Hmm, good question. I think it's somewhat individual. I've had t's that kept close tabs on the sh,and others that only addressed it if either I brought it up, or if it became severe. When my sh happens to be fueled by needing a sense of control, if t was to focused on it, it became worse. When it's been more fueled by a need to manage other symptoms, t's attention to it helped ease the frequency and severity. Other times, if I was spiraling out anyway, it didn't really matter what t did around it, it still escalated...
Currently, it's fueled by both needing a sense of control and needing to alleviate other symptoms. It's been increasing in severity even before t and I stated talking about it again...
Then there's always the point where the addiction kicks in. If it's an addiction problem, then I'm not sure t's attention or inattention to it would make much of a difference.
Perhaps it would be good to have a conversation with your t about it? I've had to ask t's to back off because the pressure of accountability was too much in the moment. It was easier with some t's than with others. There's a measure of trust needed to be able to ask t to back off, and you have to follow through with any agreements made around it. Current t and I have worked together for about 5 years now (with a 2 year gap when I moved out of state), so there's trust there. We have agreed to only address the sh if I want to address it, or if it becomes a "matter of concern". The new t's I saw while I was away needed more time to get to that level of trusting I would speak up if needed. They agreed to ask about it, but not focus too much on it unless I wanted to. Some of it was clinic guidelines for maintaining safety, but they also didn't really know me too well, so they needed to assess how much of an issue it was. I've found frank and honest conversations around it are the easiest way to build trust (even if much of the talk is around fears about talking about it, or difficulties talking about it, or a sense of needing to be "at your worst" if they focus too much on it).