C was a 16- [year]-old girl who was mutilating herself by scarring her skin. She first came to the clinic in 2008 because of the decrease in her academic achievement in her high school education. After a few sessions she started to talk about some of her depressive symptoms such being uninterested in usual habits (playing piano or dancing), sleeping more than usual, and crying a lot. In addition to these symptoms she stated that she had cut her hair at a time she was feeling extremely angry and she was scarring her skin when she felt bored or helpless. During the session she talked about how she likes the pain and how she wanted to feel the pain so she did not want anyone's help, and wanted to die in a big accident or stay in a hospital for a while because of an important (may be temporary) illness. After this session she was referred to the Rorschach Test for psychological assessment. According the findings of this test, she was in an essential depression and unable to manage her depressive affect. She did not have the capacity to move on without the support of someone else. These findings were discussed within the light of literature about self - mutilation and negative (malign) narcissism.