Most of the time - I do do "tally marks". They are not deep (just deep enough to bleed - or they do not *count*). About 1-4 inches long. In one sitting (cutting session) - I have done over five thousand at a time.... it really isn't that many if you are not cutting deep.

as for your shrink - tell him/her to **** off - the remark s/he made was about as stupid of a a comment that I have ever heard.