The author discusses the case of a 25 year old woman who has been admitted to hospital 49 times in 10 years for various self-destructive acts; the nursing management problems involved & how the medical model approach can perpetuate maladaptive behavior in someone whose problem is behavioral rather than psychotic. The hospital setting supplies the attention desired by the patient & the acceptance of the behavior as resulting from illness provides an excuse for continuing the behavior. (GW)