Milia examines the effect of art therapy interventions with clients who harm their bodies. Her starting point is the definition of self-mutilation. In many cultures, self-mutilation is ritualized as a means of healing the whole socity. Body modifications such as scarification and tattooing are used in rites of purification, healing and maturity as well as performance art. The author draws out these aspects of self-mutilation, informing the reader with theories from psychoanalytical literature to explain how art therapy can help patients who self-harm. She argues that using art as interventiona supports the self-mutilator's preference for ritualized symbolic action and need to create transitional objects. She describes artmaking in terms of the modification of the self-mutilator's own body. The creative process itself provides an arena for aggressive impulses and develops self-control, patience and self-esteem. Demonstrating how these theories can be implemented in practice, the author then describes examples from clinical experience and includes a case study. She analyses art therapy sessions and the process and content of artwork.