Self-injurious behaviors were compared with tattooing and piercing in a college population. Findings indicate a high prevalence of self-injury. Students who self-injured were motivated by a desire to alleviate emotional pain; students who tattooed and pierced by self-expression. Students who self-injured scored higher than students who tattooed and pierced on measures of depression and scored lower on self-esteem and sense of control scales. The incidence of all 3 body-altering behaviors was higher among participants reporting physical/sexual abuse or eating disorders.

This case study describes the counseling experience of a college woman undergoing treatment to address self-injurious behavior. The article presents and illustrates a counseling approach that is conceptually based on attachment and object relations theory. The approach emphasizes the client-counselor relationship and the need to establish a supportive interpersonal environment as the main factors contributing to positive change in the client's self-injuring behavior.