Under the Skin

A Psychoanalytic Study of Body Modification

Alessandra Lemma

• Publisher: Routledge
• Year: 2010
• Print ISBN: 9780415485692
• eBook ISBN: 9781135160975
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Alessandra Lemma - Winner of the Levy-Goldfarb Award for Child Psychoanalysis!

Under the Skin considers the motivation behind why people pierce, tattoo, cosmetically enhance, or otherwise modify their body, from a psychoanalytic perspective. It discusses how the therapist can understand and help individuals for whom the manipulation of the body is felt to be psychically necessary, regardless of whether the process of modification causes pain.

In this book, psychoanalyst Alessandra Lemma draws on her work in the consulting room, as well as films, fiction, art and clinical research to suggest that the motivation for extensively modifying the surface of the body, and being excessively preoccupied with its appearance, comes from the person's internal world – under their skin. Topics covered include:

• body image disturbance
• appearance anxiety
• body dysmorphic disorder
• the psychological function of cosmetic surgery, tattooing, piercing, and scarification.

Under the Skin provides a detailed study of the challenges posed by our embodied nature through an exploration of the unconscious phantasies that underlie the need for body modification, making it essential reading for all clinicians working with those who are preoccupied with their appearance and modify their bodies including psychotherapists, counsellors, psychiatrists and psychologists.

Chapter 1
As you desire me

If I make the lashes dark
And the eyes more bright
And the lips more scarlet,
Or ask if all be right
From mirror to mirror
No vanity’s displayed:
I’m looking for the face I had
Before the world was made

(Yeats 1865)

I am looking for the face I had…What exactly are we looking for? Yeats hints that it is the face I had before the world was made, that is, the face of a person who has not yet had to be an exteriority to itself (i.e. who has not yet assumed the position of observer to itself). It is the face of the ‘I’ who has not yet had to be separate and had to depend on the other’s look. It is the face unblemished by reality, by what we have to bear in ourselves, and with others, as we develop. It is also, he says, the face I had—not just past, lost, but also that the self once possessed. Indeed what has to be relinquished—what is lost—and what we all keep trying to recreate, more or less compulsively, is the omnipotent state of mind in which one believes one is what one has (e.g. I have a small nose and hence I am ‘good’/lovable) (Lemoine-Luccioni 1983), and in which what one has, is of one’s own creation, that is, we are the artist and the canvas. This excess of narcissism conceals from us what actually defines us: an insufficiency, a lack. It is a state of mind that is inimical to the vicissitudes of desire, and therefore to relating with others because, in its more extreme form, its hallmark is the delusion that the other does not exist.

I am looking for the face I had…The past tense that Yeats deploys here is evocative: it speaks to a quality of being that is lost and that we yearn to recapture in the mirror. It evokes a longing for time to stand still. And yet we are what we become and that is always evolving, subject to internal and external forces we are never completely in charge of. Nowhere are the inexorable changes we must all undergo more enduring and visible than through our changing bodies as we develop: the transition from the visceral togetherness of life inside the womb to adaptation outside the womb, or from the comforts of a child’s carefree body to the assault of a pubertal body that runs faster than our mind can walk, or from a potent adult body to the gradual undoing of this body whose integrity breaks down into a series of malfunctioning parts with every passing moment.

How we integrate the biological changes that steadfastly and resolutely lead us towards death would be challenge enough, but our experience of our body is fundamentally shaped by the quality of our relationships with others and, more particularly, whether through our earliest exchanges with others we internalise an image of ourselves as lovable and desirable.

The object of desire

The face I had is the face that has not yet met the other’s desire. We both yearn to be the object of desire and fear, or even hate, its inevitable ties. The existence of the other’s desire, which is expressed and experienced most concretely through the earliest gaze-touch relationship with the ‘object of desire’ (Britton 1998), can be, for some people, an experience of being enslaved to, or consumed by, the other.

I am choosing the term object of desire as opposed to ‘primary object’ or ‘significant other’ to underline the sensory, sensual, bodily components of this earliest relationship and how critical it is to the establishment of a desiring and desirable body-self. This provides the foundation for the expectation that the self will be desirable and loved, and that it can desire and love.

In order to approach the experiential realm of being-in-a-body, it is essential to think about desire. The body, desire and sexuality were at the heart of Freud’s account of development, but they appear to have lost currency in much contemporary analytic literature, and consequently analytic theory and practice are all the poorer for it (Fonagy 2006).

I am concerned here with ‘desire’ in relation to two related processes. First, in order to feel desirable we are dependent on the other’s libidinal cathexis of our body self, most crucially in early development, that is, we are dependent on the other’s desire for us. Second, and related to the latter, I consider it vital developmentally to have the experience of being able to arouse in the other—in the object of desire—an acknowledgement of the necessity of the self to the other as proof of the self’s desirability. This, I am suggesting, is an experience that is originally mediated by the felt-to-be desirability of the body self in early development, and of the body self’s perceived ability to both elicit and to satisfy the other’s desire. I am not suggesting that the (m)other should make the child feel he is ‘necessary’ in a way that impinges on his development as a person in his own right. Rather, what is important is to have the experience that it is possible for the self to satisfy the other’s desire in an unconditional manner. Of course, these moments are temporary and illusory in one sense—a child cannot fulfil, and should not fulfil, the whole of the (m)other’s desire. But feeling, at least some of the time, that we are the ideal for the other is as important developmentally as learning to bear one’s limitations and imperfections.

In this respect Lacan’s incisive analysis of the dialectic of desire is profound, as he draws attention to the way in which it is not sufficient to be an object of love or of need; what is required, as he puts it, is ‘to stand as the cause of desire’ (Lacan 1977:81, my italics). Lacan does not root this in the body, but I want to suggest that this ‘requirement’ is felt acutely at the level of the body self and can be discerned in our attempts to mould the body according to a physical form that we imagine will guarantee us a privileged, exclusive access, and control over the other. In order to more fully grasp the dialectics of desire we need to turn to the visual relationship between self and other.

The field of vision

Throughout life the body remains an exposed site. No matter how much we cover it up, conceal it, even change it, the body never escapes from the imprint of the other through the other’s gaze. Sartre, (1943) argued that ‘the look’ (le regard) is the domain of domination and mastery. It both provides access to its object without requiring contact with the object, but it also, of course, allows the object to have mastery over us. In all these ways the body thus always bears the trace of the other. This fundamental psychic truth has to be somehow integrated into our image of ourselves. Facing the reality of the body thus involves a paradox: it means simultaneously taking ownership of the body, its desires and limitations, and integrating the fact that the body is the site where we meet the other, where we negotiate the meaning of sameness and difference, of dependency and separation.

Sartre (1943) captured very well the interpersonal tension we all have to manage in his discussion of ‘the look’. He described two different kinds of looking: there is the me-who-looks (the voyeur), but this me-who-looks is inevitably also the me-who-is-on-view (the spectacle). The tables turn round —always. The face I had belongs to a self that omnipotently assumes that its own look is the point in relation to which the world is ordered. The realisation that the self assumes its coherence in relation to the other’s perspective is deeply threatening, not least because this other perspective is inaccessible to us in so far as we cannot control in any absolute way the other’s thoughts, feelings or perceptions. Being cognisant of our own specularity leads to the discovery that our foundations lie outside of oneself or, as Sartre (1943) put it, that we ‘exist for the other’. This ‘existing for the other’ implies a state of dependency that, I am suggesting, is experienced first and foremost in the body.

Lacan’s field of vision introduces the central role of desire.¹ For Lacan, however, desire is a linguistic process, detached from any taint of bodily excitation. In this respect Julia Kristeva’s (1995) views—which are an elaboration of Lacan’s—retain what I consider to be an essential connection with the body, through her emphasis on the pre-symbolic dimension of experience.² She is referring here to the space in which meaning is semiotic, that is, below the surface of the speaking being (e.g. bodily energies, rhythm).³ Much of her work has concerned itself with the mind/body dichotomy, showing how bodily energies permeate our signifying practices, and hence how body and mind can never be separated. We will return to her ideas in more depth in Chapter 5. For now, however, it is helpful to stay with Lacan, despite the above caveat, because some of his ideas are nevertheless very pertinent to this discussion.

Lacan (1977) proposes that the other’s gaze, through which the voyeur becomes the spectacle for the other, strips him of his sense of illusory mastery. Lacan thus points out that at the core of human being is an exhibitionistic impulse: in order for us to see ourselves we must be seen. He compares this visual mediation to photography:

in the scopic field, the gaze is outside, I am looked at, that is to say, I am a picture…. what determines me, at the most profound level, in the visible, is the gaze that is outside. It is through the gaze that I enter life and it is from the gaze that I receive its effects…the gaze is the instrument through which light is embodied and through which…. I am photographed.

(Lacan 1977:106)

The problem with being a photograph for the other is that it can feel as if we become a still, imprisoned in someone else’s moment over which we have no control. No matter how we present ourselves, we cannot ultimately control what the other sees. This is so because the other’s perception of us is embedded in the shifting matrix of their own unconscious feelings, memories and phantasies, and it is filtered through projective mechanisms that make us either desirable, ‘bad’ or invisible to the other (Silverman 1996).

However desirable we feel, we will probably all nevertheless traverse moments in our lives when we feel dogged by an experience of insufficiency,⁴ of not being desirable enough. This subjective experience is rooted first and foremost in the body, and it is in our body that we continue to feel it most viscerally throughout life. We all have to find ways of managing this unsettling experience in ourselves, more or less successfully. We do so sometimes directly through the manipulation of the body, for example, trying to make ourselves look attractive. This universal, core experience of insufficiency is predicated on an important, if painful, fact of life that shatters our omnipotent strivings: we cannot fulfil the mother’s desire in any absolute sense (Freud 1924; Lacan 1977; Kristeva 1982). Indeed, when this phantasy is actualised (as when a child is ‘used’ by the mother to satisfy her desire), the functioning of the mind is compromised.

We are then faced with a central paradox: we cannot fulfil the mother’s desire, yet we bear the imprint of her desire (or lack of) on our body. Throughout life it is the experience of feeling desired by the other that softens the blow to our omnipotence, that gives us respite from an otherwise relentless confrontation with our insufficiency. We replace the lost, early omnipotence through recreating it in the moment we feel desired, when we can feel ourselves to be the ideal for the other as they desire us. We thus search for an ideal image of ourselves in the other. The urgency with which we may seek this is powerfully expressed in Pirandello’s play As You Desire Me (1930). In a moving exchange between its main protagonist, L’Ignota, whose identity is in question, and Bruno, the husband, whose wife she may or may not be, she implores him to ‘look’ at her:

Look at me, Bruno, look at me. I have been here for four months…. Look at me…. Let me see myself in your eyes. Look at me, look at me! I’ve created myself in that image, the image I see gazing back at me in your eyes. That is now me—as you desire me.

(Pirandello 2005:47–48)

It can be difficult to reconcile oneself to the fact that it is ultimately only through the other that we can discover and/or rediscover an image of ourselves as ideal. This realisation inevitably confronts the self with the separate existence of the other such that the very person who can bestow on us an image of ourselves as ideal, is the same person who can withdraw it. The inevitable dependency that this discloses may be felt to be deeply threatening for some people. Moreover, if what the (m)other-as-mirror reflects back to us is a blank, or if the image is laced with envy or hatred, then the integrity of the self may be challenged.

Although an idealised image of the body—the body we want to have—is likely to be partly shaped by broad cultural standards, the individual meanings ascribed to the body by significant others play an important role (see Chapters 2 and 3). If we think about idealisation, we need to also consider identificatory processes. Through idealisation, the person invests an other with the power to make the self perfect, which immediately places the self in an identificatory relation to the other. In On Narcissism Freud (1914) reminded us that: ‘What man projects before him as his ideal is the substitute for the lost narcissism of his childhood’ (Freud 1914:94). The vicissitudes of identification are such that the fate of the idealised other can be uncertain depending on the self’s capacity to grant the other its separateness and autonomy. A healthy identification is inspired, as it were, by the perceived idea...

Table of contents

• Contents
• Acknowledgements
• Introduction
• Chapter 1 As you desire me
• Chapter 2 The symptom of ugliness
• Chapter 3 Mirrors
• Chapter 4 Being seen or being watched1
• Chapter 5 Occupied territories and foreign parts
• Chapter 6 Copies without originals
• Chapter 7 The botoxing of experience
• Chapter 8 Ink, holes and scars
• Conclusion
• Notes
• References
• Index