This narrative review draws upon a broad range of literature, including theory and empirical research, to argue that positive emotions are a useful adjunct to therapy when working with individuals who self-harm. The review highlights how self-harm is often employed as a method of emotion regulation and may be both negatively and positively reinforced. It is suggested that individuals who self-harm have potential difficulty in experiencing positive and negative emotions. The compatibility of an emotion focused approach to therapy for individuals who self-harm is therefore deemed an appropriate one. However, current therapeutic models predominantly focus on unpleasant or negative emotions and largely tend to neglect positive emotions, such as happiness. Broaden and build theory indicates that positive emotions can reduce the effects of negative emotions and aid recovery from intolerable negative emotions that may underpin self-harming behaviours. Therefore, the incorporation of positive emotions into therapy is likely to be helpful. In addition, if cultivated over time, positive emotions can build resilience that may enable individuals to cope better with events that precipitate self-injurious behaviours. The review emphasizes how positive emotions represent a valuable addition to therapeutic work but also highlights that the negatively valenced and painful emotions often experienced by those who self-injure must still be addressed.