Given the multiple challenges faced by our study participants in New Mexico, and the extraordinary conditions that define the contours of struggle for coherence in their lives, a focus on the specific act of cutting offers a necessarily limited but existentially critical insight into the nature of their experience. Without a doubt this requires attending to the question of children’s agency as a capacity with which youth are endowed, as we have invoked by citing childhood studies literature and in our analysis of individual vignettes. Childhood studies scholars embrace a concept of agency as a reaction against models of childhood with more structural and chronological substrates, allowing children to be recognized as meaning makers rather than passive recipients of action . However, in the present context, we must also see agency as a fundamental human process that is no less fundamental for being challenged by illness . Specifically, self-cutting is a crisis in the agentive relation between adolescent bodies and the surrounding world, or put another way, a crisis of their bodily being in the life-world that they inhabit. In understanding embodiment as an indeterminate methodological field, this relationship between body and world is defined by three modes or moments of agency: the intentionality of our bodies in acting on the world or being-toward-the-world, the reciprocal interplay of body and world embedded in a habitus, and the discursive power of the world upon our bodies to establish expectation and shape subjectivity . To be precise, approaching the interpretation of cutting from the standpoint of agency in these troubled adolescents’ body-world relationship has the immediate effect of shifting interpretive attention from the wounded flesh to the relation between the active hand of the cutter and the self-inflicted wound. It is then not just a matter of the pain, the relief, or the blood that originates at the violated boundary between self and world, and the concomitant breach in bodily integrity.
In the first mode of agency,vertical farm tray regardless of the implement used to cut with, the cutter’s hand is an agent of self, and the opening of the wound and flow of blood are an emanation of personhood into the world. Cutting is a form of active being toward-the-world whether understood as a form of projecting outward or as a kind of leaking and draining into the world. This mode of agency is epitomized in the statements of identity such as “I am a cutter.” In the second mode or moment of agency, hand and flesh together instantiate the reciprocal relationship of body and world. The cutting hand interpellates the part of the animal and material world that is one’s very own body, and that precise fragment of the world responds with the opening of the flesh . In this way cutting highlights the simultaneity of body as both self and other.The reciprocity between body and world is highlighted in the simultaneous infliction of pain and the granting of relief. The cutter’s body is also the locus of an anguished subjectivity that elicits the application to itself by an agentive hand ambivalently cruel and kind, of an otherwise inert implement from the material world, whether it is a razor blade or a piece of glass. In the third mode of agency, both hand and flesh are no longer part of an inviolate self but conscripts of the world’s oppressive agency, and one’s body may as well not be one’s own but just a body, any body, “the” body as an object rather than a subject. The cutter’s hand is now the hand of the other, the wound is world-inflicted, and structural violence is incorporated at the most intimate bodily level. That is, it is inflicted by an anonymous oppressive world or the world dominated by the cruelty of others, and one’s flesh becomes an inert object alienated not only from self hood but from the trajectory of a possible life, isolated from others and immersed in the immediacy of present pain and unproductive bodily transformation. We must take care to distinguish what is specific to each young person and what is fundamental to their bodily experience in the account we have just given.
Attending to the immediate life worlds of individual youth reminds us that each has a distinct experience of cutting under distinct circumstances. Gender, ethnicity, and socioeconomic status matter to define these circumstances, while family relations and especially family instability are particularly insistent and frequent themes. Insofar as all the youth we have discussed were psychiatric inpatients, they can be counted among the more extreme instance of adolescent self-cutters, while exhibiting varied diagnostic profiles, levels of functioning, regimes of psychiatric medication, and phases of treatment and recovery. The combination of individual uniqueness and shared extremity across their situations has allowed us to elaborate a multilayered crisis of agency in the relation between body and world and highlights the existential profundity of cutting as a function of its mute immediacy in practice. The possibility for this kind of embodied existential analysis is that cutting is not an idiosyncratic occurrence but a culturally patterned act. Yet it cannot be accounted for just because other kids do it, and this is why it has been important to examine it in the lives of afflicted adolescents rather than simply as an element in the ethnography of “Emo” culture. The interpretive point is that the trajectory of our argument from experiential specificity on the individual level to the fundamental human process of agency does not define the ends of a continuum. We must instead understand the extraordinary conditions of suffering as simultaneous with the enactment of fundamental human process, because the relation between body and world is always embedded in a specific instance, and each specific instance points to our shared existential condition of embodiment. Identifying the wounded flesh as locus of agency at the intersection of body and world as we have done brings to the fore a particular configuration of relations between self as active and passive, strategy and symptom, subjectivity and subjectivation.
The moment of cutting is a fulcrum or hinge between the self as agent or as patient, with an intended pun on the medical sense of patient. From the standpoint of individual experience, cutting in the first sense is a strategy that is part of the self as agent, while in the second sense it is a symptom that is part of a disease process. As a cultural phenomenon, cutting in the first sense exhibits the body as existential ground of culture and wellspring of agentive subjectivity , while in the second sense cutting identifies the body as a site at which cultural practice and structural violence are inscribed and have the effect of subjectivation . In this respect, the distinction between subjectivation and subjectivity in the cut/cutting body is substantively parallel to the distinction between symptom and strategy in the afflicted person. Perhaps the analysis we have presented suggests that self-cutting may indeed be sufficiently complex to serve as the core of a distinct diagnostic category and too problematic with respect to agency to be defined as a symptom in the ordinary sense. Whether or not this proves to be the case, the existential complexity to which we have pointed is precisely what one would expect by bringing attention to bear on cutting as a crisis of agency with its locus at the intersection of body and world.Public health measures to contain the spread of COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, have affected billions of people worldwide. In March 2020, approximately 1.7 billion people were under orders to remain at home or shelter-in-place . Such orders,vertical farming suppliers which mandate remaining at home except for essential activities and outdoor exercise with social distance , are crucial to slowing transmission of COVID-19, preserving healthcare systems’ capacities, and limiting deaths . However, successes in mitigating the spread of COVID-19 are paired with devastating economic, social, and psychological effects .Yet, engaging in regular PA can be challenging under even normal circumstances. In 2018, 54.2% of American adults engaged in light or moderate activity for 150+ minutes/week or vigorous activity for 75+ minutes per week . SIP orders may further reduce activity levels by decreasing incidental daily PA and exercise opportunities . As such, the World Health Organization issued recommendations for engaging in PA at home . Many people face serious challenges to being physically active during SIP. Many neighborhoods may not be conducive to safe, socially distant outdoor exercise. Moreover, many individuals have increased demands on their time during SIP, such as essential work, caring for family members, and standing in long lines to buy necessities.
Vulnerable communities, particularly communities of color, have been disproportionately affected by COVID-19 . On the other hand, SIP may facilitate greater PA for some individuals. Those who transitioned from commuting to working from home may have more free time for PA. Additionally, individuals and families may spend time outside to combat boredom and stress. Some stress management strategies that may be used during COVID-19 involve physical activity , while others are mostly sedentary . We hypothesized that adults who met PA guidelines during COVID-19 SIP would be less likely to report increased stress during SIP and would be more likely to report use of physically active stress management strategies. We also explored whether increased stress would be associated with PA pattern or associated with use of specific stress management strategies. Participants were recruited from the U.S. component of the Stanford WELL for Life initiative , a cohort of adults residing mostly in Northern California. Eligible participants for the WELL for Life cohort were age 18 or older, residing in the U.S., and able to complete the online survey in English. Participants were recruited through research registries, Stanford listservs, social media, and through existing community partnerships . WELL for Life cohort participants who had indicated willingness to participate in other studies were invited to participate in the present study examining well-being during COVID-19. Participants completed surveys in early SIP and mid-SIP . Participants provided informed consent and the study was approved by the Stanford University Institutional Review Board. The majority of participants resided in the San Francisco Bay Area, where a regional SIP order on 17 March 2020 affecting 6 Bay Area counties and the city of Berkeley mandated closure of indoor and outdoor recreation venues such as gyms, climbing walls, playgrounds, golf courses, basketball and tennis courts, and pools . Additionally, the state of California closed many state parks and beaches and instructed residents to stay close to home for recreation . Most restrictions remained in place through the end of May 2020 . Past-month PA was measured with the Stanford Leisure-Time Activity Categorical Item , a validated measure with excellent sensitivity to change in PA over time . Participants selected one of six descriptions that best matched their past month leisure time physical activity. Scoring was based on adherence to the 2007 American College of Sports Medicine/American Heart Association guideline of: a) 30+ minutes of moderate-intensity aerobic physical activity 5 days/week, b) 20+ minutes of vigorous-intensityaerobic physical activity 3 days/week, or c) a combination of the above . Responses were categorized as meeting/exceeding or not meeting PA guidelines. Participants responded to, “What are you currently doing to manage your stress?”. In early SIP, the question was open-ended. Participant responses from early SIP informed the 10 response options provided in mid-SIP: outdoor physical activities , indoor physical activities , yoga/meditation/prayer, calling/video-chatting with friends and family, watching TV/movies at home, reading, listening to music, gardening, sleeping more, and eating more. Participant characteristics Participants reported their age, gender, race, education, total combined family income, marital status, employment status, and the number of people living in their household. Participants also reported the number of days they drank alcohol in the past month and whether they used cannabis in the past two weeks . Current smoking status was derived from two items; participants were considered current smokers if they reported 100+ lifetime cigarettes and currently smoking “some days” or “every day” . Differences in participant characteristics by mid-SIP PA were tested using independent-samples t-tests and chi-square tests. PA pattern from early SIP to mid-SIP was coded as “remaining inactive” , “remaining active” , “becoming inactive” , or “becoming active” .