Yes. My therapist and I have conversations about how to know it is real and that he believes me. He also usually points out that he and my pdoc are both trained to know what is real and what isn't and that they agree that I'm having whatever episode I say I am.

I used to try to injure myself for attention too when I was a little kid. Somehow it never moved on to self-injury but I did all sorts of things trying to break bones. I also used to punish myself, including hitting myself or setting a time I had to stand in a corner or whatever. I was fascinated with getting in trouble at school but always made sure I was on my best behavior. My mom was a teacher and would have known about anything I did in 5 minutes and I was too scared to act out.

You are not alone.