My current T has an interesting approach that has helped me. I used to self harm for attention a lot, and I don’t do that anymore, because of her method. Her policy is that she is happy to talk to me outside of session, on the phone, as much as I need it (assuming she has time). However, if I call or email her saying I self-harmed, she won’t call or email me back. She refuses to acknowledge the behavior in such a way, and she said that I’m in telling her that, then I already made my choice and she has no reason to call me back. She will always, always call me back if I say I am having trouble fighting off urges and need her help. She has called me after hours before, and stayed late just for me, because she doesn’t want to leave without making sure I’m going to be okay. There was one time, though, a couple of months ago now, that I self harmed and I drunk emailed her about it, and then didn’t get a call back for 2 days straight and I was SO angry at her and was ready to charge in there and tell her off, until she made me realize that my own behavior is why she purposefully did not call me. I would’ve gotten to talk to her 2 says sooner and not have had 2 extremely miserable days had I thought about my self harm behaviors and held off for help. That was a painful lesson, and she said it was painful for her to have to do that to me, knowing I was upset, but that it was important. Most effective thing anyone has ever done for me in regards to self harm.

Don’t get me wrong, I still have my slip-ups, and I can still talk about those in session, but I do not attention seek with them, and instead we work through more solutions of what I can do to avoid it. She always says that she’s never going to condemn me for doing it, because slip ups happen and she doesn’t expect me to be perfect, but she also doesn’t condone it.