It was very hard for me to open up to my T about SI even though I share everthing else with her and do all I can to help myself. Once I felt safe enough to open up it was a huge change but in a good way. I am very lucky my T isn't close minded and she has done alot of learning about DBT, which is what we are using to help me cope in a better way. I am a borderline and SI is often part of that diagnosis and DBT has been a life changing/saving treatment. Through the work with my T, DBT, and journaling I have found I SI when I am overwhelmed with emotions that I feel/think that I can't handle and the SI doesn't hurt when I do it but instead it releases endorphins (our bodies own natural painkillers) and all of the emotion that had been taking over relaxes away. BUT this is temporary. I feel worse afterwards and I am embarrassed and I feel guilty. When I tell my T though instead of threatening me or getting mad we work together to figure out what emotions I was initially feeling unable to handle and soon I realize that I have the skills to deal with the emotions and to make progress. I am not cured but I SI far less.