Book excerpt: It’s a troubling phenomenon that many of us think of as a modern psychological epidemic, a symptom of extreme emotional turmoil in young people, especially young women: cutting and self-harm. But few of us know that it was 150 years ago—with the introduction of institutional asylum psychiatry—that self-mutilation was first described as a category of behavior, which psychiatrists, and later psychologists and social workers, attempted to understand. With care and focus, Psyche on the Skin tells the secret but necessary history of self-harm from the 1860s to the present, showing just how deeply entrenched this practice is in human culture. Sarah Chaney looks at many different kinds of self-injurious acts, including sexual self-mutilation and hysterical malingering in the late Victorian period, self-marking religious sects, and self-mutilation and self-destruction in art, music, and popular culture. As she shows, while self-harm is a widespread phenomenon found in many different contexts, it doesn’t necessarily have any kind of universal meaning—it always has to be understood within the historical and cultural context that surrounds it. Bravely sharing her own personal experiences with self-harm and placing them within its wider history, Chaney offers a sensitive but engaging account—supported with powerful images—that challenges the misconceptions and controversies that surround this often misunderstood phenomenon. The result is crucial reading for therapists and other professionals in the field, as well as those affected by this emotive, challenging act.