This is really really long so I apologize in advance. Trigger warning for SH references scattered throughout.

I explained that the more I wanted to be cared about the more I wanted to hurt myself. That I hated myself for it. That when I let myself be cared about I had to punish myself. He kind of sighed again in a way that sounded sad. And I got some kind of satisfaction from that, and I hate myself for it.

I said I still didn't care about myself. We talked about me feeling like other people's feelings and pain matter, but mine doesn't as long as I can keep myself from making it anyone else's problem. He pointed out that that was unfair, and I said I wasn't there because I was great at being rational and having emotions consistent with my intellectual beliefs. He said that I was there so at least part of me believed that I mattered or wanted to do this for myself. I told him that I didn't get help until it started affecting my work and other people, that being super anemic interfered with my work and I was missing work because of the ER and psych holds. He kind of sighed and said it felt like we were playing tug of war.

He asked me if I could look at him at some point during this time but I don't remember exactly which part. I glanced up at him, but it was too much and I hid my head again. And every time he "validated my feelings" or acknowledged how cruel I am to myself and that that must be really painful or said something compassionate or understanding I kind of involuntarily flinched and curled up tighter defensively and in shame. So I'm sure he noticed that and that was part of it.

He made a rare personal disclosure. He said that he had had to learn a really hard lesson early on and he was in supervision and his supervisor told him that you can't care about someone else's health more than they care about themselves. Hearing that he'd struggled with that made me feel a bit better.
Sometimes I worry that the boundaries and the fact that he doesn't act upset about my pain aren't just because it's important for me but that it's really easy for him to not care and it doesn't bother him at all and that it's presumptuous of me to even think that he might be affected at all.
Even though he's told me before that it would upset him if I gave up, and that one of the hardest things is watching someone you care about give up and not take care of themselves but that you also have to accept that it's their choice and you can't control them.
Knowing that he struggled with caring too much at one point made me feel better, that maybe it's not just super easy for him to not give a **** about me.

That conversation was why I threw away my razor blades when I left and I got rid of all my suturing stuff when I got home. I want to try to care about myself and I want to want to get better.

And there's still part of me that's doing it so that I can "earn" him caring about me and wants him to be glad and proud when I tell him, not just in a professional doing his job way, but because he cares.
And I don't know if I'll tell him that.