How Do I Tell My Therapist This?

[Justmehere]

I have been working with a new trauma therapist for 5 months. I didn't get regular therapy for two years before that for a variety of reasons. I had one form of treatment - an intensive specialized trauma treatment program.

I used to have a really big problem with a very specific form of self injury. 13 months ago, when I did the intensive program, I stopped. I finally managed to break the habit and stopped doing it despite going through a lot of awful things over the past year.

I actually managed to not self injure for the past 13 months, until very recently.

Somehow, I have also managed to not tell my therapist I used to have this problem... and here I am. It's come back. I almost told her about it very early on in treatment with her, but instead, all I said was "I found lots of bad ways to cope." I figured I would tell her later. I think she figured that I would clarify that later on too. It never came up.

I am really discouraged. I didn't just fall back and do it lightly or just once. It's a full fledged battle all over and I'm scaring me and I want to stop.

I know I can go back and do the intensive treatment program again, and the program actually said people sometimes come back for a second round of treatment and it's something they encouraged me to keep in mind. It is in another state. It's a short term program, but it helps break downward spirals, like the one I feel like I am on. I almost want to go back to it. Things have been rough, and I have the ability right now to take a break from work and everything to go and do it. I won't have the ability to get away and go in a few months from now.

In order to go, I would have to tell my therapist. Even if I don't go, I feel like I need to tell my therapist - it's the responsible thing to do.

I'm so scared she will quit if I tell her. But if she quits because of the truth about me, then so be it... at least this is what I'm telling myself.

I don't know how to even begin to tell her. Do I say, "oh hey by the way... I'm self injuring again?" I see my therapist tomorrow, in less than 20 hours, and we were going to do somatic experiencing trauma processing work. She's excited about it. I want to do that. So much. She already knows I am struggling really deeply, she just doesn't know the self injury has come back up in the past few days.

How do I tell her? What if she quits? I've so utterly failed. Does anyone have any thoughts or any feedback? Even harsh feedback is welcome.

 

[bitterfight_]

You need to be honest with her and tell her. If you brush it off and try to do this somatic experiencing trauma processing work while you're in this state, it could only make things even worse. You haven't failed - you have hit a bump in the road. We all hit them, and sometimes they're rougher than others, but you haven't utterly failed. She won't quit - that would make her a very incompetent therapist. I know it's hard, trust me, I had trust issues with telling my therapist about these things, but just begin with "I really need to tell you something before we begin today", and then tell her you've struggled with self harming in the past, and that you're doing it again. I doubt you'll find harsh feedback here - everyone is so caring and understanding :) good luck. If you need anything, my inbox is always open!

 

[maryel42]

Y'know, I have struggled with self-injury myself for longer than I will ever care to admit. I've sunk into really bad and scary places in my own head chasing it. I spent more years figuring out how to stop using it as my go to... and I have never found a perfect way to tell someone.

I think that it becomes harder when we have stopped using it for a long time. When we have been able to consider it as "something I used to do, but it wasn't a good coping strategy", and then have to say "oh and by the way I have started doing this again"

I just had a relapse into my own self injury this past winter. My wounds are finally healed. I was embarrassed and knew I had to tell my therapist and didn't know how for a while, and knew that it would get harder if I waited.

I sent him an email about it. I agonized over it for days and wrote draft and draft explaining what it did for me, why I do it, and pretty much how I have viewed it during the whole of my life.

He took it well. No major drama, no over the top of Safety Contract! Inpatient! Back, you insane psycho person who is too damaged to treat! (I have the feeling that you've had that reaction before. I sure have.)

In the end you just need to take a breath and leap. Either way. Draft your statement. Practice it here, or to a friend. I'd be happy to read it and give you feedback. (I'm not easy to shock, either). Sometimes practicing it can give you more confidence.

 

[Hope4Now]

Yes, you need to tell her as hard as that will be. It is part of the path to healing...not hiding thing. It sounds like the intensive program would be a good thing for you! My heart is with you as you find your courage.

 

[broken brain]

I would be nervous too and can understand why you would feel like you've let her down in someway, but you probably feel like you've let yourself down more than anything. I can't imagine your T quitting on you. You seem very committed toward healing, you haven't failed. Quitting self-harm is like quitting any substance-relapse is a normal part. You see a great opportunity to receive treatment, take it! :) The nerves are normal.

 

[Justmehere]

Thank you for the good input everyone! I really do need to say something.

My therapist knows about the intensive program that I did - I told her about it before. It was for PTSD, I just didn't mention that I stopped the self injuring by doing it.

Maybe I can print out the referral form and tell her I want to go back, here's why... and then I think, NO, I want to stay here... and then... the urges come back and then...

my head is going in circles.

 

[Deleted member 1860]

Did the program teach you to stop self injuring or was it a byproduct? If it was a byproduct, perhaps a self injury program would be better because you'd learn a lot of coping skills that are heard toward injurers. If you don't know the skills, this issue will continue to resurface when you get stressed/triggered.

 

[Justmehere]

It was a program for PTSD and everyone had different goals - some to stop drinking, some stop self injuring, some who isolated. I learned a lot about how to stop the self injuring, and we did a lot of relapse prevention work. We had to diagram out the behaviors and every event we could think of that would lead up to a relapse and what we would do in the future... So it was for different bad coping skills of various kinds, but in my case, specifically addressed the self harm in individual and group therapy.

I agree. It's going to keep coming up, and I'm not sure what I need to change to pull myself out of it. It's like everything is setting me off to do it - and the more I do it, the more I keep doing it.

I'm thinking through what happened today, and I think the main reason I'm falling back into it is that I am letting myself feel more pain than I ever have. I need to strengthen my coping skills.

 

[Rumors]

What if you just said, "my negative coping skills are back and I am doing things that aren't healthy." It isn't overly descriptive, but gets the dialogue moving. I am sure that is difficult. Hang in there!

 

[Justmehere]

I can't sleep. I'm trying to write her a letter. It turned into writing stuff like, "you said I was resilient. You were wrong." Yeah, I'm oddly irritated she has beloved in me. Oh dear. I'm a mess.

Time to re-write.

@Rumors I like your idea...

 

[Mayday]

If something is too hard for me to bring up directly with my T then I email her. I recently did this about problem gambling.

I was so embarressed and ashamed about it and I was sure she'd be disappointed in me. It felt like a lie. It's a problem I've had off and on for a long time but it wasn't a problem when I first started seeing her so I never mentioned it. Then it came back and I agonised for months before telling her.

She was fine about it. Very understanding. I felt a big release when I told her and she still accepted me.

Hope this helps, it's not physical self harm but is still self destructive, shameful behaviour.

 

[Jane.l]

I like rumours suggestion too . I made a promise to myself that I would always tell my T when I self harm because I feel him knowing keeps me safer. He doesn't judge me for it and your T won 't either - I am sure it's something they deal with a lot. It is important to bring your T in on this - don't keep secrets from your T - my latest motto !