this is all really helping me think about this.

I think this is a good learning experience for me - in therapy and real life. I often do not have enough confidence to express my needs.

It sounds as if many of you have had in depth conversations about this kind of thing with your T's and then it kind of tapered off so that you didn't talk about it so much. My T and I have never really talked about it, and I think I just need to get it out there more and have it be acknowledged, as skeksi said:

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Being heard and seen, and having my pain be believed and valued, helped dissipate the urgency that led to self-injury

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I just don't know if I have the courage or ability to express it as well to my T.