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This study examines the Object relations of hospitalized children who exhibit nonsuicidal self-injurious behavior (NSSI). A retrospective review of medical records of 87 adolescents in an urban psychiatric hospital was conducted. Thematic Apperception Test responses of NSSI children were scored using the Social Cognition and Object relations Scale and compared to non-NSSI peers. Results of Analysis of Variance showed a significant difference in complexity of representation of others between NSSI and non-NSSI adolescents, and trends in the data showed lower emotional investment in values and moral standards and greater understanding of social causality among NSSI youth. NSSI participants had a greater percentage of nonspecific learning disorders and trend towards a greater percentage of depression. NSSI adolescents were significantly older than non-NSSI adolescents. Clinical implications for psychotherapy are discussed.