This chapter provides a case of a 29-year-old man who presents with his sixth deliberate self-harm episode in 4 months. He has made four attempts to hang himself, jumped out of a building and thrown himself in front of traffic. He was brought to the emergency department as he tried to hang himself outside his girlfriend's house. Each hanging attempt has been triggered by an argument with his estranged girlfriend. He wants to ensure that she is aware of what he is doing and the extent to which he is suffering because of her behaviour. He has been charged with domestic violence in the past, but the charges were dropped as she withdrew her complaint. There is no suicide note and he has made no efforts to settle any of his affairs. He does not have any ties to anyone in particular and most of his relationships tend to be fairly transitory as he ends up falling out with people.