This has been a topic for me recently, as I've struggled with thoughts. T never brings it up, but when I do, he mostly just listens. Sometimes I talk about how ashamed I am of the thoughts and he will say something like he's with me (which helps--I worry a lot about him being disgusted by this stuff).

I think he doesn't talk a lot about the SI so I don't fixate on it and because it's related to the other stuff we are doing in therapy--it's a symptom of how much is stirred up for me. So he focuses on helping managing the other stuff, I guess.