Self-injurious behaviors (SIBs) represent a significant threat to the morbidity and mortality of vulnerable prisoners, and are now a ubiquitous aspect of the correctional system. Currently, correctional staff receive little specific training or appropriate guidance from national standards to respond to this dangerous behavior. To date, the overwhelming majority of empirical research on self-injury in prison has relied upon the viewpoint of academicians and/or correctional staff. This select viewpoint has reduced the perspective of the self-injuring prisoner to a passive role. In response, we utilized a qualitative methodology to access the perspectives of 20 highly recidivistic self-injuring inmates housed in three South Carolina prison. Interpretative phenomenological analysis was employed to identify fundamental themes underlying SIBs. Findings indicate that the meaning of self-injury is rooted in traumatic family milieus with the behavior becoming a fixed coping mechanism over time. Respondents perceived stress and control as dominant themes, though mental illness, physiological responses, and negative emotional states were also important. While desistance from self-injury appears unlikely, key policy solutions are presented in accordance with these inmate perspectives. This phenomenological inquiry suggests that efforts to understand these inmate "accounts" and personal history serve as a potentially efficacious means of understanding SIBs occurring in prison.Keywords self-injurious behaviors; qualitative interviews; prison inmate; phenomenology; mental illness On 9 February 2010 at approximately 6:40 pm the following incident occurred in Dorm C in Heartwood Prison. Officer Johnson was conducting a security check. Officer Johnson observed Inmate Harold Owens bleeding from his left arm and left leg. First responders were called and arrived at Hayden P. Smith is an assistant professor of criminology & criminal justice at the University of South Carolina. His principal focus of study is the intersection of the criminal justice and public health systems. This includes studies on self-injurious behaviors by inmates, mental health needs of correctional populations, jail diversion, national standards of care, and premature morbidity and mortality associated with reentry. Correspondence to: