A political approach to thinking about self-harm

By Guy Aitchison and Ryan Essex.

In April 2016, the Iranian refugee, Omid Masoumali, set himself on fire in front of UN inspectors at the Nauru island detention centre run by Australia. He later died of his injuries after delays in his treatment. Before carrying out his act, he shouted “This is how tired we are”. Omar’s case is extreme but not unusual. A great many people in immigration detention harm themselves. Things are especially bad in offshore facilities of the kind Australia runs in the Pacific and the UK has recently introduced in Rwanda. Indeed, one study found that rates of self-harm in an Australian offshore centre were 216 times higher than in the general community. Across the world immigration detention is known to produce anxiety, depression and PTSD, as well as high rates of self-harm and even suicide.

A number of media outlets – especially the Guardian Australia – have done important work in bringing the individual stories behind such acts to light. But for the most part, the world has turned a blind eye, dismissed or demonised these acts. Authorities dismiss self-harm by detainees as an attempt at ‘manipulation’ or as a purely medical problem. A medical approach brings with it certain assumptions. Self-harm is usually treated as something maladaptive that stems from personal (rather than collective) factors. Diagnosis and treatment by medical professionals is the preferred ‘solution’. For the most part, advocates for detainees have endorsed a medical approach. When we began the project that produced our recent paper in the Journal of Medical Ethics we wanted to uncover the political side of self-harm. We felt it was important to situate it within a broader context of resistance to punitive border controls. Self-harm is a difficult, complex topic and it inevitably brings one into contact with a great deal of human misery. We admit to a certain amount of unease at the prospect of writing about this issue. At the same time, government across the world benefit from keeping the topic taboo.

Our paper sheds light on the political role that self-harm can have as a form of resistance. One of us (Guy) has a long-standing interest in the political philosophy of resistance, while the other (Ryan) previously worked providing therapeutic care in detention facilities in Australia and has since transitioned into academia. One important aim of the paper is to show how acts of self-harm that do not fit the ‘traditional’ model of political action (as public, collective, etc) may nonetheless count as resistance. It can be an attempt to share the depth of one’s pain – something for which words are completely inadequate. It can also be a means to frustrate power relations and the operation of the institution, reclaiming some measure of control over one’s body and fate against an oppressive system.

As part of the research, we spoke to a number of current and former detainees from the Manus and Nauru detention centres who had either engaged in self-harm or witnessed such acts. Shockingly, many had spent the best part of a decade in the hellish legal blackhole of offshore detention. They told us of the trauma they suffered and how ordinary forms of protest were suppressed by the authorities. While it is not common to carry out interviews in political philosophy, we wanted to ensure that our ideas were grounded in the lived reality of detainees. We hope that the paper prompts people to think about self-harm in a different way. While we focus on immigration detention, the relevance of the argument is potentially much wider. When it comes to self-harm and suicide, there are often important issues of power, injustice and resistance at stake. A purely medical approach that treats this behaviour as pathological risks obscuring this.


Paper: Self-harm in immigration detention: political, not (just) medical

Authors: Guy Aitchison, Ryan Essex

Affiliations: GA: Loughborough University;  RE: Greenwich University

Competing interests: None.

Social media accounts of post authors: @GuyAitchison @RyEssex

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