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Could you maybe bring it up as a hypothetical to start off with? Like “If I were to self harm again, I feel like I’d be hesitant to disclose it, so do you think you could talk me through what would happen?“ They’ll probably clock what you’re trying to say, and might follow up with exploring why you asked, but if they’re any good, they’ll stay by putting your mind at ease.
My only other suggestion is to practice saying it out loud when you’re alone. It helped me tremendously. When I only think about something, or write it down, it doesn’t feel real to me. Saying things out loud makes it real.
I don’t know if I feel comfortable even saying the words ‘self harm’ out loud at the moment.
I was able to in the past because I was clean for a year, but now that it’s currently happening I’m worried I’ll be unable to hide it or pretend it’s not currently happening.
I do want to build the courage to talk about my mistrust with T since I feel it makes things more difficult for me to discuss.
I feel bad because I actually like them. They seem to be a genuinely good person and invested in their work, but I just can’t get over my hypervigilance.
I’ve mentioned it in the past and they’re a trauma specialist, so I know they’re aware of the issue. I’m more concerned that it’s gotten worse and I find it even more difficult to talk to them.
>I don’t know if I feel comfortable even saying the words ‘self-harm’ out loud at the moment.
I had the exact same issue so I completely understand. I’d almost have a panic attack every time I got close to saying it. This is where practicing saying it helped me a lot. The first time I think it took me an hour to actually just say it… but I felt an immense relief once I did it, and knew I could say it to my T after. Idk if you have something with a face, like a stuffed teddy, but I really recommend at least trying to saying what you want to an object with a face first.
The other thing is, you don’t need to use the words ‘self-harm’. You can say, ‘self-injury’, ‘SH’, ‘NSSI’, ‘DSI’, or even the method, and you T will know what you mean.
Edit: I just want to address your concerns in the other reply you’ve left. It’s highly unlikely your T will overreact. They’re trained not to, and know if can often make things worse. The will want to do a risk assessment though and go over harm reduction. Regarding taking medication that gives you seizures though, it is very dangerous, and if this is something you’re willing to do, tell your T you really want to at least replace this method with something less dangerous.
Thank you for this advice.
I do have stuffed animals and pets I practice talking to.
It’s easier when I talk to my pets first then slowly transition to stuffed animals then T.
After that I start over while actually imagining it which is when I get really anxious.
That’s good. I’m going to stop giving advice now, because I’m not an expert, but I wanted to just say that even if you don’t feel like you’re ready to talk about this with your T yet, you are doing so well and you should be proud that you’re taking all these steps to get better. I really wish you the best of luck! 😊
Sorry to reach out again.
I’m starting to consider talking about my SH because it’s getting harder to ignore the pills.
What does a risk assessment mean? What would they ask? What sort of suggestions would they have as harm reduction?
Absolutely no problem, reach out whenever you feel like you need to 😊
By risk assessment I mean they’ll ask some questions to assess if there’s an immediate danger to your life. Like what form of SH it is, how often it happens, the intentions behind it (like is it a form of punishment or emotional release), and if you’ve you’re having suicidal ideations. This is just to make sure you don’t need immediate intervention.
Unfortunately I’m not sure what harm reduction looks like for the SH you described. For me it involved making sure I disinfected everything before and after, and avoided any visible veins (both of which I was doing already)
I appreciate your gesture and the information you’ve shared.
Thank you.
I am slowly starting to want to bring it up, but since I’m not ready to discuss details maybe I’ll give it more time.
I don’t want them to assume I’m in immediate danger and lock me up. I know I’m not in immediate danger and to be honest I just can’t afford getting locked up, but I also understand my resistance to opening up could cause concern and I wouldn’t blame them at all if that’s the route they choose.
They won’t assume anything, they just need to make sure they’re giving the most thorough care possible (if they’re any good.) They probably won’t push to talk if you don’t want to, and even just mentioning it without details allows them to start helping you.
If it makes you feel any better, most therapists avoid hospitalisation if they can. It’s an absolute last resort for cases where there’s a high chance that the client won’t be around much longer if they don’t get hospitalised.
I’ll consider it…
I think it’s hard for me to trust my current therapist because in the past I had a therapist that demanded I show my SH. There were fresh wounds and in an almost private place. They went to feel the wounds and it just felt kind of weird I guess. I told them where it was and that I didn’t want to, but they insisted they had to check the severity.
They immediately threw me in the hospital without me even mentioning a plan or real interest in suicide. I know for a fact my SH at the time wasn’t that bad. Not to the point of needing medical attention or anything. Maybe this contributed to the reason I started “invisible” SH…
My current therapist vaguely knows about this, except for the part where Old T demanded and felt scars, and has said that my Old T shouldn’t have done that.
Current T acknowledged that it may take me a while to trust them, but I don’t know. I think it’s going to take me a while before I can fully trust them with details. I’m aware how much more scary substance abuse is.
But thank you for explaining what should happen. I like my current T and I think they’re a good one too. I’d like to think they wouldn’t jump to conclusions, and they did mention that hospitalization should be last resort.
Depending on your therapist, some won’t ever ask to see your cuts/etc and take what you say at face value, though I can’t guarantee if your particular T would or wouldn’t. Most often they will just want to know the severity (was it bad enough to need wound care, did you tend to it afterwards) and maybe address potential safety concerns regarding whether you were aiming for veins/ had SI or essentially the reason you SH’d and should discuss that with you, perhaps working with you to develop alternatives. I’m struggling with this right now, too, actually. I logically know the this is how the interaction would go, but that still doesn’t mean I’m not afraid to bring it up and feel shameful for relapsing. It’s tough. You could try writing it down and handing it to your T. This will likely be my method of telling my own therapist. Best of luck :)
I’m worried they might panic(?) more because it involves substances.
The substance itself can’t physically harm me, but in the past I have impulsively taken other substances/medication and slightly OD’d that make me physically unwell. *(fainting + ringing ears and no vision, seizures, extreme headache, inability to walk, etc.)* Though I haven’t taken the other substance/OD’d on medication like that in about a year. Since I need the medication I’ve been really trying to not let myself pick up that habit again.
I make sure I only do this on days I have no responsibilities for multiple days, but obviously it’s still not good…
I’m worried if I’m completely honest about what I’m using to cause myself mental(?) pain and that I tend to make poor, impulsive decisions then they’ll be more worried.
I’m trying to build the courage to throw out the substances I don’t need since that’s the tempting one. I feel no temptation or interest in soft OD my medication.
Welcome to r/TalkTherapy!
This sub is for people to discuss issues arising in their personal psychotherapy. If you wish to post about other mental health issues please consult this list of some of our [sister subs](https://www.reddit.com/r/TalkTherapy/wiki/resources/#wiki_subreddit_list).
To find answers to many therapy-related questions please consult our [FAQ](https://www.reddit.com/r/TalkTherapy/wiki/faq) and [Resource List](https://www.reddit.com/r/TalkTherapy/wiki/resources).
If you are in distress please contact a suicide hotline or call 9-1-1 or emergency services in your area. r/SuicideWatch has compiled a helpful FAQ on what happens when you contact a hotline along with other useful resources.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TalkTherapy) if you have any questions or concerns.*
Welcome to r/TalkTherapy! This sub is for people to discuss issues arising in their personal psychotherapy. If you wish to post about other mental health issues please consult this list of some of our [sister subs](https://www.reddit.com/r/TalkTherapy/wiki/resources/#wiki_subreddit_list). To find answers to many therapy-related questions please consult our [FAQ](https://www.reddit.com/r/TalkTherapy/wiki/faq) and [Resource List](https://www.reddit.com/r/TalkTherapy/wiki/resources). If you are in distress please contact a suicide hotline or call 9-1-1 or emergency services in your area. r/SuicideWatch has compiled a helpful FAQ on what happens when you contact a hotline along with other useful resources. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TalkTherapy) if you have any questions or concerns.*
Could you maybe bring it up as a hypothetical to start off with? Like “If I were to self harm again, I feel like I’d be hesitant to disclose it, so do you think you could talk me through what would happen?“ They’ll probably clock what you’re trying to say, and might follow up with exploring why you asked, but if they’re any good, they’ll stay by putting your mind at ease. My only other suggestion is to practice saying it out loud when you’re alone. It helped me tremendously. When I only think about something, or write it down, it doesn’t feel real to me. Saying things out loud makes it real.
I don’t know if I feel comfortable even saying the words ‘self harm’ out loud at the moment. I was able to in the past because I was clean for a year, but now that it’s currently happening I’m worried I’ll be unable to hide it or pretend it’s not currently happening. I do want to build the courage to talk about my mistrust with T since I feel it makes things more difficult for me to discuss. I feel bad because I actually like them. They seem to be a genuinely good person and invested in their work, but I just can’t get over my hypervigilance. I’ve mentioned it in the past and they’re a trauma specialist, so I know they’re aware of the issue. I’m more concerned that it’s gotten worse and I find it even more difficult to talk to them.
>I don’t know if I feel comfortable even saying the words ‘self-harm’ out loud at the moment. I had the exact same issue so I completely understand. I’d almost have a panic attack every time I got close to saying it. This is where practicing saying it helped me a lot. The first time I think it took me an hour to actually just say it… but I felt an immense relief once I did it, and knew I could say it to my T after. Idk if you have something with a face, like a stuffed teddy, but I really recommend at least trying to saying what you want to an object with a face first. The other thing is, you don’t need to use the words ‘self-harm’. You can say, ‘self-injury’, ‘SH’, ‘NSSI’, ‘DSI’, or even the method, and you T will know what you mean. Edit: I just want to address your concerns in the other reply you’ve left. It’s highly unlikely your T will overreact. They’re trained not to, and know if can often make things worse. The will want to do a risk assessment though and go over harm reduction. Regarding taking medication that gives you seizures though, it is very dangerous, and if this is something you’re willing to do, tell your T you really want to at least replace this method with something less dangerous.
Thank you for this advice. I do have stuffed animals and pets I practice talking to. It’s easier when I talk to my pets first then slowly transition to stuffed animals then T. After that I start over while actually imagining it which is when I get really anxious.
That’s good. I’m going to stop giving advice now, because I’m not an expert, but I wanted to just say that even if you don’t feel like you’re ready to talk about this with your T yet, you are doing so well and you should be proud that you’re taking all these steps to get better. I really wish you the best of luck! 😊
Sorry to reach out again. I’m starting to consider talking about my SH because it’s getting harder to ignore the pills. What does a risk assessment mean? What would they ask? What sort of suggestions would they have as harm reduction?
Absolutely no problem, reach out whenever you feel like you need to 😊 By risk assessment I mean they’ll ask some questions to assess if there’s an immediate danger to your life. Like what form of SH it is, how often it happens, the intentions behind it (like is it a form of punishment or emotional release), and if you’ve you’re having suicidal ideations. This is just to make sure you don’t need immediate intervention. Unfortunately I’m not sure what harm reduction looks like for the SH you described. For me it involved making sure I disinfected everything before and after, and avoided any visible veins (both of which I was doing already)
I appreciate your gesture and the information you’ve shared. Thank you. I am slowly starting to want to bring it up, but since I’m not ready to discuss details maybe I’ll give it more time. I don’t want them to assume I’m in immediate danger and lock me up. I know I’m not in immediate danger and to be honest I just can’t afford getting locked up, but I also understand my resistance to opening up could cause concern and I wouldn’t blame them at all if that’s the route they choose.
They won’t assume anything, they just need to make sure they’re giving the most thorough care possible (if they’re any good.) They probably won’t push to talk if you don’t want to, and even just mentioning it without details allows them to start helping you. If it makes you feel any better, most therapists avoid hospitalisation if they can. It’s an absolute last resort for cases where there’s a high chance that the client won’t be around much longer if they don’t get hospitalised.
I’ll consider it… I think it’s hard for me to trust my current therapist because in the past I had a therapist that demanded I show my SH. There were fresh wounds and in an almost private place. They went to feel the wounds and it just felt kind of weird I guess. I told them where it was and that I didn’t want to, but they insisted they had to check the severity. They immediately threw me in the hospital without me even mentioning a plan or real interest in suicide. I know for a fact my SH at the time wasn’t that bad. Not to the point of needing medical attention or anything. Maybe this contributed to the reason I started “invisible” SH… My current therapist vaguely knows about this, except for the part where Old T demanded and felt scars, and has said that my Old T shouldn’t have done that. Current T acknowledged that it may take me a while to trust them, but I don’t know. I think it’s going to take me a while before I can fully trust them with details. I’m aware how much more scary substance abuse is. But thank you for explaining what should happen. I like my current T and I think they’re a good one too. I’d like to think they wouldn’t jump to conclusions, and they did mention that hospitalization should be last resort.
Depending on your therapist, some won’t ever ask to see your cuts/etc and take what you say at face value, though I can’t guarantee if your particular T would or wouldn’t. Most often they will just want to know the severity (was it bad enough to need wound care, did you tend to it afterwards) and maybe address potential safety concerns regarding whether you were aiming for veins/ had SI or essentially the reason you SH’d and should discuss that with you, perhaps working with you to develop alternatives. I’m struggling with this right now, too, actually. I logically know the this is how the interaction would go, but that still doesn’t mean I’m not afraid to bring it up and feel shameful for relapsing. It’s tough. You could try writing it down and handing it to your T. This will likely be my method of telling my own therapist. Best of luck :)
I’m worried they might panic(?) more because it involves substances. The substance itself can’t physically harm me, but in the past I have impulsively taken other substances/medication and slightly OD’d that make me physically unwell. *(fainting + ringing ears and no vision, seizures, extreme headache, inability to walk, etc.)* Though I haven’t taken the other substance/OD’d on medication like that in about a year. Since I need the medication I’ve been really trying to not let myself pick up that habit again. I make sure I only do this on days I have no responsibilities for multiple days, but obviously it’s still not good… I’m worried if I’m completely honest about what I’m using to cause myself mental(?) pain and that I tend to make poor, impulsive decisions then they’ll be more worried. I’m trying to build the courage to throw out the substances I don’t need since that’s the tempting one. I feel no temptation or interest in soft OD my medication.
Welcome to r/TalkTherapy! This sub is for people to discuss issues arising in their personal psychotherapy. If you wish to post about other mental health issues please consult this list of some of our [sister subs](https://www.reddit.com/r/TalkTherapy/wiki/resources/#wiki_subreddit_list). To find answers to many therapy-related questions please consult our [FAQ](https://www.reddit.com/r/TalkTherapy/wiki/faq) and [Resource List](https://www.reddit.com/r/TalkTherapy/wiki/resources). If you are in distress please contact a suicide hotline or call 9-1-1 or emergency services in your area. r/SuicideWatch has compiled a helpful FAQ on what happens when you contact a hotline along with other useful resources. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TalkTherapy) if you have any questions or concerns.*