LonesomeTonight, I'm sorry for what you're going through. I don't think pressing your fingernails into your skin or scratching hard or things like that would count as clear self-harm, I think lots of people do stuff like that as way to distract themselves (or in some ways "ground" themselves) when they're real upset or dissociated.

But they're not nothing either. I mean you are dealing with a pain here and I can understand you also worried about SI and also freaking out your therapist by talking about those things.

How much do you trust your T to be a good T? Has something you said so far has freaked her out? If not, then don't worry about it so much, you might be surprised that your T is more accepting and understanding of those urges than you might imagine. If you like, you can start talking about self harm in general or even mention these things like scratching and so on, and watch her reaction and keep going till you get to point you cover all SI stuff and telling your T everything. Remember, you can stop at any time. Say only as much as you're comfortable.