Self-mutilation is generally seen only as a negative response to trauma. But when trauma cannot be expressed, other forms of communication become necessary. As gestural communication, self-mutilation can reorganize and stabilize the trauma victim's world, providing a "voice on the skin" when the actual voice is forbidden. This is a plausible extension of Merleau-Ponty's gestural theory of language, and an interesting comment on his notion of "reversibility" as essential to linguistic communication.