"It could be cutting, scratching, pins, razor blades, knives, anything, shards of broken glass," Duffy said.
Most of the time, it is a silent scream no one sees. Covered up, Vicki has about 300 scars. Elaina used to self harm, too, but doesn't anymore. She has scars on her forearm, thigh and stomach.
"It was a release for me - couldn't cry, I had a hard time. This was a way to get out the pain," she said.
So what worked to stop this? Spending time with people who understand, and giving other's opinions less weight.
"Letting go of what they viewed of me, and knowing my self-esteem was more important than what anyone else thought of me," says Launching Point member Kevin Hofmann.
Now, Hofmann has a big job in sales and counsels and volunteers. Elaina is doing well, too, but at 18 she tried to commit suicide.
"I didn't seek help, but there I was in ICU and I saw what it did to my mother, and how it affected her," Elaina said.
Duffy has created a safe place at Launching Point - they even do outreach at fairs and festivals. She makes sure people know that self-harm is violence.
"I call it violence because there is nothing happy or good about it," adds Duffy.
However, Launching Point is the opposite - people bond, go out, laugh, cry and get better. What does Duffy say to family and friends of those who are self-harming? She says listen, say nothing and give no advice. She says to let them know that there is hope out there - and help.