[MASIMO]

Was wondering what others have experienced regarding their
T's reactions to cutting. My T seems to avoid talking about it and
doesn't ask me if I'm still doing it. It doesn't get discussed unless I
bring it up. I would seem to me that it would be an important issue
to address. I can only assume he feels he would be encouraging
me to SI by discussing it. That he would be reinforcing the behavior
because we talk about it.

[Rapunzel]

Yeah, a lot do avoid it. Some think that talking about it will reinforce the behavior. Others just aren't comfortable with it, or don't know what to say. As a therapist myself, I have had other therapists ask if I would assist with a self-injuring client or have that case transferred to me because they weren't comfortable with it. As a client in therapy, the first therapist I told about cutting myself (before I knew what it was or that anyone else ever did that) showed no reaction at all at the time and then threw it in my face a few weeks later by saying that the way I had said it was suspicious. Others never addressed it at all (I was reluctant to bring it up again), or wouldn't spend much time talking about it if I did bring it up. My last therapist has a history of SI herself, and she wouldn't let me talk about SI much either, saying that I was hiding behind symptoms and avoiding what was real.

None of the therapists I went to practiced DBT. DBT therapists are trained to focus on SI or other destructive or therapy-interfering behaviors as top priority if they have occurred, and not to allow the client to discuss other things until after a thorough analysis of the SI behavior, why the client chose to do it, and what they could have done instead. Since DBT clients are supposed to present a diary card at the beginning of each session, the client is always expected to report SI and other destructive behaviors so that they can be addressed.

I don't think that avoiding talking about SI is helpful, and I can see how being required to address it could be a lot more effective for extinguishing the behavior, even though that could be really annoying too. I think that the important thing is to understand the emotions and motivations behind SI, and not to focus on the actual SI itself. And also to find ways to cope with emotions and distress in healthier ways.

[dance59326]

Very much agreed Rapunzel,
My psychiatrist actually has told me in full that she does in fact self-harm and that we shouldn't discuss too much about self-harm. I'm not sure about my DBT therapists though. I have self-harmed in the past, but it has now been over 230 days since my last act of self-harm, which is a positive, however I am sooooo tempted to do it again. I feel that if I self-harm then I'm letting her down, not necessarily myself down though. I don't really care, in fact, I really want to more than anything in the world. If I did, would it really matter to her, or would that hurt her more than me???
Flipping back to the topic:
some therapists do self-harm and others don't, some avoid it because they don't want to trigger you, but sometimes I really think that they do it because they feel triggered themselves.
~ dance59326
PS, nice discussion topic brought to the table

[ballet_girl]

My T will usually ask me at the beginning of every session if it is something we have talked about recently or if she can tell that I'm having a really hard time. I really love her because when I first told her I thought she would have some sort of reaction but she didn't at all... and she's even told me that she wants me to learn healthier ways to cope with my emotions and she wants me to stop but that she won't tell me to stop because maybe its the only way I have right now to deal with my emotions, and she realizes that I can't just hold them inside.

[MASIMO]

I recently SI, had been a couple of months. Told my T. The next session
he asked me to promise to call him if I felt myself going in that direction. He
said maybe just planting that thought might help me not do it. I doubt whether
I would ever call him....maybe...