Self-esteem and self-mutilation often go hand in hand. Don't like yourself, then find a way to change yourself so you can move on mentally. Workout, learn, create, etc. Those that have nothing but the skin on their flesh get tattoos. Those who have tried all they can think about then mutilate themselves a bit more with piercings, and more than that it's just general depressiveness and a downward spiral. To do a shody parallel, pilots in downward spirals can recover, by identifying the situation, and providing input to counter the movement, I think bodies and minds are a bit like that, so don't give up, find out what's bringing you down and counter it until you soar above the clouds.