In this article, the author discusses self-injury, which is a strategy to manage painful emotions. Generally, it is not about attempting suicide. In addition, it operates in complex ways. One one level, it is a method of communicating feelings when the self-injurer lacks other skills with which to express them. On another level, it helps people crystallize and clarify nebulous emotional feelings into tangible physical sensations. Although treatment is often effective, for colleges and universities self-injurious behavior (SIB) can sometimes be an intractable problem that presents distinct challenges because it is so easily and often confused with suicidal intent. To respond effectively, higher-education institutions should first ensure that their counseling services' clinical staff members are trained to assess and treat SIB. Second, colleges and universities would benefit from developing administrative protocols for responding to self-injury. Because the line is not always clear between a private act of self-injury and one that involves numerous students, professors, and staff members, college officials should also include clear behavioral definitions of what actually constitutes a disruption to the campus. Policies should encourage students to seek help and should not be punitive.