Most often, it is young girls and women who visibly self-harm (cutting and slicing the skin, burning with cigarettes and lighters, scalding, etc.). Their numbers are increasing; in all psychotherapeutic and psychiatric clinics, they are pronounced problem patients. The causes and psychodynamics of this deliberately horrific behavior are so peculiar that self-harming behavior must be regarded as a distinct disorder. The author has researched this phenomenon over 15 years of psychiatric and psychotherapeutic work. In this book, he develops a psychoanalytic therapy strategy based on a variety of clinical examples, addressing anamnesis, psychodynamics, structure and diagnosis, as well as specific issues in inpatient psychiatric and psychotherapeutic care and in outpatient long-term psychotherapy.