I think the blunt honesty can be a fine balance, which shifts naturally back and forth depending on whatever is going on. Between my T and I, at least.

And I can be bluntly honest back even if I know she wouldn't like it, even as I'm not intentionally hurtful.

There's benefits in learning to be assertive with your therapist when there's misattunement, as well as times where if he knows you're having a difficult time... it seems "common sense" that he ought to try to be more gentle.

Regarding the SH bit, I don't know if that's a red flag or not. My T works with patients with chronic self-harm (and I've a history of it, in the past), so she's not overly worried but also takes note of the reasons. Eg, if I wasn't grounded enough after a session of processing when I left etc.