each case is different- i know of someone who does get piercings as a form of self-harm, it doesn't have to take any one form. i also know of someone who cuts themselves as morlun said, as a form of release- it was described to me as feeling the pain took their mind off other things for a split second. as for 'attention seekers'- the fact that they feel they need to cut themselves just to get someone to take notice, does that not suggest there must be something seriously wrong in the first place? and i'm not talking about the stereotypes here.