a letter? was that meant for me? >> yeah. >> how are you doing? >> so i see people when they need to be seen, when they asked to be seen, when somebody else thinks they need to be seen. i will see what's wrong, see what can be done in the institution to help them cope. >> the only way i can get out of this mood, i mean, i don't care, you can give me drugs, alcohol. the only way i can get out of moods is through self-injury. >> okay. >> group therapy in the shu is conducted with each inmate locked in a separate holding cell. dr. sims moderates this small group of self-mutilators. >> once i see my blood, i'm in another world. i'm a different -- i'm someone totally different from myself. i mean, that's the only time i actually, you know, can actually feel real, feel alive, and feel like everything's going to be okay. >> for me, it's being in control. my whole life, i felt like i wasn't in control. but then when i had times when i do cut myself, i'm in control of the situation. >> there are a group of people that self-injure when they come to prison as a way to control their level of pain, that when they're in so much pain that they don't know what to do, that they are starting to feel like suicide, that self-injury cuts their level of pain down, so it's pain control. >> self-injury really isn't bettering yourself. and sometimes people die. but i mean, it's just -- >> it's the survival tool that you developed. some people self-injure as a