Hi virtualhugs - wow that's a big question.

SI can be very addicitve and hard to resist as it has pretty much immediate effects and works in reducing the overwhelming feelings - the negative part of it (often shame / guilt) that comes later does not come soom enough for our brains to pair it with the SI behaviour and so we get stuck in that cycle of bad feelings wanting immediate relief and turning to what we know works.

The way me and my T are tackling it is to pretty much ignore the SI behaviour - we rarely talk about it in sessions maybe 5 times in the 2 years I have been seeing T (T will sometimes just ask about any changes frequency) - but instead his view is that if I learn to deal with the overwhelming feelings in a more healthy way then the SI will no longer be the only option for me and I will be able to choose a different way of dealing with things.

In terms of resisting the urges - I find that very hard (but not impossible) - once the idea is in my head it just sticks there and eats away at me until I give in. For me I really don't think I could tackle these things without seeing a T.

I have read your profile and it sounds like you have had a hard time and have a lot to deal with right now. I really admire what you wrote in this thread about not blaming others and taking responsibility for your health. However I think these things can be really hard to work through on your own and wondered if there anyway you could change your mental health worker and find a T that you feel more comfortable with?

Be kind to yourself, you do matter - Soup