How did you tell, how did they react?

I know I've asked this before, but I'm still curious. I've always promised myself that if I cut again, I would tell a T. However, when thinking about this, I wonder if I would ever be able to do it or how I would go about it. Would anyone mind sharing their stories of how they told their T, how their T reacted, and how they felt about it? I don't mean to pry or get into other peoples 'personal space' but I really feel like I could benefit from someone elses story...

Depends on which counselor I am talking about. I have had 19 therapy professionals. Some still don't know. Others saw the scars in the summer so I did not have to tell. Some read it in my files so again they didn't need me to tell them. I don't think I out right sat in front of my therapy professional and said I've been known to do it. Those that didn't get it from my medical and mental health files and didn't see past scars got the full effect when I burst into thier office dripping blood and not remembering how and with what it happened.

The reactions from the file readers and the seeing past scars was them having me sign a contract not to do anything without talking to them first.

If what they saw was fresh within 24 hour time period I was involuntarily taken to the ER for psych assessment for suicide (which is why I DON"T discuss my cutting or show evidence of cutting with my therapists)

My present therapist knows I cut from my files and had me sign something that said I would not hurt myself or others during therapy sessions.

and she also knows she will not see any fresh within the 24 hour commitment time period evidence of my cutting nor will I tell her during that 24 hour commitment time period that I am cutting. She knows I am actively working on fighting it and how and how long its been since the last time.

My recent past therapist and my present therapist feel ok with the fact that I do it, not that they are promoting it, they would rather I didn't cut but they know I am doing my best and the time frame between cuttings each time gets longer (presently I have not cut in 9 months) which means I am getting stronger at fighting it and I am actively using appropiate coping tools to do so.

When it comes to therapy or anything like that, I'm pretty blunt. When I get the first session I go in there tell a little about myself and say I'm a cutter. I really don't pay much attention to their reactions. I just don't care about what people think about it anymore. After 15 years you kinda lose interest in what others think about it, ya know?

Maybe I'm not the best one to answer this one! I'm pretty blunt with T's and all that.

I didn't have to tell mine, per se...it was the reason I was hospitalized (and suicide attempt) and he got the info from the hospital. He asked a bit about it, what I did etc. I just answered simply and honestly. I don't know if that helps?

BP - Anything helps, thanks!

Lex - Heh, well, I'm glad you're blunt with your therapists, atleast they know exactly what they are dealing with and can help you in the best way possible. I admire you in that aspect...usually I'm too stuck on the light things like school and such.

myself - I'm sorry you've had such bad experiences with therapists. See, this is my problem. I've heard lots of these horror stories about there therapist commiting them or making them sign something...for me it's like, I haven't said anything yet because I don't want to sign anything or be commited - I just want them to help me out!

Thank you all for your stories. I hope someone comes along with a happy ending type story (I'm a sucker for 'em!).

I didnt haft to tell my first T, a doctor did it for me. My second T well i just came out and said it. My first psychiatrist got the info from my first T and my second Psychiatrist got it from a doctor.

The first therapist that I told was not a great experience, but I never had a decent relationship with him anyway. I remember that I mentioned that I had scratched my wrists in what I thought at the time was a suicide attempt. I was very uncomfortable saying that, and when I'm nervous and uncomfortable I smile or even laugh. He didn't react at all. I thought that he didn't hear me. But, a few weeks later he confronted me with it, and the smile, I felt implying that I had just been manipulating because I didn't show the affect that he would have expected in talking about a suicide attempt. That was the last that I saw him - I didn't make another appointment after that.

I was in therapy several times and didn't mention SI, but I wasn't actively cutting then and didn't know about SI (although I was using methods other than cutting, just not knowing that it was significant). I really never got anywhere with those therapists, largely because I didn't talk about significant things. I'm not sure that I knew what I was supposed to be talking about. Eventually I did get into more scratching and cutting.

The next time that I was offered therapy it was because my husband and others had gotten concerned about the cutting. I think my husband, who worked with that T in the same office, had mentioned it to him. But I did have to tell him about it too. He used a detailed questionaire and that brought it out (there was a question about wanting to hurt yourself, I think). And he went over the questionaire verbally and asked about what I wrote. Writing is the easiest way for me to talk about things like SI.

My next (current) T was the professor for a psychology class I was taking. I was in the habit of emailing her about class, and one night SI came up as a subject in casual discussion at my location (It was a distance class - we saw the professor on a TV screen and communicated mostly by email). I wrote to her that night and mentioned that the subject had come up in connection with the topics covered in class, and remarked about how much more common cutting was than I had ever thought before, as out of five of us present, one was a self-injurer (at that point I didn't tell her that it was me) and two others had a friend or sister who cut. A few weeks later I confessed in email that I was the one. She brought up self-injury as a class topic some time after that. Her responses were that she wasn't surprised about self-injury coming up as a discussion topic in our group, and when I told her it was me she put me at ease about telling her that, expressing concern and suggesting treatment, but acknowleging the need to cope in whatever ways we have learned if we haven't developed other ways.

When I finally did become a client, she already knew of course. At that point she said that she understood that she couldn't ask me to stop without having learned other coping methods, but she did ask me to limit it, and also to make a verbal agreement that I would not make any suicide attempts or do any significant injuries (defined as requiring medical attention) without talking to her about it first and giving her a chance to help work through it.

Not every therapist is good at handling self-injury, but they are getting better about it, and my last two handled it well. Neither of them have addressed it directly very much. It is important for them to know about it, but it isn't the main issue - just a symptom.

I've tended in the last several years to choose therapists that I already knew somehow, because that made it a lot easier to get started, and they already knew where to start with me. But that isn't always the best option or even a possibility. In that case, I think that writing it down is the easiest way to tell them.

The type of "contract" or plan I had with my past therapist and this one isn't anything major.

The past one was that I wouldn't do anything before talking to her. Nowhere in the agreement did it say I couldn't cut. (In fact there were plenty of times after talking to her I still wanted and followed through with cutting) The agreement, promise, contract whichever word you want to use was just that I had to call her and hold on until we talked.

When she first brought up this idea I told her "Yea right and while I'm holding on you're getting the commitment order" She said no no matter what happens if I end up cutting before talking to her or after talking to her she would not have me hospitalized. So I had her put in writing for me that if I called her she WOULD NOT hospitalize me even if I cut after talking to her. And I kept that paper in my backpack for about a year just in case.

I agreed and did call her when the urges hit. At first she called me back or came to my house right away. Then as I got stronger at fighting the urges she spaced out little by little my waiting time beween my calling her and her calling or coming to me. As I got stronger she slowly dropped her coming to me out of the picture. I can't count how many times I called her and each time we both followed through with the agreement.

It wasnt the agreement that held me to it. There was no consequences if I would have broken it. It was the trust that we both had for each other that held me to that promise, contract, agreement. I held myself to that agreement and still do because I wanted and want to not because I had/have to.

So I consider my experience with her around this (and all issues with her) a successful and happy one.

The agreement, promise I have now with my present therapist is simply I won't hurt her or myself DURING therapy sessions. This was suggested by my past therapist because during a session with her while in a memory piece I had thrown a table at her and she didn't want that to happen to my present therapist. My past therapist and I (including me in various memory pieces) had a verbal agreement like this after throwing the table but in the transition process she wanted the agreement to include my present therapist so my present therapist put it in writing. The funny part (well not really funny but) is that I still hold me to that promise not because of consequences and so on with my present therapist because there were none to the agreement but because I have that promise to my past therapist. She's not my therapist anymore but that trust is still there as my friendship with and for her. I care too much for our friendship to break promises to her regardless of when they were made.

But anyway nowhere in that agreement does it say CAN'T cut on my own time outside of therapy. I hold myself to not cutting and/or fighting the urge as long as I can before doing so and my present therapist knows when I have cut the last time and has not hospitalized me so I call this a successful and happy situation too.

Right now I have enough trust built up with this therapist to know if it was up to her she would not hospitalize me if she knew within the 24 hour time period but because she works for an agency not private practice she may be bound by law to have me evaluated for involuntary commitment and so I told her I would not put her into that position of wanting to not hospitalize me but yet having to follow the law and rules of the agency. It wouldn't be fair for me to have her promise not to hosptialize me then show up on agency property with blood dripping down my arm and so on. I didn't put my past therapist through that theres no reason for me to put th is one through that moral and ethical delema.

So I hold myself to fighting the urges. My present therapist has told me she will help in any way that she can, All I need to do is tell her what I need from her and how she can help. Right now the plans my past therapist and I put in place are working so there's nothing this therapist can do. She can't be at my house 24 hours a day taking razors and so on out of my hands. Only I can do that.

Maybe what you can try is sit down with paper and pen and write out what you want to do-

how you want to tell your therapist
what you hope the reaction will be
and what the therapist can do to help you with this
what therapy options you will accept and deny.

Then give it to your therapist for discussion. Therapists like to see these kinds of activities. it shows you have been thinking about the problem and are trying to work on it.

Before you entered therapy, how would you ask?

Like, how would you ask in a way that protected you from getting sent to a funny farm? Ask them before they even saw you or made an appointment?

Or if therapy had already started, asked and then they'd assume you'd done it, and then institutionalized you? O_O;;;

Just be open and honest. Therapists don't want to hospitalize you unless it really is in your best interest. Most people who self-injure are high functioning and intelligent and resourceful. We do this more as a way to survive and keep going than anything else. It usually doesn't indicate being suicidal. Be ready to tell T what you have to live for, and show that you want to work towards improving your life. They are generally only going to hospitalize you if it is necessary to keep you safe and alive, or if you and T decide together that you would get something out of it, and you voluntarily choose it as a treatment option. Your therapist will have your best interests in mind, and being open and honest helps them best to know what is in your best interests, as well as gives you more trust and more options and more say in your own treatment.

you mean if I have never had therapy so they had no files to read but I wanted help for this..

Thats a hard one - trying to ignore what I know from over 20 years of therapy. That would take me back to age 18 fresh out of highschool and I entered therapy for panic attacks and nightmares. I was cutting back then but I never disclosed it to the therapist.

Ok I want help for just this one thing huh. I think first I would take time to get to know the therapist and the therapsit get to know me. Im cutting so I already know some situations that make me want to cut say I cut when I get in a fight with my parents.

I would call up a therapist and say something like I did the first time I entered therapy - hello Im so and so. I'm 18, no job yet and my parents are driving me so nuts I have trouble thinking straight can you help me.

That right there is enough to get my feet in their door at least once so that I can get a feel for the therapist, and his/her therapy style so that I can decide if I want to see that person again.

The first session is always basic name address phone number type of family basic background stuff and of course the question why are you here..I can either say I got in a fight and took it out on my arm with a razor and I want to stop that but I don't want to do it in hospitals is that something you can help me with, if not who do you recommend? or I can keep my mouth shut about the cutting for a few visits and say simply how frustrated I get when fighting with my parents. Then when I am comfortable with the therapist and the question of how do I cope with it comes up then say right out I cut. or show the person the scars.

If therapy had already started and I asked their help on it and got hospitalized that means I had cut within the past 24 hours so therapists see that as still being in the danger zone. in that case theres nothing I can do but not fight the commitment order that will only get me restrained.

The way I ask or tell my therapists now is I know they have access to my files so I let them see it there and then answer their questions honestly after. Just a few weeks ago my therapist knew I was not sleeping and knew the holidays would be a bit hard without my son so she asked right out if I was engaging in cutting. I told her no - not yet and the late date I had cut. She asked if I had needed stitches and I told her right out no I use super glue and she asked right out to see where I had cut last so I flat out pulled up my sleave and showed her. The first time we discussed my cutting I told her right out why I don't do hospitals and the things I do to help myself with this cutting problem. She knows I am working on it and I am not trying to kill myself and why I don't do hosptials so she has all the answers she needs to make her decision and that decision is no hospital unless it is something we cannot find other options for.

the key here that keeps me out of the hospital is that I am actively working on it, being completely honest with answering her questions and I am open to trying anything and everything that she may feel we should try in the event that I cant handle things with what I am doing now to help myself.

Course I didn't start therapy to work on my cutting only so I am just taking a stab in the dark on this one. Good luck and take care.

Another idea for bringing the subject up at first is to just ask them what their policy and approach is to working with self-injury. You don't actually have to tell them at that point that you do it. See if their answer is something that you can deal with. If they work for an agency, they might be more bound by agency policy and required to take action that they might not personally feel is warranted.

Apparently, policies will vary. I have never had a therapist suggest hospitalizing me for SI, and I have shown them wounds that were just hours old (small ones), and I've written saying that I really wanted to cut and didn't care whether I did that night or not. Once I was saw T and had a wound that was still bleeding (not in a visable area) that I didn't mention, but I bet he suspected something from my facial expressions.

But don't you think if you ask them about self-injury, they are going to pretty much get it? I know if I asked my T about it, she would ask if I did it or question why I was asking.

I only really want to tell my T if I cut if it happens again, since last time was in June. But I feel like I might be close to slipping up, and I wonder if it's better to tell her before I cut to prevent it - or after I cut just so I can make sure I was actually going to cut and didn't tell her for nothing. I know which answer is right, but it's all much easier said than done.

ETA: Also, I believe she works in someone elses office, would that count as an 'agency'? I was thinking if I told her to make her promise not to hospitalize me. But I bet she'd do what she wanted anyway.

Yes, if you ask about SI, they will strongly suspect that you have a reason for asking that, and will probably ask you for more information. So it's a way to put it on the table. You still don't have to tell them if you don't like their answer. You could decide to go to another therapist, (or ask for a referral to one with experience dealing with SI), and/or you can just say that you don't want to say any more about that. They won't have enough to hospitalize you, since all they have is a suspicion. But they won't want to hospitalize you, especially since you haven't cut since June.

I feel strongly that it is important to be open with your therapist, especially when it's hard like this. Although SI isn't your main issue (it never is, really), it is important information that will help your T to understand how you cope, and how to help you better. And as long as you have something that you are holding back on, the relationship won't be what it could be.

Don't you think that it would be better to bring it up before it happens again, and ask for help to prevent it, than to hold off until after it happens? In the first option you get help dealing with your feelings before they get to the out of control point, and it shows that you are sincere about learning how to deal with them effectively. If you wait until after, that's more likely to show that you're going to keep on doing things the way you always have and not accept help. Telling her wouldn't be for nothing because opening up like that is a step forward in the relationship.

Working in someone else's office isn't what I had in mind when I mentioned an agency. Agencies often have fairly rigid rules that counselors have to follow, while a private office, even with a partner or supervisor, is more likely to allow for flexibility and using their own judgement.

Another thing to consider is that therapists know how important it is to be open and honest, and to keep their word. They won't give you a promise that they don't intend to keep. They know that they have to earn and keep your trust in order to be able to help you.

Good luck with your decision!

Rap

I have found therapists react ALOT more positively about my cutting if they know about it BEFORE they have to actually deal with the already sliced arm. It was my not telling my therapists (at that time I hade a mental health therapist and a rape crisis therapist) this was a factor that got me my first hospitalization. They didn't know cutting was a factor and when my rape crisis therapsit saw my arm she called my mental health therapist and the mental health therapist immediately jumped to the conclusion of "she's losing ground if this is starting to happen or she is in active suicide phase" and off to the hospital I went two hours later complete with police escort to the ER, in the ER stripped and full body search and up on the unit within 2 more hours. It took me almost two weeks in there to finally realize all they wanted to her me say was I feel better now no more suicidal thoughts and no I won't do it again. It didn't matter that I knew I wasn't suicidal. They were going by my therapist notes of no known history of cutting so in her mind I was losing ground and had become suicidal. When I got out I explained to the rape crisis therapist cutting was a factor and I wasn't suicidal and Dropped that mental health therapist for another mental health therapist.

Private practice can have more than one therapist working in the same building.

How about if yuo somehow stear the conversation to say having seen a book in a library about various self injury situations and on the inside cover it said the book was not a replacement for therapy and to find out what your states and mental health agencys protocal on self injurious behaviour is contact them. And then tell her/him it got you curious about protocals and what hers was if she had a client that self injured. Its a safe way to do it. libraries always have books laying around on this table and that and people waiting for their turn on computers pick up the nearest one just to pass the time. And then based on the therapist answer you can decide if you are ready to disclose that you are a cutter.

In any case if you are thinking about having her be a part of knowing AFTER you cut the next time then yea I think its time she knew now before it happens, so save any repercussions of her shocked reaction of BOOM I did this now what are you going to do/ what can we do?

Thank you all for your support and the sharing of your stories. I still don't know what I'm going to do...I wouldn't be able to see her until April anyway, and I feel like I'm kinda slipping. I haven't done anything yet and I'll work/try my hardest to keep from doing anything stupid, but it's still so hard. It's hard to know that I can feel better if I just do this one thing, and then prevent myself from doing that one thing.

Anyways, thanks you guys, I really appreciate the help.

Yes it is hard. I've already reached my record. 9 Months was the last record and here I am fighting it every day trying to make it just one more hour, just one more day and if I get lucky my new record will be 10 months which will be on January 18th. I know that I will feel SSSOO much better to get that release. Sometimes I want it so bad that all I can do is hop on my bike and pedal as fast as I can down that bike path behind this appartment. I had to have been a comical site today pedaling and singing out loud the songs playing on my walkman. When my legs couldnt pedal no more I came home and took a long bath, walked to the store and bought some groceries and some chocolate for treating myself for the fact that I didn't give in, came home and rented a movie on cable and ate my dinner and chocolate. hang in there. Im going to try too.

myself - Hey, we can try together. We both have a good amount of months under our belts! Hopefully we can keep it that way, although I'm sure we can. I mean after going so long without it you lose the 'habitual' nature of it and only have to fight the urges. It makes it a bit easier...do you see what I'm saying? Anyway, I like your idea of treating yourself when you don't cut. I've never tried that. Maybe I will next time.

Thanks!