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Three terms that refer to the bleeding that occurs in the skin are petechiae, purpura, and ecchymoses. Generally, the term "petechiae" refers to smaller lesions. "Purpura" and "ecchymoses" are terms that refer to larger lesions. In certain situations purpura may be palpable. In all situations, petechiae, ecchymoses, and purpura do not blanch or turn white when pressed, but remain a purple and angry-looking wound.

petechiae pupura ecchymoses

Autoerythrocyte sensitization syndrome is a condition, usually occurring in women, in which bruising occurs easily, with the resulting ecchymoses tending to enlarge and involve adjacent tissues, causing pain in the affected parts; it may be a form of autosensitization or may be due to psychogenic causes. Because of its possible psychogenic origins, coupled with the Christian’s intense and deep reverence, love, and knowledge of the position of Christ’s wounds, it is easy to imagine how, if causally psychogenic, these wounds would appear in the same places as the individual imagines them to be on Christ.

The term “psychogenic” was coined at the beginning of the 20th century to mean “originating in the mind or in mental or emotional conflict” (Merriam-Webster Online) or, according the Oxford English Dictionary, “Having a psychological cause, esp. as opposed to a physical one.” Consistent with the prominence of bleeding in popular depictions of Christ’s wounds, stigmatics have often exhibited not only bruising, but also open wounds that bled profusely.

The primary clinical feature of psychogenic purpura reported in the literature is recurring ecchymoses. Apart from skin lesions, different Journal for the Study of Religions and Ideologies, 8, 25 (Spring 2010) Robert F. Mullen Holy Stigmata, Anorexia and Self-Mutilation systemic symptoms have been mentioned, including episodic abdominal pain, nausea, vomiting, arthralgia, headache, and other hemorrhages such as epistaxis, and gastrointestinal bleeding. Occasionally bleeding from the ear canals and the eyes has been reported. Some of the patients with psychogenic purpura also have dissociative reactions, conversion symptoms, and hysterical traits along with their hemorrhagic symptoms.24 It is a medical opinion that, while psychogenic purpura may contribute to the formation of stigmata, it is unluckily to be the sole cause.

Active self-mutilation is probably involved as well. However, unlike secular self-mutilators who generally recognize themselves as the cause of their wounds, true stigmatics likely engage in self-mutilation during altered states of consciousness involving an experience of the divine, while retaining no overt awareness of their actions.25 Moreover, proof has been provided by the microscope that the red liquid which oozes forth from these wounds is not blood; its color is due to a particular substance, and it does not proceed from a wound, but is due, like sweat, to a dilation of the pores of the skin.

Yaryura et al26 also offer the premise that the onset of the menstrual cycle may involve two components of the limbic system: “the hypothalamus and the amygdala (amygdale).” The first contributes to the secretion of two corticotrophin hormones, “follicle stimulating hormone (FSH) and luteinizing hormone (LH),” both necessary for menstruation.

The amygdala, one of two tiny, almond-shaped masses of gray matter that are part of the limbic system located in the temporal lobes of the cerebral hemispheres regulates rage, which may be manifested as self-harmful behavior. “Therefore, a disturbance of the limbic system resulting in both self-mutilation and menstrual disturbances were noted in a group of wrist cutters.” It should be emphasized that all of these scientific explanations may unduly minimize the power of the imagination, joined to an emotion.

The Anorexic

Anorexia comes from the Greek an (privation) and orexis (appetite), and is a general term used to describe any “diminution of appetite or aversion to food.”27 Anorexia nervosa is diagnostically defined in the DSMIV-TR (Diagnostic and Statistical Manual of Mental Disorders) to that individual who refuses “to maintain a minimally normal body weight, is intensely afraid of gaining weight, and exhibits a significant disturbance in the perception of the shape or size of his or her body.” Rudolph Bell, whose book, Holy Anorexia (1985) is a well-documented source for biographic essays of female saints of the 13th century, retroactively applies the contemporary diagnoses in his analysis of the blessed and the sainted examples provided in his book. Being a young female commoner in the Middle Ages was not a positive asset. Her choices for dignified survival were sparse. Some of the few who somehow had the financial whereJournal for the Study of Religions and Ideologies, 8, 25 (Spring 2010) Robert F. Mullen Holy Stigmata, Anorexia and Self-Mutilation withal to enter a monastery may have been inculcated into spiritual fervor, but any aversion to eating as an ascetic extension of their active religious mortification probably superseded concerns with maintaining a normal body weight or the shapeliness of their bodies. Bell lists several young women, all of Italian descent, all stigmatic, some of whom would purge and vomit, and exhibit propensities towards “self-mutilation, and severe “dietary constriction.” He glorifies “holy anorexia” as part of a “wider pattern of heroic, ascetic masochism amply justified” in the literature of radical Christian religiosity,28 yet he contradicts any sublimation of the stigmata by documenting chronicled aberrances through “ambiguous hagiographical sources.” If there is an overreaching premise to Bell’s book, it is less a work of innovative ethnography than a wellresearched overview of various stigmatic women, saintly and otherwise, who practiced fasting and meditation, long deemed a formidable prerequisite for achieving transcendence. Bell purports that the holy anorexic, by rejecting the advice of her confessors and of saintly intercession, ultimately dies of starvation and by doing so, “becomes a saint.” However, in his defense, Bell29 makes a clear distinction between anorexia nervosa and its pathological inheritances, and what he calls holy anorexia, where the potential stigmatic “stops eating, taking her nourishment from the [Eucharistic] host.” This inability to ingest anything except the Eucharistic host as a comparative definition for anorexia nervosa is insufficient for this study. The reality is larger than that and there are numerous psycho/physiological similarities between fasting, the ascetic, holy stigmata, and anorexic self-mutilators which we attempt to clarify in this paper.

The subject of fasting as religious ritual lies well beyond the requirements of this paper. Fasting is often used as preliminary for trance (as is sleep disruption and deprivation). One reads about it in the works of Carlos Castaneda. Eliade writes of it prolifically, citing, for one, Marduk’s descent into hell where there “corresponded a period of mourning and fasting.”30 Catholics are asked to fast for Lent. The young male Jivaro initiate of South America does not eat for days, only drinking “narcotic beverages.”31 North American Indians require fasting in solitude to provoke “the dreams and visions” that accompany trance initiations, often abstaining from food for up to four days. The Carob youth in Dutch Guinea cannot become a pujai (spiritual exorciser) without absolute fasting.32 Those for whom the subsequent hallucination or trance “connotes a mystical state” attribute the condition to either “the temporary absence of the subject’s soul” or possession by a “supernatural power.”33 There is vast evidence that fasting is, and historically has been, widely used in many cultures as an element of “systematic measures intended to ‘induce trance states,’ and in many cases, is emically associated with ‘transcending spacetime to access mystical knowledge’”34

–  –  –

What Defines the Self-Cutter Joyce Wagner’s35 quantitative study explored possible relationships between college-aged women’s self-injurious behaviors, sexual selfconcept, and spiritual development. On the topic of spirituality and religion, Wagner’s sample of self-cutters overall had a much higher average level of spiritual development than anticipated. She hypothesizes that, in part due to their struggles with self-injurious behavior, her participants in the survey had a more critical commitment to their choice of beliefs, values, and commitments while “taking personal responsibility for these choices, making their faith more individualized and selfauthentic.” The self-cutter and holy stigmatic have analogous influences and their experiences are “often reduced to the “symbolisms”36 that [are] defined by “cultural constructions of meaning and morality,”37 or, in essence, “learning, expectations, and beliefs.”38 The misogynistic treatment of women by men and the Church during the Middle Ages is no secret. “Not merely a defensive reaction on the part of men who were in fact socially, economically and politically dominant, it is fully articulated in theological, philosophical and scientific theory that is centuries old.”39 Howard R. Bloch believes the misogyny was so dominant, persistent, and slow to dissipate, that even today, such prevailing opinion and terms “still govern (consciously or not) the ways in which the question of woman is conceived by women as well as by men,”40 which weaves an interesting relationship between young, impressionable, female stigmatics to their young, vulnerable, modern counterparts.

Anthropologist Daniel Fessler41 posits that stigmatism occurs from “preexisting schemas” that involve “fasting, visions” and wounding. The unwillingness or inability to eat is both a form of spiritual and/or penitential asceticism in religiosity, as well as a way of “asserting power over a body that may be lacking in other forms of control.” Bynum adds that this asceticism, “particularly in the form of food deprivation” and “self-inflicted suffering,” was prevalent in medieval women’s religious behavior.42 The phenomena she describes are also part of the present day ritual of self-cutters.

“It’s virtually another world. It’s a world within this world. It’s strange; it’s like a spiritual world … It’s pure spiritual rather than the intellectualized spirit … and the stage of being where you can meditate and think deep and wonderful thoughts about existence.”43 That depth of gracious interiority could just as easily been a declaration from a saint as the tortured, teenage self-cutter who authored it. Either runs the risk of falling “into nothingness and tortured identity Journal for the Study of Religions and Ideologies, 8, 25 (Spring 2010) Robert F. Mullen Holy Stigmata, Anorexia and Self-Mutilation diffusion”44 without a mutilation, a sacrifice so to speak. “Sacrifice,” in line with the subject matter, is defined as performing a calculated act of desperation in favor of gaining a higher telos. To wound is to heal.

Healing is a process. The ripped skin becomes the physical manifestation of “confessing, atoning, or cleansing”45 in preparation for that more embracing telos.


Somewhere in the author’s family archives there is a photograph of a young and impressionable Catholic youth walking the aisle after his first Holy Communion. Around his neck hangs the requisite theca (pay-forindulgence). Encased within the plastic is the bone splinter of a saint whose name now escapes. His hands are clasped so tightly and fervently under his chin they resemble a flesh-colored necktie. He had dreams of joining the seminary and eventually fulfilled his aspirations for a time. His parents were both Irish, Sunday-only Christians and he was greatly indoctrinated by nuns and priests at parochial schools. Frederick Streng explains his youthful spiritual energy as a determination in part created by associated biological and neurological forces accompanied by psychological, “social…and linguistic structures.”46 It is not difficult to strengthen this childlike resolve into adult experience.

Another of Gillian Straker’s self-cutting patients expresses her experience thusly: “Finally, something to touch, feel that is outside in the world. It sort of forces your inside out in a manner of speaking. It makes the interior, the pain, legible to you and then to others.”47 It is here that the phenomena of the stigmatic and the self-cutter merge to encompass the mutual bricolage of pain, imagining, languaging, self identity, and scientific supposition within bodies under siege. Are there warning signs, physical evidence, emotional catharses, and/or common personality traits that predetermine the viability of those prone to skinmutilation? It has already been evidenced that there are multitudes of individuals who have a propensity towards fasting. Fessler posits that these individuals are “most likely” to find “meaning, justification, and additional motivational force by creating a systematic symbolism.”48 Yaryura et al warn that those with compulsive-obsessive disorder may also be susceptible to self-mutilation for the simple fact that OCD demonstrates “many similarities” with ritualized behavior,49 as researchers maintain a “substantial correlation” between OCD and religiosity.50 Glucklich astutely sums it up by understanding that “[i]dentity, personality, and self” reside within “mental-cultural factors and neurodynamics.”51 Some blame the serotonin neurotransmission levels, or a maladjusted or over-stimulated hypothalamus, as well as a decrease “in the intensity of the serotonin transporter binding sites in the frontal cortex.”52 Journal for the Study of Religions and Ideologies, 8, 25 (Spring 2010) Robert F. Mullen Holy Stigmata, Anorexia and Self-Mutilation Developing hypotheses, while working diligently to explain psycho/physiological causes, do not yet adequately address the following imperative inquiries: 1) what types of personality engage in the need for connecting or reconnecting with another self, whether it be an altering or higher one; 2) how do they integrate into this empowered self; 3) why is pain or even painless cutting necessary to achieve this telos; and 4) what are the net benefits of this transition or transcendence?

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