Self-inflicted injury, an increasingly common phenomenon in psychiatric settings, often is seen in borderline clients who scratch or burn themselves repeatedly. Their dysfunctional behavioral patterns present special challenges to the psychiatric/mental health nurse who seeks to interrupt such destructive means of coping. Aside from the difficult task of assisting these individuals to deal with their feelings in a constructive way, the psychiatric nurse often struggles with difficult countertransference feelings. The authors review a historical perspective of self-injury behaviors, define the phenomenon through the procedure of concept analysis, propose the creation of a new nursing diagnosis, and outline interventions appropriate for these clients.