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Stitches brew: A brief look at self-harm lip sewing

In previous blogs I have examined both self-harming behaviour (such as cutting off one’s own genitals, removing one’s own eye, removing one’s own ear, self-asphyxial risk taking in adolescence, and religious self-flagellation) and extreme body modification. One area where these two areas intersect is lip sewing. According to the Wikipedia entry on lip sewing:

“Lip sewing or mouth sewing, the operation of stitching together human lips, is a form of body modification. It may be carried out for aesthetic or religious reasons; as a play piercing practice; or as a form of protest. Sutures are often used to stitch the lips together, though sometimes piercings are made with needle blades or cannulas and monofilament is threaded through the holes. There is usually a fair amount of swelling, but permanent scarring is rare. Lip sewing may be done for aesthetic reasons, or to aid meditation by helping the mind to focus by removing the temptation to speak. BMEzine, an online magazine for body modification culture, published an article about a 23-year-old film student Inza, whose quest for body modifications was very varied. She spoke about her experiences with lip sewing as a form of play piercing”.

My reason for writing this blog was prompted by a case study published by Dr. Safak Taktak and his colleagues in the journal Health Care Current Reviews. (I ought to add that I have read a number of papers by Taktak and his colleagues as they have reported some interesting other interesting case studies including those on shoe fetishism, semen fetishism, and fetishes more generally – see ‘Further reading’ below). In this particular paper, they reported the case of a male prisoner who had continually sewed his lips together. Although they were aware of cases of sewing lips together as a form of protest, they claimed that there had never been any case reported in the medical literature.

lip-sewing

The case report involved a male 37-year old Turkish (imprisoned) farmer, father of two children, with only basic education. After sewing his lips together, the man was brought into the hospital by the police, along with a handwritten note that read: “My jinns imposed speech ban to me and they made me sew my lips unwillingly. Otherwise, they threaten me with my children. I want to meet a psychiatrist urgently”. (Jinns I later learned are – in Arabian and Muslim mythology – intelligent spirits of lower rank than the angels, able to appear in human and animal forms and are able to possess humans). Not only were his lips sown together with black thread but he had also sewn both of his ears to the side of his head (these are also photographed in the paper and you can download the report free from here). This was actually the fourth time the man had sewed his lips together (but the first that he had sewn his ears). Each time, the doctors took out the stitches and dressed the wounds. The authors examined previous documentation about the man and reported that the man had been in prison for four years after injuring someone (no details were provided) and had been diagnosed with both anxiety disorder and anti-social personality disorder. On a prison ward comprising ten other prisoners, he had attempted suicide when trying to hang himself (in fact, you can clearly see the marks on his neck in the paper’s photographs). The authors reported that:

[The man] had blunted affect. He wasn’t able to stay in the [prison] ward because of the directive voices in his head. He declared he needed to stay in the ward alone. He heard all the words as swearing and he was punished by some people as well as some entities. He also said that some jinns in the form of animals threatened him not to speak and listen to anyone; otherwise they were going to kill his kids. He wanted to protect his children [and] he stitched his lips not to speak anyone and stitched his ears not to hear anyone. In his family history, he stated that his uncle committed suicide by hanging himself and saying ‘the birds are calling me’; his father was schizophrenia-diagnosed”.

The authors then reported:

“The patient stated that he sewed his lips with any colour of thread he could find. He had approximately fifteen pinholes on his upper and lower lips. He tended to suicide with directive auditory and visual hallucination (sic) and reference paranoid delirium. As he was imprisoned, he wasn’t able to use drugs. The patient who was thought to have a psychotic disorder was injected [with] 10 mg haloperidol intramuscularly and he was sent to a safe psychiatry hospital”.

As I have noted in my previous blogs on self-harming behaviour (and as noted in this particular paper), there are many different definitions of what constitutes self-destructive behaviour. This particular case was said to be suited to the psychotic behaviours characterised by Dr. Armando Favazza’s three self-destructive behaviours (i.e., compulsive, typical, and psychotic) outlined in his 1992 paper ‘Repetitive self-mutilation’ (published in the journal Psychiatry Annals). In their discussion of the case, the authors noted:

“The cases like sewing one’s own lips which we observe as a different type of destructing oneself in our case are mostly regarded as intercultural expression of feelings. The ones, who sew their lips in order to protest something, show their reactions by blocking the nutrition intake organ to the ones who want to continue their superiority. It can be expected in psychotic cases that the patients or his beloved ones might be harmed, damaged or affected emotionally. Thus, the patient who is furious and anxious might react by [attempting] violence as a reaction to these repetitive threats. Auditory hallucinations giving orders can cause the aggressive behaviours to start…In our psychotic case, this kind of behaviour is a way to prevent the voices coming from his inner world, not to answer them and hence making passive defending to world which he does not want to interact. By this means, he may harmonise with the secret natural powers which affect him and he may protect himself his children…[also] there can be a relief through sewing lips and ears or strangulation against the oppression created by the person not being able to adapt the prison…It should not be forgotten that the prison is a stressful environment and stressful living [increases] the disposition to psychopathologic behaviour that the living difficulties in prisons can affect the way of thinking and the capacity of coping and it may cause different psychiatric incidences”.

As noted at the start of this article, lip sewing is typically attributed to religious reasons, reasons of protest or aesthetic reasons. In this particular case, none of these reasons was apparent (and therefore notable – in the medical and psychiatric literature at the very least). The addition of sewing his ears appears to be even more rare, and thus warrants further research.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Favazza, A.R. (1992). Repetitive self-mutilation. Psychiatric Annals, 22(2), 60-63.

Taktak, S., Ersoy, S., Ünsal, A., & Yetkiner, M. (2014). The man who sewed his mouth and ears: A case report. Health Care Current Reviews, 2(121), 2.

Taktak, S., Karakus, M., & Eke, S. M. (2015). The man whose fetish object is ejaculate: A case report. Journal of Psychiatry, 18(276), 2.

Taktak, S., Karakuş, M., Kaplan, A., & Eke, S. M. (2015). Shoe fetishism and kleptomania comorbidity: A case report. European Journal of Pharmaceutical and Medical Research, 2, 14-19.

Taktak, S., Yılmaz, E., Karamustafalıoglu, O., & Ünsal, A. (2016). Characteristics of paraphilics in Turkey: A retrospective study – 20years. International Journal of Law and Psychiatry, in press.

Wikipedia (2016). Lip sewing. Located at: https://en.wikipedia.org/wiki/Lip_sewing

Glum drone pleasures: The psychology of Ian Curtis and Joy Division

“Now there’s a really good book…[by French economist] Jacques Attali wrote in the late [1970s] called ‘Noise: The Political Economy of Music’…and the main tenet of that book is that…music is the best form of prophecy that we have…so that working with music or sound is our best way of divining a future, and being able to show to ourselves what’s round the corner in that psychological, or even psychic sense” (writer and graphic designer Jon Wozencroft being interviewed for the 2007 film Joy Division)

As a poverty stricken teenager in the early 1980s, all of my minimal disposable income was spent on buying records, cassettes, and music magazines (and to be honest, 35 years later nothing much has changed except I now buy far too many CDs instead of cassettes). Unlike most of my friends at the time I refused to be pigeon holed as a new romantic, a punk, a mod, or a goth because I liked music from all those genres. In the early 1980s was as equally as likely to buy a record by Adam and the Ants and Bauhaus as I was to buy records by Secret Affair and The Clash. I was also into city music scenes with my favourites being the ‘Liverpool scene’ (Echo and the Bunnymen, Teardrop Explodes, Wah! etc.), the ‘Sheffield scene’ (Human League, Heaven 17, Cabaret Voltaire, etc.), and the ‘Manchester scene’ (Magazine, Buzzcocks, Joy Division, The Smiths, The Passage, etc.).

The Manchester music scene was incredibly buoyant although often portrayed by the music press at the time as psychologically and emotionally ‘miserablist’. My parents could never understand what I saw in the “depressing and alienating music” (as they saw it) of bands like Joy Division and The Smiths. But it was through these bands that I developed an interest in psychology and what could be described as ‘psychgeography of post-punk’. In the case of Joy Division, their geographical location in Manchester and its surrounding area (Salford, Macclesfield) was integral to their music. In fact, a number of commentators (such as Liz Naylor, the co-editor of City Fun fanzine) have asserted that Joy Division “relayed the aura of Manchester” in the late 1970s and early 1980s.

All of my information about Joy Division came from reading the NME, listening to the John Peel Show on Radio 1, and listening to their two studio LPs (Unknown Pleasures and Closer) and assorted singles (that I mainly taped off the radio as most of them were not widely available). I was too young to go to gigs and they rarely appeared on television. Of the four members of Joy Division – Ian Curtis (vocals), Peter Hook (bass guitar), Bernard ‘Barney’ Sumner (guitar), and Stephen Morris (drums) – it was Curtis that captivated my adolescent attention. It was through Curtis’ documented medical conditions that helped develop my interest in psychology. Curtis suffered from epilepsy (like one of musical heroes Jim Morrison of The Doors) and clinical depression. It has also been alleged that he suffered from bipolar disorder (i.e., what used to be called ‘manic depression’) although this was never formally diagnosed (and many of those close to Curtis claim that such a claim is speculative at best).

Descriptions of Curtis’ behaviour on first sight look like bipolar disorder given the reports by his wife and others of his severe mood swings (where on one day he could have feelings of happiness and elation but on the next day could have feelings of intense depression and despair). However, other members of the band claimed that the mood swings were caused by the epilepsy medication Curtis was taking. However, bipolar disorder is not uncommon among musicians given many other high profile rock and pop stars have suffered from it including Brian Wilson (Beach Boys), Syd Barrett (Pink Floyd), Kurt Cobain (Nirvana), Ray Davies (The Kinks), Sinéad O’Connor, Poly Styrene (X-Ray Spex), and Adam Ant (to name just a few). Curtis was never afraid to write about psychological and medical conditions and the song ‘She’s Lost Control’ is arguably the most insightful song ever written about epilepsy (based not on his own experiences, but his observations of a female epileptic client who died while he was an Assistant Disablement Resettlement Officer based at the Job Centre in Macclesfield).

As any Joy Division fan knows, as a result of his severe depression, Curtis committed suicide by hanging himself on May 18, 1980 (a date I always remember because it was my favourite gran’s birthday), just two days before Joy Division were due to go on their first US tour. Even as a 14-year old teenager, I remember going to my local library in Loughborough not long after his death to learn more about depression, epilepsy, suicide, and attempted suicide (as he had two previous attempts to commit suicide earlier that year). I’m not saying that this alone was responsible for my career choice but it certainly facilitated my growing interest in psychology and mental health issues.

It was also through Joy Division that I started to read history books (and still do) on various psychological and non-psychological aspects of Nazism (and is evidenced by my previous blogs on the personality of Adolf Hitler and Nazi fetishism). Back in the late 1970s and early 1980s, Joy Division were often accused of having Nazi tendencies. It didn’t help that their name came from the 1955 novella House of Dolls by Jewish writer and Holocaust survivor Yehiel De-Nu (writing under his pen name Ka-tzetnik 135633). The ‘Joy Division’ was the name given to a group of Jewish women in World War II concentration camps whose only purpose was to provide sexual pleasure to Nazi soldiers. I have to admit I’ve never read any of De-Nu’s books. According to an online article by David Mikies (‘Holocaust Pulp Fiction’), De-Nu’s writings were “often lurid novel-memoirs, works that shock the reader with grotesque scenes of torture, perverse sexuality, and cannibalism“. In the 2006 book Joy Division and the Making of Unknown Pleasures, Jake Kennedy asserted that “Curtis’ fascination with extremes would hint to anyone willing to look beyond the headlines that the choice of name was probably an old fashioned punk exercise,  matter of old habits dying hard”.

One of the bands earliest songs ‘Warsaw’ (which was also their band name prior to becoming Joy Division) is arguably a lyrical biography of Hitler’s deputy Führer Rudolf Hess. The song even begins with the lyric “3 5 0 1 2 5 Go!” (Hess’ prisoner of war serial number after he was captured after flying to the UK in 1941). Another of their early songs ‘No Love Lost’ features a spoken word section with a complete paragraph from The House of Dolls. A 2008 article by music writer Jon Savage in The Guardian newspaper noted that Curtis’ songs “such as ‘Novelty’, ‘Leaders of Men’ and ‘Warsaw’ were barely digested regurgitations of their sources: lumpy screeds of frustration, failure, and anger with militaristic and totalitarian overtones”.

Deborah Curtis (Ian’s wife) also remembered that her husband had a book by John Heartfield that included photomontages of the Nazi Period and that graphically documented the spread of Hitler’s ideals. The cover artwork of the band’s first record, the ‘An Ideal For Living’ EP, also featured a boy member the Hitler Youth drawn by guitarist Barney Sumner banging on a drum. Much of the flirtation with Nazi symbolism was arguably juvenile fascination and playful naivety. It’s also been noted that Joy Division’s early music concentrated on the nihilistic provocations of industrial music’s pioneers Throbbing Gristle (whose music I also examined at length in a previous blog). An interesting 2010 article by Mateo on the A View From The Annex website defended Joy Division’s use of Nazi imagery and lyrics:

“The Labour government´s betrayal of the working class during the 1970s and the rise of Thatcherism at the end of the 1970s heralded a future of mass unemployment, government repression and decaying industry. The perspective taken by Ian Curtis, the band´s sole lyricist, towards this growing authoritarianism and despair is crucial to understand if one is to place the references to fascism found in the band´s album art in the context intended by the artist, that is, a despairing anti-Nazism…Punk at that time was a unique music scene in which battles between anti-racists and neo-nazis were being thrashed out at concerts as the skinheads tried to appropriate the punk aesthetic and hijack the following of alienated, disillusioned working class youth who gravitated towards such a sub-culture in places like Manchester at the beginning of the 1980s…The lyrics of Ian Curtis made it clear that this was a presence suffered and feared as opposed to tolerated or toyed with by the band…Joy Division feared fascism, they did not flirt with it and the artwork and lyrics in ‘An Ideal for Living’ serves as a warning of growing fascistic tendencies in British society…For this, Curtis and his bandmates should be lauded for tackling such a controversial issue and expressing such a well-grounded fear and hostility towards such a veritable enemy of the working class during a swift turn to the right in Britain”.

By all accounts, Curtis was a voracious reader and read books by William Burroughs, Fyodor Dostoyevsky, Franz Kafka, Friedrich Nietzsche, Nikolai Gogol, Jean-Paul Sartre, Hermann Hesse and J.G. Ballard, many of which made their way into various Joy Division songs (an obvious example being their song ‘Interzone’ taken directly from a collection of short stories by William Burroughs). As Jon Savage noted:

“Curtis’s great lyrical achievement was to capture the underlying reality of a society in turmoil, and to make it both universal and personal. Distilled emotion is the essence of pop music and, just as Joy Division are perfectly poised between white light and dark despair, so Curtis’s lyrics oscillate between hopelessness and the possibility, if not need, for human connection. At bottom is the fear of losing the ability to feel”.

J.G. Ballard was a particular inspiration to Curtis (particularly the books High Rise and Crash, the latter of which was about the suffering of car accident victims and sexual arousal, and which I wrote about in a previous blog on symphorophilia). One of Joy Division’s best known songs (the opening ‘Atrocity Exhibition’ from their second LP Closer) took its’ name from Ballard’s collection of ‘condensed novels’ (and given its focus on mental asylums is of great psychological interest). So distinct is Ballard’s work that it gave rise to a new adjective (‘Ballardian’) and defined by the Collins English Dictionary as “resembling or suggestive of the conditions described in J.G. Ballard’s novels and stories, especially dystopian modernity, man-made landscapes and the psychological effects of technological, social or environmental developments”. Given this definition, many of Joy Division’s songs are clearly Ballardian as they examine the emotional and psychological effects of everything around them (including personal relationships on songs such as their most well known and most covered song, and only British hit ‘Love Will tear Us Apart’).

The overriding psychology and underlying philosophy of both Ian Curtis and Joy Division are both contradictory and complex but ultimately the band members were a product of the environment they were brought up in and the sum of their musical and literary influences. At the age of 24 years, Curtis’ suicide was undoubtedly tragic and like many other literary and musical ‘artists’, his death has been somewhat romanticized by the mass media. Although he didn’t quite make it into the infamous ‘27 Club’ of ‘rock martyr’ musicians that died when they were 27 years (e.g., Dave Alexander [The Stooges], Chris Bell [Big Star], Kurt Cobain [Nirvana], Richey Edwards [Manic Street Preachers], Pete Ham [Badfinger], Jimi Hendrix, Robert Johnson, Brian Jones [Rolling Sones], Janis Joplin, Jim Morrison [The Doors], Amy Winehouse) he is surely a candidate for being a prime honorary member (along with Jeff Buckley). Retrospectively looking at his lyrics (In the shadowplay, acting out your own death, knowing no more” from ‘Shadowplay’, you can’t help but wonder (given that many of them were autobiographical) whether Curtis’ death could have been prevented by those closest to him.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Curtis, D. (1995). Touching From A Distance. London: Faber and Faber.

Curtis, I., Savage, J. & Curtis, D. (2015). So This Is Permanence: Joy Division Lyrics and Notebooks. London: Faber and Faber.

Gleason. P. (2015). This Is the Way: “So This Is Permanence” by Ian Curtis. Located at: http://stereoembersmagazine.com/way-permanence-ian-curtis/

Hook, P. (2013). Unknown Pleasures: Inside Joy Division. London: Simon and Schuster.

Kennedy, J. (2006). Joy Division and the Making of Unknown Pleasures. London: Omnibus.

Mikies, D. (2012). Holocaust pulp fiction. The Tablet, April 19. Located at: http://www.tabletmag.com/jewish-arts-and-culture/books/97160/ka-tzetnik?all=1

Morley, P. (2007). Joy Division: Piece by Piece: Writing About Joy Division 1977-2007. London: Plexus Publishing.

Reynolds, S. (2006). Rip It Up and Start Again: Postpunk, 1978–1984. New York: Penguin.

Savage, J. (2008). Controlled chaos. The Guardian, May 10. Located at: http://www.theguardian.com/books/2008/may/10/popandrock.joydivision