In this chapter, the author describes how women in the criminal justice system, including those in secure mental health settings, use self-harm to contain and communicate violent feelings, experiences and thoughts. She argues that self-harm has a hopeful function for many women, and is not simply a pathological expression of despair, nor necessarily a suicidal act. The addictive, intoxicating aspect of self-harm creates intense feelings in staff, and this is part of its communicative power. The author explores how practitioners respond to self-harm, and how some responses are enactments, with destructive consequences. She considers self-harm separately from suicide, though the two can be linked. There are important literal and symbolic uses of self-harm as a form of inscription, making links with the practice and function of tattooing as marking, possessing and articulating the body. For many women, including those in custody, self-harm is not about suicide but about survival:That’s when the author wanted to cut.