AbstractSelf-injuring behavior in teenagers and adults is highly correlated with histories of childhood trauma. These symptoms, including self-mutilation, eating disorders, substance abuse, excessive cosmetic surgeries, and compulsive exposure to danger, can be understood as physical and psychological reenactments of trauma-based relationships with the abuser(s) and the nonprotecting bystanders. Using an integrated three-stage treatment model, Trauma Reen-actment Syndrome (TRS) can be approached through a narrative focus on the logic and relational functions of the self-harming behavior. Assessment and treatment guidelines are described.