Kim Hewitt explores self-mutilation through history and across cultural divisions, finding these acts "positive expressions of social custom, individualism and resourcefulness . . . symptomatic of crises of identity, religious faith, or modern social structures." In modern contexts, such ancient rituals continue to function as an avenue of symbolic death and rebirth. In her analysis of the origins and motivations of body modification, the author draws upon psychological, medical, and cultural theories on self-inflicted pain-tattooing and scarification as well as fasting, bulimia, and some performance art. She finds such contemporary acts of self-mutilation may "express a change in how society perceives marginalization."