This work analyzes the complex issues surrounding self-mutilation, drawing on case studies from clinical psychiatry and cultural anthropology to show that the phenomenon is deeply embedded culturally, and far more common than is often thought. Although body modification and blood rituals are shown to be common in many religions, rites-of-passage ceremonies, and therapeutic procedures, deviant self-mutilation, the author argues, is a distinct syndrome of impulse dyscontrol beginning in adolescence and often associated with eating disorders. According to the author, up to half of all female chronic self-mutilators have a history of anorexia or bulimia. This edition contains new information on the diagnosis and treatment of self-mutilation; the link between self-mutilation and eating disorders; and new research on the neurotransmitter serotonin, and associated advances in drug therapy.