosa and the Internet. Journal of Adolescent Health, 32 (2), 123–124. Duggan, J.M., Heath, N.L., Lewis, S.P., and Baxter, A.L., 2012. An Examination of the Scope and Nature of Non-Suicidal Self-Injury Online Activities: Implications for School Mental Health Professionals. School Mental Health, 4 (1), 56–67. Eler, A. and Durbin, K., 2013. The Teen-Girl Tumblr Aesthetic [online]. Hyperallergic. Available from: http://hyperallergic.com/66038/the-teen-girl-tumblr-aesthetic/ [Accessed 6 Oct 2014]. Farber, S.K., Jackson, C.C., Tabin, J.K., and Bachar, E., 2007. Death and Annihilation Anxieties in Anorexia Nervosa, Bulimia, and Self-Mutilation. Psychoanalytic Psychology, 24 (2), 289–305. Favazza, A.R., 2011. Bodies under siege: Self-mutilation, nonsuicidal self-injury, and body modification in culture and psychiatry. 3rd ed. Baltimore: Johns Hopkins University Press. Fox, N., Ward, K., and O’Rourke, A., 2005. Pro-Anorexia, Weight-Loss Drugs and the Internet: An ‘anti-recovery’ Explanatory Model of Anorexia. Sociology of Health and Illness, 27 (7), 944–971. Gardner, F., 2002. Self-Harm: A Psychotherapeutic Approach. Hove; New York: Routledge. Geisler, J., Heidlberg, S., and Van Velsor, S., 2014. OK2TALK: Using Tumblr to Give Youth a Voice to Discuss Mental Illness. Presented at the 2014 National Conference on Health Communication, Marketing, and Media, Atlanta, Georgia.

160  Suggestions for clinical practitioners Girls XPress – Documentary, 2004. Gore, R., 2014. ‘Beautiful Sadness’: The Internet’s Romanticism of Self-Harm [online]. Storify. Available from: https://storify.com/rachelegore/the-internet-s-romanticism-ofself-harm [Accessed 2 Feb 2015]. Gradin Franzén, A. and Gottzén, L., 2011. The Beauty of Blood? Self-Injury and Ambivalence in an Internet Community. Journal of Youth Studies, 14 (3), 279–294. Gratz, K.L., Hepworth, C., Tull, M.T., Paulson, A., Clarke, S., Remington, B., and Lejuez, C.W., 2011. An Experimental Investigation of Emotional Willingness and Physical Pain Tolerance in Deliberate Self-Harm:The Moderating Role of Interpersonal Distress. Comprehensive Psychiatry, 52 (1), 63–74. Grimaldi, J., 2016. Recovering. Julia Grimaldi. Gupta, M.A., Gupta, A.K., and Haberman, H.F., 1987.The Self-Inflicted Dermatoses: A Critical Review. General Hospital Psychiatry, 9 (1), 45–52. Han, H., Chou, C., Liu, I.-C., Rong, J.-R., and Shiau, S., 2014. New Start: The Life Experiences of Recovering Suicidal Adolescents. European Scientific Journal, 10 (6), 88–101. Harris, I.M. and Roberts, L.M., 2013. Exploring the Use and Effects of Deliberate SelfHarm Websites: An Internet-Based Study. Journal of Medical Internet Research, 15 (12), e285. Hawton, K., Rodham, K., Evans, E., and Weatherall, R., 2002. Deliberate Self Harm in Adolescents: Self Report Survey in Schools in England. BMJ, 325, 1207–1211. Health Report, 2001. Aboriginal Youth Suicide, ABC Radio National. Aug 6. Heath, N.L., Ross, S., Toste, J.R., Charlebois, A., and Nedecheva, T., 2009. Retrospective Analysis of Social Factors and Nonsuicidal Self-Injury Among Young Adults. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 41 (3), 180–186. Hewamanne, S., 2010. Suicide Narratives and In-Between Identities Among Sri Lanka’s Factory Workers. Ethnology, 49 (1), 1–22. Jarvis, E., 2012. Diverging Perspectives on Self-Injury in Psychology and Society: The Last Thirty Years. Inkblot:The Undergraduate Journal of Psychology, 1, 18–23. Jones, T., 2009. Boys Action Self-Harm MySpace: www.myspace.com/bashgroup. Child and Adolescent Mental Health, 14 (3), 157. Juarascio, A.S., Shoaib, A., and Timko, C.A., 2010. Pro-Eating Disorder Communities on Social Networking Sites: A Content Analysis. Eating Disorders, 18 (5), 393–407. Kristen, 2013. Soft Grunge: Mental Illness Is Not a Style [online]. Pride in Madness. Available from: http://prideinmadness.wordpress.com/2013/12/26/soft-grunge-mental-illness-isnot-a-style/ [Accessed 22 Jan 2014]. Leander, K.M. and McKim, K.K., 2003. Tracing the Everyday ‘Sitings’ of Adolescents on the Internet: A Strategic Adaptation of Ethnography Across Online and Offline Spaces. Education, Communication & Information, 3 (2), 211–240. Lewis, S.P. and Baker, T.G., 2011. The Possible Risks of Self-Injury Web Sites: A Content Analysis. Archives of Suicide Research, 15 (4), 390–396. Lewis, S.P., Heath, N.L., Michal, N.J., and Duggan, J.M., 2012. Non-Suicidal Self-Injury, Youth, and the Internet: What Mental Health Professionals Need to Know. Child and Adolescent Psychiatry and Mental Health, 6 (1), 13. Lindgren, S., Dahlberg-Grundberg, M., and Johansson, A., 2014. Hybrid Media Culture: An Introduction. In: S. Lindgren, ed. Hybrid media culture: Sensing place in a world of flows. London: Routledge, 1–15. Lyons, E.J., Mehl, M.R., and Pennebaker, J.W., 2006. Pro-Anorexics and Recovering Anorexics Differ in Their Linguistic Internet Self-Presentation. Journal of Psychosomatic Research, 60 (3), 253–256.

Suggestions for clinical practitioners 161 MacNeil, M.S., 2008. An Epidemiologic Study of Aboriginal Adolescent Risk in Canada: The Meaning of Suicide. Journal of Child and Adolescent Psychiatric Nursing, 21 (1), 3–12. McCleave, N.R. and Latham, D., 1998. Self-Injurious Behaviour in Police Custody. Journal of Clinical Forensic Medicine, 5 (1), 13–26. McGorry, P., 2012. A Deadly Silence That Has to End. Sydney Morning Herald, 10 Sep. McManus, S., Bebbington, P., National Centre for Social Research (Great Britain), University of Leicester, Department of Health Sciences, Great Britain, National Health Service, and Information Centre, 2009. Adult psychiatric morbidity in England, 2007: Results of a household survey. London: National Centre for Social Research. Newman, C.F., 2009. Cognitive Therapy for Nonsuicidal Self-Injury. In: M.K. Nock, ed. Understanding nonsuicidal self-injury: Origins, assessment, and treatment. Washington, DC: American Psychological Association, 201–219. Peebles, R., Harrison, S., McCown, K.,Wilson, J., Borzekowski, D., and Lock, J., 2012.Voices of Pro-Ana and Pro-Mia: A Qualitative Analysis of Reasons for Entering and Continuing Pro-Eating Disorder Website Usage. Journal of Adolescent Health, 50 (2), S62. Podvoll, E.M., 1969. Self-Mutilation Within a Hospital Setting: A Study of Identity and Social Compliance. British Journal of Medical Psychology, 42, 213–221. Reisner, S.L.,Vetters, R., Leclerc, M., Zaslow, S.,Wolfrum, S., Shumer, D., and Mimiaga, M.J., 2015. Mental Health of Transgender Youth in Care at an Adolescent Urban Community Health Center: A Matched Retrospective Cohort Study. Journal of Adolescent Health, 56 (3), 274–279. Robinson, J., McCutcheon, L., Browne, V., and Witt, K., 2016. Looking the other way: Young people and self-harm. Melbourne: Orygen, The National Centre of Excellence in Youth Mental Health. Rouleau, C.R. and von Ranson, K.M., 2011. Potential Risks of Pro-Eating Disorder Websites. Clinical Psychology Review, 31 (4), 525–531. Rowe, A., 2014.The Utter Insufficiency of Anti-Suicide Activism [online]. Automatic Writing. Available from: https://automaticwriting1.wordpress.com/2014/08/13/the-utter-insuf ficiency-of-anti-suicide-activism/ [Accessed 14 Sep 2015]. Seko,Y., Kidd, S., Wiljer, D., and McKenzie, K., 2014.Youth Mental Health Interventions via Mobile Phones: A Scoping Review. Cyberpsychology, Behavior, and Social Networking, 17 (9), 591–602. Silburn, S., Glaskin, B., Henry, D., and Drew, N., 2014. Preventing Suicide Among Indigenous Australians. In: P. Dudgeon, H. Milroy, R.Walker, and N. Purdie, eds. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. Canberra: Office of Aboriginal and Torres Strait Islander Health. Sloan McLeod, S., 2013. On Tumblr’s Romanticization of Depression [online]. Available from: http://astrorice.com/romanticization-of-depression/ [Accessed 3 Feb 2014]. Stallard, P., Velleman, S., and Richardson, T., 2010. Computer Use and Attitudes Towards Computerised Therapy Amongst Young People and Parents Attending Child and Adolescent Mental Health Services. Child and Adolescent Mental Health, 15 (2), 80–84. Strother, E., Lemberg, R., Stanford, S.C., and Turberville, D., 2012. Eating Disorders in Men: Underdiagnosed, Undertreated, and Misunderstood. Eating Disorders, 20 (5), 346–355. Tarr, C., 2006. Director’s Cuts: The Aesthetics of Self-Harming in Marina de Van’s Dans Ma Peau. Nottingham French Studies, 45 (3), 78–91. Tatz, C.M., 2005. Aboriginal suicide is different: A portrait of life and self-destruction. 2nd ed. Canberra: Aboriginal Studies Press. Thompson, R., 2012. Looking Healthy:Visualizing Mental Health and Illness Online. Visual Communication, 11 (4), 395–420.

162  Suggestions for clinical practitioners Tong, S.T., Heinemann-LaFave, D., Jeon, J., Kolodziej-Smith, R., and Warshay, N., 2013. The Use of Pro-Ana Blogs for Online Social Support. Eating Disorders, 21 (5), 408–422. TransgenderTeen Survival Guide, 2014. (URGENT) Binder Self-Harm Anon [online]. Tumblr. Available from: https://transgenderteensurvivalguide.tumblr.com/post/105068900235/ urgent-binder-self-harm-anon-ive-sent-you-two [Accessed 28 Dec 2016]. Transgender Teen Survival Guide, 2015. Is It Transphobic to Say. . . . [online]. Tumblr. Available from: https://transgenderteensurvivalguide.tumblr.com/post/108744183295/is-ittransphobic-to-say-youll-always-be-my [Accessed 28 Dec 2016]. Transgender Teen Survival Guide, 2016. [super urgent] I’m Really Scared [online]. Tumblr. Available from: https://transgenderteensurvivalguide.tumblr.com/post/148452085240/ super-urgent-im-really-scared-cause-i-think-i [Accessed 28 Dec 2016]. Turner, B.J., Chapman, A.L., and Gratz, K.L., 2014. Why Stop Self-Injuring? Development of the Reasons to Stop Self-Injury Questionnaire. Behavior Modification, 38 (1), 69–106. van der Kolk, B.A., Roth, S., Pelcovitz, D., Sunday, S., and Spinazzola, J., 2005. Disorders of Extreme Stress: The Empirical Foundation of a Complex Adaptation to Trauma. Journal of Traumatic Stress, 18 (5), 389–399. Walsh, B.W. and Doerfler, L.A., 2009. Residential Treatment of Nonsuicidal Self-Injury. In: M.K. Nock, ed. Understanding nonsuicidal self-injury: Origins, assessment, and treatment. Washington, DC: American Psychological Association, 271–290. Whitlock, J., Lader, W., and Conterio, K., 2007. The Internet and Self-Injury: What Psychotherapists Should Know. Journal of Clinical Psychology, 63 (11), 1135–1143. Whitlock, J.L., Powers, J.L., and Eckenrode, J., 2006. The Virtual Cutting Edge: The Internet and Adolescent Self-Injury. Developmental Psychology, 42 (3), 407–417. Widger, T., 2014. Reading Sri Lanka’s Suicide Rate. Modern Asian Studies, 48 (3), 791–825. Williams, S. and Reid, M., 2010. Understanding the Experience of Ambivalence in Anorexia Nervosa: The Maintainer’s Perspective. Psychology & Health, 25 (5), 551–567. Worrall-Davies, A. and Marino-Francis, F., 2008. Eliciting Children’s and Young People’s Views of Child and Adolescent Mental Health Services: A Systematic Review of Best Practice. Child and Adolescent Mental Health, 13 (1), 9–15. Yates, T.M., 2009. Developmental Pathways from Child Maltreatment to Nonsuicidal SelfInjury. In: M.K. Nock, ed. Understanding nonsuicidal self-injury: Origins, assessment, and treatment. Washington, DC: American Psychological Association, 117–137. Yeshua-Katz, D. and Martins, N., 2013. Communicating Stigma: The Pro-Ana Paradox. Health Communication, 28 (5), 499–508. Zahl, D.L. and Hawton, K., 2004. Media Influences on Suicidal Behaviour: An Interview Study of Young People. Behavioural and Cognitive Psychotherapy, 32 (2), 189–198.

Chapter 5

Healing through aesthetics

Healing through aestheticsHealing through aesthetics

How images can guide behaviour and health

Self-harm, disordered eating, suicidal urges, and the romanticisation of depression are all rampant online. They are fed by very powerful communities and persuasive philosophies that challenge medical professionals and their clinical advice. Nevertheless, the dynamics of these communities can be understood and the reasons for their persuasiveness can be evaluated and learned from. In this chapter, I suggest ways in which patients or other vulnerable people can be engaged in online spaces and how these spaces can be constructed in helpful and realistic ways. Instead of rejecting the visual rhetoric used by self-harmers and pro-self-harm groups, I provide a range of ways for replicating benefits and understanding what these rhetorical choices provide in terms of individual and communal identities. Aesthetic communities have the power to heal, and to teach people new ways of performing sadness that are less life-threatening and more life-affirming. Wollen calls her Sad Girl aesthetic “a general methodology for existing or surviving – a way of thinking about ‘looking’ that helps me continue this wavering project of ‘being’ ” (Tunnicliffe 2015). I think this is the kind of philosophy that we need to communicate to those who are looking for ways to express their distress and inner turmoil. Philosophies like this might not be ‘cheerful’, but they are authentic, powerful, and very able to heal. The aesthetics and the ritual dimensions of self-harm can be considered and employed by those who wish to develop new treatment opportunities. In the previous chapter, I gave suggestions for safe and powerful online resources. But, by themselves, such resources are not likely to be powerful enough or to compete with opposing discourses.To really inhabit the consciousness of a user, resources need to include some kind of persuasive aesthetic style and have some kind of performative aspect that makes people act in a new way. So how can we use the internet as a way of shifting people from problematic and destructive mutilation and starvation and to a more constructive way of articulating pain and creating new realities of health or happiness? Luckily, there are many possibilities and many aesthetics that have already shown success. In the following, I explore Straight Edge, Fitblr, and Radical Softness.The best way to encourage people to cease dangerous behaviours is to help them undergo substantial lifestyle changes that make self-harm genuinely less appealing and relevant. One of

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the reasons why online communities are so necessary for the healing journey is that they provide sophisticated companionship and support networks in order to encourage such a change to take place. When this ability to connect with others is paired with a greater artistic and ritualistic motivation, the results can be impressive.

Construction of an alternative online aesthetic There is no real reason why healing aesthetics should be limited to offline experiences. It is possible for a carefully constructed online movement to free people from negative thoughts and actions through the power of evocative aesthetics and meaningful action. It is important that such a movement be complex and engrossing and focus on the construction of a genuine community experience. A healing journey needs to be more than just talking. It needs to be about shared expression and community action. While talking therapies are excellent ways of understanding harmful urges in patients and assisting them to overcome such impulses, this technique is not always powerful enough to combat the appeal of communities that encourage self-harm or disordered eating as potent ways of dealing with stress. This is because these (mal)adaptations bring with them a powerful sense of community and shared meaning. In examining the question of whether self-harm is a kind of maladaptive affect-regulation based on distraction, Klonsky notes that such a theory would “have to explain why less damaging and more socially acceptable methods of distraction like exercise, cold showers, or calling a friend are not sufficient” (2007, p. 236). I would argue that their insufficiency is due to the lack of group bonding or meaning-making available within these rather banal activities. Deep friendships are important, but phoning a friend may not be enough to arrest a mental health crisis. Moderate- and high-intensity aerobic exercise has been proved to ameliorate depression symptoms as a result of endorphin release (Balchin et al. 2016), but a single jogger does not a supportive community make. Even pointing a patient in the direction of a new community group or a new aesthetic can help. The change does not have to be immediate, and it is likely that a request for a person to abruptly leave a beloved pro-harm community would be met with resentment. Newman outlines some of the ways in which therapists can lessen power struggles between themselves and their clients. One is “acknowledging that the clients do not necessarily have to relinquish their beliefs entirely. It may be sufficient to lower their degree of belief or to find alternative beliefs that may supersede the original beliefs” (2009, p. 204). There is evidence that many people have gradually changed their minds about the power, meaning, and aesthetic value of their injuries over time. In a study of non-medicated recovery from self-harm, several participants described gradually changing their attitudes towards self-harm when they realised how much physical damage it was doing to their bodies. One such participant explained

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that the wounds on his hands, especially after they were stitched up, became abhorrent to him. Using his horror towards his scars, this man was able to undergo a dramatic change in perception as to what his wounds meant and what his relationship with them might be. Two other participants underwent a similar transformation when their wounds became infected (Buser and Pitchko 2014, p. 441). If a person is introduced to a community that values something like bodily integrity, health, or the verbal expression of pain, self-inflicted wounds and starvation may slowly become unappealing or seem less effective as a way of expressing emotion. Giving people new ways to articulate, perform, and express their pain can also help slowly denude monomaniacal subject matter, which is rife within pro-harm communities. For example, in the Lyons et al. survey, the particular linguistic tropes and themes of pro-ana websites were tallied. It was found that pro-anorexics communicate less anxiety about their condition online, use more positive language, and use fewer cognitive mechanism words that would reveal a deep reflection or insight as to their state of being. Their language is geared towards the present and the here and now. Eating was the main subject preoccupation, with fewer references made to school and death than were found in the discussions of those recovering from the disease (2006, p. 255). By talking with each other about a shared disease/lifestyle, this became a preoccupation of the community and distracted from others discussions, feelings, or ideas. Many people with eating disorders struggle to see themselves as separate from their disease identity. As such, Bates recommends that medical practitioners work on removing their patients’ powerful self-metaphors that are based on disordered eating in order to help them focus on a life and identity outside of anorexia. She suggests the development of the self as mother, friend, traveller, and so on in order to give a sense of credibility to other facets of the self and different future ambitions (2015, p. 200). This helps to weaken a maximalist view of eating disorders as a complete life descriptor. Those who lack a deep self-harm community connection can also benefit from new ways of talking about their pain. Many self-harmers have individually embarked on healing journeys and have invited others to join them through the medium of art.There are numerous artists who are working towards healing and self-expression through their creative output. Once such artist is Alyssa Zoé Amaro, whose work has a strong following on Flickr. Amaro’s oeuvre shows her self-harm journey in brutal honesty, capturing the mutilation on her flesh as a mirror of her damaged emotional life. Nevertheless, her work contains a powerful message about her ceaseless drive for recovery and healing. Her photograph Apocolypsis (2013a)1 contains the caption: As much as I fall apart, I will never lose the pieces that compose me . . . my hands as bloody and as cracked as they may ever be, trembling and incredibly tired, will never cease to put the pieces back together. (Amaro 2013a)

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The image in question, showing a pair of scarred arms and hands, can be read as a statement on the possibility of healing as much as it is a photograph of violent injury. One arm shows white, shiny scars and a large wound covered by stitches.The other holds a thin strand of yellow daisies.The muted purple tones give a sense of intimate revelation. Amaro vows to always bring the pieces of her wounded self back together again, no matter how much damage is done. This artwork is about resilience in the face of pain, not just the pain itself. Seko argues that many artists use Flickr as a medium for this kind of idea. By presenting pictures of self-inflicted wounds on Flickr, they can show that they are both vulnerable and healable, shifting images of their hurt bodies “from the domain of mental illness to the realm of advocacy and recovery”. Seko calls this “a paradoxical mix of personal catharsis and social performance” (2013). Catharsis and performance are indeed frequently linked in the work of those who creatively represent their pain. Amaro shows a similar journey in her photograph Healing Process (2013b).2 In this image, the artist presents a succession of Band-Aids.The first is so sodden with blood that it looks insufficient for the wound it covered. As the viewer moves their eyes towards the left of the work, they see the amount of blood on each Band-Aid diminish.The final one is still in its wrapping, as yet unused and unneeded. Amaro deems this image a “personal post” (2013b). Nevertheless, it is one of her most popular.While it focuses on bloodstains and their containment, there is once more a focus on healing as seen in the ambiguous and haunting Apocolypsis. This message is raw and honest, making it part of a very genuine discussion on healing. This is healthy for her and encourages her viewers to consider possibilities for their own healing journeys. What is even more powerful is group aesthetic schemas that encourage group healing, promote overall health, and show people ways to express pain that do not involve punishing their own bodies. Straight Edge

The creation of a pro-health and anti-harm community that will actually address these concerns without being offensive or boring to its target audience is easier said than done. A fine example of what is possible is the Straight Edge movement, often abbreviated to sXe. Straight Edge emerged out of the hardcore punk scene during the 1980s and posits itself as a reaction to the destructive excesses of the punk lifestyle. Straight Edge adherents tend to be health conscious, avoid the consumption of animal products (Plate 17), avoid promiscuity, and reject drugs (including legal substances and sometimes even prescription medication). Straight Edge developed during a period in which the American government was conducting a very public war on drugs. This war included TV announcements about the dangers of drugs and the likelihood of brain damage, the insultingly reductive ‘just say no’ campaign, and various censorship measures

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against music and lifestyles that were seen to be connected with drug use or other anti-social choices. While these campaigns failed to diminish recreational drug usage and the connections between drugs and musical subcultures, the change they advocated unexpectedly came from within. Straight Edge emerged as a punk-led movement in reaction to the dangers of recreational drugs and unhealthy lifestyle choices (Sutherland 2006). Since its inception, Straight Edge has been a generally well-respected facet of the punk world and is deemed to be both genuine and reputable by other punks. Using the language and imagery of this subculture, the rhetorical choices made by Straight Edgers have won over more hearts and minds than governmental campaigns or nagging parents ever could. This temperance movement is still going strong 30-odd years later, with a consistent and recognisable aesthetic in tattoos, clothing, and events (Plate 18). People who were not even born during its inception are now amongst the more important trendsetters within sXe. Straight Edge adherents often brand themselves with specific tattoos that make their long-term commitment to the cause clear. The ‘X’ symbol is the most common and is often triplicated. Many tattoos are in the American Traditional style, and others match the hardcore punk aesthetic of densely populated graphics with dark content and an animated style. Severed limbs, spiders, skulls, and the like are common motifs.Tattooed phrases are popular, for example, ‘stay true’, ‘never stand down’, or ‘stay pure’. Bold X shapes are commonly placed on the back of the hands, the arms, or the thighs where they can be seen clearly. Sometimes they are even placed on the face and skull. Most tattoo designs purposefully foreground this element.3 It can also be found on Straight Edge clothing (Plate 19).The X is thought to originate from the band Teen Idles who toured in 1980 whilst under the legal drinking age in the US. To compromise for this problem, the Mabuhay Gardens club in San Francisco drew a black X on the back of their hands in texta-pen. This allowed them to enter the venue but prevented them from procuring alcohol from the bar. This is a common technique in the US where 18-year-olds can legally enter bars and clubs to see performances but are under the legal drinking age of 21. Teen Idles went on to adopt this symbol as a reflection of their sober lifestyle choices (Azerrad 2002, p. 127). It was quick to catch on with others who wanted a clear symbol for their refusal to partake in the drinking and drugs lifestyle common to nightclubs like the Fab Mab. Straight Edgers have also been known to draw this symbol on their own hands whilst out at licenced venues, even when they are older than the legal drinking age (Kirst 1996). The band Minor Threat articulated many of the basic tenets of the movement in its 1981 song titled “Straight Edge”. The band explains that despite being “a person just like you” (‘you’ being a fan of the punk scene) they have “better things to do” than snorting cocaine or taking speed or dope. They describe these and other drugs as a “crutch” that stops people from connecting with the world. These lyrics are set to a short, rough, and intense burst of music. The idea of drugs as a crutch is woven into the punk attitude of ‘standing against

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the system’. Drugs are presented as a means by which people keep themselves oblivious and stop caring about the world (Plate 20). sXe promotes freedom from the pollution of drugs in both mind and body so that its members are able to engage with the world and strive for change (Kirst 1996). Straight Edgers have been associated with religious movements, primarily Christianity, new religious movements connected to Krishna Consciousness on the East Coast of the US, and strands of Buddhism popular on the West Coast (Abraham and Stewart 2014, p. 78). These religions have been a driving force behind elements of the philosophy such as sexual abstinence and dietary purity. The need for a pure body and mind has also meant that Straight Edge has a strong anti-self-harm component. Abraham and Stewart describe the spiritual dimensions of sXe as individualistic and therapeutic. The movement allows for individual seekers to explore self-control and personal autonomy in order to find meaning and authenticity in their lives (2014, pp. 78, 88). As part of this therapeutic core, Straight Edge is a preventative measure against self-harm. The movement tends to categorise self-harm as an attack on the body and thus against the ethos of health and purity. Self-harmers are not generally excluded from the movement for this reason alone, but they are encouraged to get help and improve their situation, as self-harm is not seen as a positive activity (SXEWORLDWIDE 2015). By promoting health and wholeness of the body, sXe adherents are encouraged to avoid mutilation and celebrate self-control. By connecting recovery from self-harm to a deep communal ethos, the Straight Edge lifestyle is an effective measure against communities that seek to do the opposite. I believe it is also helped in this pursuit by its celebration of tattoos, which allow for dramatic visual expression and a very particular visual rhetorical style. This punk sub-genre has long-term adherents who see the movement as a deep source of faith, community, and identity (Stewart 2012, p. 261). It is a dark, dirty aesthetic which is honest about struggles in life and the beauty of gloomy or grotesque imagery. At the same time, it emphasises the need to be mentally and physically pure by avoiding substance abuse and bodily damage. As such, it has real potential to heal self-harm and give people other, healthier avenues for the expression of pain and darkness. Fitblr

Fitblr is a popular Tumblr community which uses shared aesthetics, slogans, and group projects in order to inspire fat loss, muscle gain, healthy nutrition, and general well-being. The Fitblr community values imagery that celebrates healthy eating and nutritious foods, often presented beautifully, and images of people enjoying various styles of exercise (especially young, healthy women). There is a preference for attractive or unique pictures of these themes, in keeping with the importance of visuals in this aesthetic movement. A healthy lifestyle is indeed an excellent way to lessen the symptoms of many mood

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disorders. For example, recent research shows that “sweating away depression” is a real possibility, if the exercise conducted is of medium to high intensity (Balchin et al. 2016, p. 218). But what makes Fitblr is even more unique and impactful is the manner in which it promotes a sense of community and togetherness surrounding good nutrition and healthy activity. Fitblr is a community that accepts and understands people with histories of stigmatised illnesses, making it a safe space for people to share their struggles with conditions like anxiety or anorexia. Many people directly migrate from eating disorder communities to pro-health Fitblr. Others who are not yet ready to abandon their disordered eating habits or self-harm are still often aware of what Fitblr is and what it has to offer because of a large range of overlapping interests and common folksonomies. On some levels, Fitblr groups and pages are remarkably similar to pro-ED communities in terms of the way they function and the way participants present themselves. There are communal jogging sessions (often run through apps, allowing friends from across the world to form teams or challenge each other) and exercise programs designed to be shared. For example, a group of friends might elect to do the same Pop Pilates program for the month of June or promise that they will all post something positive about their bodies on Wellness Wednesday. Often, people will put their current weight, high weight, and goal weight on their profiles so that others can see their journey. Progress pics allow users to show off improved muscle tone or fat loss over time.The obvious difference here is that Fitblr espouses health and nutrition rather than starvation and self-punishment – even if the language and structure may be similar at times. Fitblr encourages an idea of health based on current best practice from an exercise, dietary, and mental health perspective. The Fitblr community is also out in the open and thus less secretive or splintered than pro-ED groups. There is a singular Fitblr community that anyone can join (known by the mass noun ‘Fitblr’), whilst pro-ED communities are smaller, more intense, and less open to outsiders. Many people with eating disorders have migrated over to Fitblr and improved their health and quality of life as a result. There is not a huge adjustment to make, and many Fitblr community members are acutely aware of the unhealthy eating practices in pro-ED spheres. They can thus provide a safe and empathetic space for recovery. There is also an acute understanding of what ‘recovery’ means as a stage of illness.To prevent relapse, Fitblr encompasses many ‘safe spaces’ where those in recovery can be shielded from triggering topics like calorie counting. This deep connection between the two types of community, including members floating from one to another, is demonstrated clearly in Waterloo’s mapping of Tumblr topic clusters. The ‘Fitblr’ tag is closely associated with the tags: ‘#losingweight’, ‘#cardio’, ‘#30ds’ (30 day shred – a fitness program) and ‘#jillian michaels’ (a famous fitness personality). It is more loosely associated with hashtags including ‘#pro ana’, ‘#pro mia’, ‘#depression’,

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and ‘#collar bones’ to name but a few (2014, p. 39).These tag associations show that Fitblr may be primarily focused on amalgamating health-based topics but still sits relatively close to harm-based communities and users suffering from mental health issues.This could be seen as a danger, but I think it also shows the possibility of changing chronic behaviours through moderate (but meaningful) lifestyle augmentations. I believe that Fitblr can address many of the common concerns expressed by self-harmers in therapy and on their own blogs. Newman has logged maladaptive beliefs pervasive amongst self-harmers, including “I hate my body, and it is my enemy” and “Doing NSSI behaviors gives me a sense of control and coping that I don’t have anywhere or anytime else” (2009, p. 204). Bodies are frequently presented as enemies or disappointments, and dangerous behaviours like self-harm and starvation are often seen as the only way of gaining control. By becoming interested in health, fitness, and sensible exercise regimes, selfharmers can start to revise their relationships with their bodies and learn new ways of feeling powerful and in control. Fitblr encourages users to love their bodies and appreciate the positive changes that can come from clean eating and healthy exercise. These changes can also help give inspire of control and personal strength. This transition is exemplified in the blog of Savvy, a young woman who swapped starvation for fitness with the help of the Fitblr community. Although she explains that “a healthy meal is hard for me sometimes”, Savvy now realises that she will never be satisfied by “some guy, starving myself, self harm or self hate”. Instead, she values food as fuel and takes part in moderate exercise, both of which are very rewarding. She explains, “I am so thankful that I choose recovery and I am so thankful for the amazing support system I have” through the Fitblr community (Savvy 2013). Fitblr user Sammy has a similar story to share. She suffered from clinical depression from age 11 and was under the care of a psychiatrist for eight years. During treatment, she attempted suicide by overdose and would ritually cut herself 10 times per day, every day of the week. After discovering Fitblr, she was able to connect with a healthier and affirmative lifestyle. Sammy is now a healthy weight, no longer on medication, and has been in recovery for a year. She explains, For the first time in 20 fucking years I live [love] myself inside out and I love my body (and I’m curvy as fuck) and I think I’m beautiful and strong and amazing. I’m not losing weight anymore, instead I’m focused on a healthy active lifestyle. (Sammy 2016) There are many other examples of people who have used Fitblr to fundamentally alter their relationship with their bodies and discontinue harmful behaviours like cutting and starvation as a result.

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Potential concerns

Nevertheless, Fitblr is not without its critics, many of whom see it as part of the general body-controlling culture that can cause eating disorders and poor self-image. Although she does not explicitly critique Fitblr, Waterloo includes pro-fitness content in her schema of dangerous Tumblr thinspiration. She believes that the theme of sports – such as colourful Nike shoes and. gifs of girls exercising – and the theme of diet – such as images of tropical fruit, salads, and smoothies – are part of a broader thinness ideal that can lead to obsession with this body type (2014, pp. 43–44). These are primary themes of the Fitblr movement, which many users would categorise as ‘healthy’ rather than ‘skinny’ images. Despite this, the manner in which a specific body type is praised within the Fitblr community does have the potential to inspire excessive thoughts about body image or an obsessive ideal of clean eating. On the blog find-a-voice-and-shout-out-loud.tumblr.com, the anonymous author shares some of the concerns she has with ‘fitspiration’ from the perspective of an eating disorder sufferer who is very wary of anything that can be used as thinspiration. In her feature article, “Thinspiration, Fitspiration and Reality”, she talks about different ways of discussing food, body image, and personal health on Tumblr. Thinspiration encourages refraining from food and idolising bodily forms of the very skinny like collar- and hip bones. Fitspiration, “the healthier side of Tumblr”, is about exercise, moderation, and good body image. The author’s big concern is that posts to do with getting fit are often tagged with #thinspiration. She argues that fitspiration can easily lead to disordered eating as it promotes excessive behaviours such as food restriction, intense exercise, calorie counting, and a set community ideal of what ‘healthy’ and ‘beautiful’ looks like. She does concede that it is the healthier of the two options and could perhaps be considered once someone with an eating disorder is in recovery and wishes to gain muscle mass. Before recovery, she warns that fitspiration can give false hope of what a body will look like after healthy eating. She suggests blocking tags like #fit, #exercise, and #weight loss to keep this kind of material away from one’s Tumblr dashboard (anon. 2012b). If advising a patient to engage with this kind of blog, it is also important to make sure that Fitblr is not used as a cover. Many pro-ED bloggers maintain decoy ‘healthy’ blogs to hide their disordered behaviour and present a more socially acceptable image (Yeshua-Katz and Martins 2013, p. 505). Some users see fitspiration as a form of thinspiration, or see thinspiration is something different to eating disorder promotion. The Tumblrs mentioned in the previous chapter for their vivid imagery of thinspo and the starved body, ‘whiteskeletons’ and ‘Dehungerize’ actually identify as thinspo blogs rather than pro-ana. This shows the danger of this grey area. They also use health rhetoric as a way of exploring and promoting extreme diets. For example, the author of Dehungerize started a new sport: Yoga Camp with Adriene Mishler, available through

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YouTube.Yoga Camp brought her a great deal of satisfaction and peace, and she has invited her followers to join her on the programme.There is, however, quite a fine line between yoga as fitness and yoga as a means to hone the mind for better weight loss through bodily discipline. Her first post on the topic reads: I see a body covered in fat. I see something ugly. I accept that I no longer want or deserve to feel that way and as a promise to myself, I will change it. I am fasting today and whenever I get the craving for food I will remember this. (Dehungerize 2016) Rather than accepting her eating disorder and committing to heal from it, she feels that “[i]t is my mission to accept the challenge of weight loss”. While she uses the positive language of acceptance, peace, and change – the actual change she seeks is far from healthy. Dehungerize’s take on yoga is reminiscent of Musolino et al.’s ‘healthy anorexia’, where starvation is hidden by mantras of health, fitness, and an ascetic lifestyle (2015, p. 21ff). The Musolino study is important material to consider when looking into the possible negative effects of a deep commitment to health and communities like Fitblr.These researchers followed Australian women who adhered to a “food regime with an explicit mantra for ‘healthy’, ‘pure’ and ‘natural’ eating”. Their subjects saw this as an ethical approach to good food and good health while the researchers deemed it to be a manifestation of orthorexia based on a damaging obsession with purity in both body and diet.The thin and ‘heathy’ body that forms the ideal aesthetic of this ascetic movement has a very high symbolic value in Australian culture. By being seen as taking care of oneself and succeeding in fat loss, people gain cultural capital because of their desired physique and careful lifestyle choices (Musolino et al. 2015, p. 19). Musolino et al. have observed similar trends in the context of disordered eating. They write of the “habitus of healthism” in which people with disordered eating habits are socially encouraged to maintain them under the guise of caring for one’s body. Thus, ‘careful’ eating becomes not a disorder, but rather a point of social distinction. ‘Careful’ eaters are able to show good taste and good values, which earns them a higher social position (2015, p. 19). In men, this often manifests in a desire for a lean and muscular body. In women, the desire is generally for a thin body that will be well received in social settings. Across genders, those who make a living from public performance were more likely to score higher on orthorexic behaviours, as were those who took part in sporting and fitness activities. This is possibly because they feel as though their bodies are the focus of scrutiny, which leads to increased anxiety about body shape and performance (Håman et al. 2015, p. e8). Eating ‘carefully’ or ritualistically can help keep this anxiety at bay. So, too, can the use of strict sporting or exercise regimens, especially those that have a strong ‘lifestyle’ component that allows them to dominate a person’s

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entire self-image. Yoga, a traditional spiritual practice from the Dharmic faiths, seems to be a fairly popular choice for people with orthorexic tendencies. One interviewee in the Musolino study chose to become a yoga instructor when she heard that a thin body was valued in this discipline. She explains, “I remember reading about yoga and it saying that the picture of a perfect yoga instructor is someone with absolutely no body fat and a smile on their face. I was just like BAM, I’m going to be a yoga instructor” (Musolino et al. 2015, p. 21). This risk factor was validated in a larger study into Ashtanga Yoga where Herranz Valera et al. hypothesised that the spiritual dimensions of yoga increased the likelihood of perfectionistic eating amongst devotees. They found that Ashtanga practitioners have a tendency to pick diets with complex rules, which can lead to obsessive thoughts.This was especially true of those who were vegetarians.Yoga seems to appeal to people with a perfectionist personality who enjoy frequent physical exercise – major risk factors for orthorexia. As such, the researchers warn that yoga teachers avoid pressuring their students into healthy eating or advocating particular food choices, as the students are at an elevated risk for an eating disorder (Herranz Valera et al. 2014, pp. 470–472). Similar considerations would be needed for advocating intense Fitblr participation. A large reason for this is the ambiguities present in communities and programs like Yoga Camp, which have been interpreted by fans such as Dehungerize in unhealthy ways. While she never advocates starvation, Mishler sees her yoga practice as something that can change bodies. The introductory video does state that Yoga Camp will help all its adherents “come into our dream bodies. We can do that, and we will do that; it is possible” (Mishler 2016). While, for many people, this will inspire ideas of a flexible or strong body, for others it may easily be interpreted as a very thin body that denies the craving for food. Nevertheless, the impact of Fitblr tends to be far more healthy than harmful. So long as the mild risk factors are recognised, there are substantial benefits to be had from steering a person towards a healthy lifestyle with a vibrant and supportive online community basis. There just needs to be an awareness for what is validated: stressful and unattainable bodily ideals or a healthy path towards reasonable fitness goals. Radical Softness

Another safe and affirming path out of self-harm is Lora Mathis’s ‘Radical Softness’ ideology, introduced in the previous chapter on aesthetics. Mathis devised this philosophy as a way of introducing and discussing their personal approach to healing (Mathis 2016a). They initially coined the notion of “radical softness as a weapon” after moving to Oregon and starting to cognitively process an emotionally abusive childhood. Mathis’s mental illness manifested in an acute crisis after the move, and they had breakdowns on a daily basis. While in the midst of breaking down, Mathis’s internal voice would say, “I was weak; that I should suck it up”. During moments of emotional clarity, they realised that

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this idea of emotion as weakness was part of a “learned stigma” against emotional pain. In order to oppose and critique their own internal dialogue, Mathis started to create images and poetry that prioritised tenderness. This quickly became key to their own healing journey and, subsequently, the healing journeys of other people. Mathis explains, “I put my honest feelings online because they were eating me up and I needed to get them out of me. Releasing the thoughts in a public sphere was very cathartic for me and allowed my circling thoughts to stop” (Mathis in Fabian 2016). Mathis started to consider the social conditioning that we have with regard to pain when they was in the middle of this emotional breakdown. In this state, they explains, “[M]y head is crueler to me than anyone I’ve met. It chimes in to tell me that no one cares about my suffering. That I am pathetic and that my suffering is a sign of personal failure” (2016a).This led them to realise that society’s messages about feelings as weakness had led to a deep internalised shame and self-hatred. To escape from this spiral of shame, Mathis needed to “destroy the idea that being open about what hurts is to be dramatic or weak” (2016b). They asks us to do the same. Mathis’s shame did not grow in a vacuum. They has a long, a personal history of struggling with the expression of emotion. Mathis spent years being told that their emotions were out of control, that they were not trying hard enough to control them, and that they were too sensitive or too ‘angsty’. Mathis has now realised that these seemingly excessive emotions were triggered by mental illness and breakdowns and showed a “valid anger towards abuse” (2016a). While Mathis believes that healing journeys should be individual, they provides an example of their own experience as a potential model for others. Mathis heals by “documenting . . . emotionality via social media” and making upfront statements about their mental illness. They also uses art and poetry as a vehicle for sorting through past trauma from mental illness and childhood abuse. Through creativity and sharing pain with strangers, they finds the courage to be more upfront about struggles in their daily discourse. The process is slow, but powerful. Mathis writes, “My healing has been a cycle of me chipping away at my layers and getting to the core of what I feel” (2016a).They explains, “I’ve got a lot of myself to get rid of ” (2015a).When asked for a favourite piece of writing, they selected one on the theme of ‘healing’:“Some days you will feel like the ocean. Others you will feel like you are drowning in it” on the basis that it makes them feel “surer in myself ” (Mathis 2015a). This emphasises the fact that healing is rarely a linear process, and its irregularities can be disconcerting. By reflecting on irregular healing patterns, people can remind themselves that an overwhelming day does not amount to failure. Mathis believes that struggling through difficult times is not a form of weakness. Rather, constantly picking oneself up after struggles shows strength (2016a). So, too, does being vulnerable.They describes vulnerability as a “healing force” that can combat the pain that comes from struggles like the trauma of conditional love, abuses of power, and receiving undue blame (Mathis

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2016c). They see healing as a real challenge requiring “hard work and a lot of dedication”. Mathis has healed by “picking myself apart and seeing how trauma has influenced my personality”, then learning how to forgive themselves. The process is long term and ongoing, taking different forms ranging from “very loud to very quiet; from taking up space in rooms and wanting to be seen, to being a gentle thing I cultivate alone” (Mathis in Fabian 2016). Through the complex process of healing, one can regain a voice. This is a reaction against the fact that genuine displays of emotion are often silenced by trauma, illness, and oppression. It is also a way of combatting and critiquing negative reactions that people display when faced with a person who is visible suffering (Mathis 2016a). Thus, Radical Softness asks that we respect and listen to the pain of others so that they, too, can achieve catharsis from their anguish. Pain should always be met with concern and love, not mockery or dismissal. Although it only dates back to October 2015, Radical Softness is already making waves as a new way of validating emotional expression. The therapeutic benefits that come from an interest in healing are obvious and feature in almost every kind of self-harm intervention. But what many of these interventions lack, Radical Softness has in droves – a clear and powerful aesthetic. This aesthetic lends power to the movement itself, motivating its adherents to cease hating and rejecting their emotions and to start expressing them. It also celebrates the human capacity for softness, sweetness, and kindness towards the self. It announces that self-esteem and sadness are not mutually exclusive things. Instead, people who are suffering or depressed are given permission to care for themselves. The aesthetic also contains constructive tools that teach people ways of healing. One of these is Mathis’s film still series – a collection of still images from imaginary films. They were inspired by similar stills made by Nan Goldin and Cindy Sherman (Fabian 2016).4 An important work within this series is Cultivating Myself (2016). This still shows a pink sunset over a bare landscape, as captured from a fast-moving vehicle. The subtitles read, “All of the things that I miss about you I am cultivating in myself ”. In a caption for the work, Mathis explains, “I am learning how to be alone without being lonely” (Mathis 2016d). As melancholy as the image may feel, it actually contains quite a proactive script for recovering from loss. Not everything that Mathis and other practitioners of Radical Softness have created is quite so gentle. It is also a rebellious and aggressive aesthetic that encourages people to defend themselves in the face of emotional attack. Mathis uses Radical Softness as part of their process of “weaponizing emotions”. By this, they means “kicking down shame” and stopping people from seeing their emotional lives a signs of weakness or as embarrassing thoughts that need to be hidden. Mathis encourages anger, even when it seems “bitter, hateful, and ugly”. Softness forms a counterpoint to this ugly rage and allows Mathis to channel their anger into productive and honest communication.This is not a censorship

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of rage – rather, it is a way of expressing deep frustration without undue blame on oneself and one’s own emotional life. Mathis explains: I have spent most of my life being very passive and afraid, and softness has taught me to stand up for myself. . . . I think this work has allowed me to hone my anger. I haven’t become less angry through it. I’ve just become more aware of my own strength. (Mathis in Fabian 2016) This is also brought to life in some of the logographic representations of Radical Softness. For example, a Radical Softness T-Shirt is presently available on Mathis’ Etsy store ‘staysoft’.5 Featuring the slogan ‘RADICAL SOFTNESS AS A WEAPON’, it displays the motifs of a knife and a rose. Together, they convey the forces of aggression and softness. Despite the sweet aesthetics of Radical Softness, Mathis’s own healing is “loud, unapologetic, and messy” (2016e). As such, these motifs remind the wearer and anyone who views the shirt that powerful emotions can be a way of fighting back against pain and abuse. Being unapologetically soft and making emotional healing a public gesture is also an important way of removing masculine stoicism from its cultural pedestal (White 2016). Radical Softness is based on the idea that modern, Western, capitalistic society is flawed. This is because it places too much emphasis on a masculine idea of stoical suffering, teaching people of all genders that they need to be quiet and in control of their inner emotional life. This is the condition of ‘hardness’ which Radical Softness rejects. Being emotional and vulnerable is thus a political move that seeks to redress a flawed society, overthrow toxic masculinity, and help create healing spaces where those who are overwhelmed by emotion and pain can know they are not alone (Mathis 2015b, p. 1). Mathis believes that we are raised in a culture that teaches us to keep our pain private. A strong person is emotionless; a weak person feels too much. Mathis feels that there are some people who are especially exposed to these accusations, primarily “women, femmes, queers, and people of color” who are commonly “dismissed as ‘crazy’ or ‘over-dramatic’ ” when they attempt to express their emotive life or their struggles (Mathis 2016a). Mathis argues that much of this anti-emotive culture is a means of hiding problems and allowing people to feel that they are free from responsibility. If people in pain vocalise their emotions, this requires “acknowledging that there is work to be done” and social problems requiring a social solution (2016a). In this way, healing is an act of collective resistance that pushes back against the dominant culture that tells those in pain to be quiet and hide their feelings (Mathis 2016f). This movement also asks people to stop being emotionally servile, especially to parties who do not deserve it. Mathis wants us to stop performing emotional labour for those who do not care about our own needs (2016g). Instead, emotional effort should be expended on constructive and self-affirming projects such as embracing one’s own feelings or “combatting

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the social stigma surrounding vulnerability” as a way of fostering group healing. Mathis also encourages the development and celebration of “tenderness, platonic intimacy, and honest communication” (Mathis in Fabian 2016). Thus, effort should go towards healing and caring, not hiding one’s feelings so as to spare the world the need to address them. This healing is by no means a project for Mathis alone. Instead, Mathis invites other artists into their creative philosophy. This shared healing journey was debuted in the 2015 inaugural Radical Softness Zine, which was launched in an inclusive free all-ages event held in Portland, Oregon. The Radical Softness Zine is filled with self-portraits from a variety of photographers, artists, and poets who sketch out what the movement means for them. Soda shares a collage in hot pink where she calls herself a “sad self-conscious girl” against a background of an anonymous love scene. Brandon Stanciell’s striking photography shows what vulnerability looks like on a Black, masculine body. Hannah Hill shares some badges from her ‘Hanecdote’ sewing project, rewarding readers for getting out of bed, getting dressed, and trying their best in a difficult world. The entire zine is a beautiful example of how pain, loneliness, vulnerability, and other troubling states can be expressed in a way that is constructive and self-affirming rather than damaging. Through texts like their zine, Mathis also presents a variety of guidelines for how one can practice Radical Softness as a path to healing in their own lives. Core to the movement is learning ways of expressing warmth and benevolence to the self. This is difficult in a social context where many people have learned to shut away these tendencies. The presence of ‘softness’ does not mean an absence of ‘hardness’ in a person. Rather, it mean acknowledging and accepting the tenderness that exists within (Mathis 2016h). The callousness within, we can assume, is already well cultivated by our society.This has an interesting resonance with the Adlers’ discussion of tender self-harm – terminology that they chose because it reflected the perspective of the self-harmers who they studied. These people described their self-harm as a therapeutic coping strategy, which was an act of helping themselves through hurting (2011, p. 1). It seems that many self-harmers are already cultivating their emotional tenderness. Discussions of how this self-tenderness can be used as part of a loving, healing process are very likely to resonate with them. So does Radical Softness really work as a transformatory philosophy that can free others from mental health crises? It is a long-term project requiring ongoing devotion, so it will take many years before we can say if it is truly curative. Nevertheless, initial results are very positive. Many people who are in recovery see Radical Softness as comparable to the kind of mind-set that helped them to heal. For example, Fabian explains how a “serendipitous discovery” of Mathis helped to solidify her developing thoughts on the importance of emotion as a tool to grow: It even transcended from a lesson to a strong belief because it acted as a catalyst for my own recoveries. So, when I discovered Lora’s work, I was

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truly struck by it. I thought, ‘Wow . . . Someone worded it perfectly.’ It validated and amplified my belief strongly. I resonated with it. (Fabian 2016) Mathis has tapped into an expanding need for the intense performance of emotion online as part of an expressive healing journey.As Gaynor explains, feelings of stress and distress are usually hidden. She believes that “[s]adness is often viewed, socially, as a passing emotion that can and should be overcome; an unproductive state that should be actively avoided” (2015). By acting out her sorrow instead of burying it, she has found an online outlet for performing her emotions in a cathartic way. Here, she is not referring explicitly to Radical Softness but aims for the same result – as do many others. Mathis has helped to capture the zeitgeist of a group of people who have started to benefit from the release of their emotions after a history of detrimentally locking them away for the sake of others. Already, Radical Softness as a philosophical mission has made a significant impact on the lives of others. At least two people have been tattooed with the phrase (Greco 2016, Lopez 2016). The idea of Radical Softness is spreading across the internet. UpWorthy featured Mathis’s philosophy in an article titled “Embracing Your Emotional Self Without Judgment Has Never Been so Beautiful”. Celebrating the Radical Softness aesthetic with its “beautiful, saturated florals” and meaningful messages, White believes that these art pieces help spread a message that informs viewers that they are allowed to cry, express themselves, and feel emotional without apology. She brought Mathis’s work to UpWorthy, a content-aggregating website, in order to share the message that there is love and softness in the world to those who may have been told otherwise (White 2016). Alex Luciano, singer and lyricist of the band Diet Cig, wrote the song “Tummy Ache” (2017) to explore feelings associated with blending together Punk and Radical Softness. She explains it can sometimes be a struggle when the Punk community reads Softness as not “powerful or cool or whatever enough” (DeVille 2017). Her song encourages other femmes to find their voice in masculine-saturated spaces. Another positive and celebrated aspect of Mathis’s philosophy is that it includes people whose bodies and moods are not normally seen as ‘soft’ – the traditional domain of White femmes. Radical Softness has been celebrated for allowing non-traditional Softness to be expressed. For example, Ruiz shares her experiences of trying to enact her ‘soft’ feelings while being “brown, hairy, and fat”. Because her body is hyper-masculated, she is often viewed as “a monstrous being who can never exhibit softness no matter how much I wish I could”. She also struggles because her actions tend to be read as “aggressive and hostile” on the basis of her physicality rather than her actual personality (Ruiz 2017). Thankfully, Radical Softness explicitly makes room for people like Ruiz to participate and reap the rewards. Mathis is adamant that “[n]o one’s softness has to look the same way. I view it as a fluid thing and one which you can tweak to fit your needs” (Mathis in Fabian 2016). Although Mathis’s “softness and feminine

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side are linked” and come together in their creative output, they do not believe that Radical Softness must be tied to femineity or bodies that are read as female (Mathis in Fabian 2016). This is an important caveat to add to the movement, as many people – like Ruiz – do not have the luxury of appearing soft, even if softness is the best representation of their internal lives. She explains: To be given a space where you are seen as soft and delicate without having negative stigmas attached to it is to have a form of privilege within this society. This is often only granted to those who fit within social norms of beauty and femininity. (Ruiz 2017) Ruiz feels supported by other dark-skinned people, socially contextualised as masculine against their will, who are now actively claiming a softer space online. She mentions the Queer Xicano Chisme page, a space “for all the sissy brown boys”, which is run by Ruben, “a shady but loving Queer Xicano” (2017). Ruben identifies with male pronouns but simultaneously celebrates the power of flowers, pastel colours, and the massive creative heritage of both Xicano and sissy cultures. Ruiz sees alternative aesthetic discourses like this as highly important because they allow marginalised people to “portray our softness in a way that is positive to us” rather than having gender norms and emotional expectations forced on them by others (Ruiz 2017). For her, Radical Softness has been a vital way of showing that soft and gentle emotions are not the exclusive domain of waifish White women. Instead, these emotions can be claimed by anyone regardless of how their bodies look. Many trans and gender non-conforming people have also felt a deep connection to Radical Softness. Twitter user, Merrick, explains how Radical Softness has guided him on his journey as a female-to-male (FTM) transman. He promises that “even as I transition into masculinity I refuse to lose my emotional center” (2016). Emotional lessons he learned through his female socialisation are still valuable and meaningful. Radical Softness is fast becoming a methodological lens through which to understand emerging artistic and political expression – especially within the non-binary and trans community. In a review of Jos Charles’ poetic anthology Safe Space (2016), Markbreiter writes of the tension within this text and within the Radical Softness aesthetic. They explains how Radical Softness is an attempt to wrest “cute” and “soft” symbolism away from its traditional referents of powerlessness. Within Charles’s anti-capitalist, anti – settler colonial, anti-America critique, softness means taking bubble baths but showing up to anti-cop protests as well, and Charles reminds us that the two aren’t contradictory. (Markbreiter 2017)

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This is exactly the kind of healing-oriented philosophy and social practice that can save lives. Radical Softness has an immense power because it contains a strong aesthetic that is understandable and participatory in nature. Mathis has given the movement a clear manifesto, but it is not an exclusionary one. Divergent bodies are invited into the discussion, which prioritises people’s emotional life and inherent right to express themselves and heal.This makes Radical Softness a positive and constructive ideology that is saving lives and helping people to free themselves from decades of deep emotional anguish.

Conclusion Aesthetic communities can hurt, but they can also heal. Rather than censoring the aesthetics of self-harm communities, I recommend learning from what makes them so compelling. Powerful visual rhetoric does not belong only to dangerous internet communities. It can also be, and is, used by groups that promote health, happiness, self-love, and recovery. Aesthetic movements are powerful because they can help self-harmers to articulate what hurts them, what they want from life, and what might be getting in the way of their goals and dreams. This gives users a sense of autonomy and self-validation while also helping address the fact that many people hurt themselves because their lives are extremely stressful or out of their control. If medical professionals are seen to aide this kind of constructive discourse, it will be an excellent opportunity to show that the medical world can be a supportive and helpful resource – not just an enemy or an annoying burden. It is also a good idea to actively model recovery, ideally with the help of those who have been through the process themselves.This can show those who are suffering that recovery is real, possible, and perhaps even appealing. Many sufferers of anorexia are very reluctant to recover because they tend to see their disease as the only way they can achieve happiness (Williams and Reid 2010, p. 551). But connecting them to real people who are happy after they stop restricting their diets can showcase other pathways to contentment and other meaningful lifestyles. Finally, it is vital to listen to reasons why other well-funded and well-planned initiatives have failed to arrest growing numbers of pro-self-harm users and problematic content online. One of the major reasons is the uniform aesthetic presentation of health, which presents happy lives as those in which people are perpetually cheerful, physically active, and surrounded by jolly friends. This is not a vision that appeals to all people, and it is not necessarily honest about the form their lives and relationships are going to take if they embark on a healing process.We need to be honest about the ongoing presence of pain and darkness in human life. Not everyone wants a sugar-coated version of health and happiness. Many people find it shallow, unrealistic, or alienating. A website, or other resource, with a darker aesthetic can feel more honest and more reliable, as it is closer to the feelings that conditions like self-harm and eating disorders are associated with. Talking about pain and trouble is also

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cathartic and can be a healthy way that people cope with stressors. Learning to articulate hurt and sadness is important and can prevent maladaptive coping mechanisms. I believe we need more aesthetic variance, including ‘Sad’ Aesthetics, in order to capture the attention of people who are suffering and give them realistic and appealing pathways out of acute mental health crises. As Martin concludes in her investigation of the legalities of pro-ED sites, “[u]ntil we give young women other paths to acceptance, power, and self-worth beyond successful management of their bodies, some of them may well continue stickling toothbrushes down their throats” (2005, p. 178). It is also vital to connect with the manner in which people, especially young people, use the internet. Without a deep level of media hybridity, online programs are obsolete. There is an increasing convergence between offline and online worlds, which pro-self-harm sites address with technological fluency. Many people are online all of the time due to portable devices. Users are no longer ‘logging on’ to find a specific piece of information. Complete internet saturation means that information often finds them. As such, recovery programs can no longer be static websites. They need to come in the form of apps to allow constant connectivity and real-time relevance or allow for an app version of a traditional website platform. Because censorship of problematic content is not viable or constructive, patients should still be allowed to use social media sites as a vehicle for socialising and self-expression. Indeed, sites like Tumblr have real therapeutic potential. As such, there is real value in the construction of alternative online aesthetics as ways to encourage healing. By creating or supporting these radical ventures, medical professionals can help foster a healing culture that is truly effective – not merely a generic panacea or a site riddled with platitudes and ‘happy’ imagery. As inspiration for this rather monumental task, I have presented here some relevant movements from the past few decades up until the present day. Straight Edge, Fitblr, and Radical Softness are all communal projects dedicated to the active creation of a good, healthy, happy life in the face of darkness and disease. As shown in the previous chapter, there are also benefits in being a Sad Girl or engaging with Soft Grunge – so long as these projects are directed towards a healthy expression of negative emotion that can help purge bad feelings and tell an authentic and affirming story about the self. We need this kind of radical change and radical treatment in order to deal with self-harm and help those who struggle with it. We need to understand the power of aesthetics and the kind of deep change that an aesthetic movement can create.

Notes 1 Commercial reproduction rights were not available for this image, but it can be found on Flickr at www.flickr.com/photos/alyzam6/9045126250 2 This work can be viewed on Flickr at www.flickr.com/photos/alyzam6/11153857914

182  Healing through aesthetics 3 For a good selection of sXe tattoos, see http://straightedgetattoos.tumblr.com/.This movement has also recently expanded into a large range of merchandise, including clothing, phone cases, and wall art. One can purchase, for example, a watch reading “STRAIGHT EDGE DRUG FREE HARDCORE”. See http://shop.straightedgeworldwide.com/ collections/watches/products/watch-clean-steel/. 4 It is unclear if Mathis is also aware of Tracey Moffatt and her faux ‘film still’ series including Something More (1989) and Up in the Sky (1997).These works are described as evocative of “1950s B-grade movie stills with their melodramatic staging and camp sensibility” (Peacock 2011).They also tell an important story about Indigenous Australia.These images are very similar to the film still genre occupied by Goldin, Sherman, and now Mathis. 5 This, plus other Radical Softness items, can be purchased at www.etsy.com/shop/staysoft.

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