Acts of psychotic self-injury that occur in institutions often leave staff members at a loss and powerless when facing such instances involving the acting out of the body’s “attacks” in the real. The caregivers have trouble making sense of such acts. It appears fundamental to question the background situation that triggers such an act with a thorough psychopathological study of the body’s return of the real, as defined by modernity. Beyond this point, the clinical study of self-harm questions the idea of a body itself and the individual’s relationship to the world, to the other. The author shows how the transition from cutting the body to a trace, a line, or even writing on the body can be an attempt to “knot together” the real, symbolic, and imaginary so as to place the body within its boundaries. These inscriptions of the real on the body are, in certain cases, to be considered as “auto-therapeutic” solutions with their calming effects for the patient.