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The extremely common occurance of self mutilations (with a frequency of more than 80 % of cases) in borderline functioning and identity instabilities should make them an almost pathognomic symptom if we didn’t see them developing as well in other forms and at other intensities in the whole array of mental pathologies, which themselves are always an extreme reflection of social evolution. By its polymorphic expression, self mutilation demonstrates that it refers back to diverse psychic structures, from precarious neurotic structures to melancholic depression, passing by way of the false self and alexithymic functioning, which are more or less organized with perverse defense mechanisms.