Help! I’m Afraid to Talk to My Therapist about Self-Injury

I'm having a tough time bringing up the important stuff during counseling sessions! I'm a college freshman and I've been seeing a school counselor since September of the fall semester. I had a lot of problems in high school, namely depression and self-injury. These did not go away once I came to college and I came to really yearn for help, so I sought it. I'm very thankful for the opportunity to have counseling and I want to make the most of it, but I just can't bring up what I really want to talk about. Up to date, we've mostly been addressing depression but in more recent days my self-injury and other bad habits have resurfaced and are wreaking emotional havoc. I really need my counselor's help but I can't find the words to start the conversation and I'm scared to reveal how I'm feeling! It's a very embarrassing and even shameful thing for me to talk about. I'm afraid of how he might perceive this. I completely trust him and I know he is experienced and totally qualified, but I'm still afraid of bringing this up even though I really want (and need) to. Any suggestions are appreciated! Thank you! —Holding Back
Dear Holding Back,

You are feeling frightened and ashamed to talk to your counselor about your problems with self-injury and other “bad habits.” You might worry that your counselor will feel critical or think less of you, even though you know that it is an unlikely reaction to occur to a trained therapist. You know that you must discuss your worries and problems in order for the therapy to work. This is the hardest part of therapy—and the best part, too—because here is where you learn and develop yourself more than almost anywhere else. I have some thoughts and suggestions that might help you out.

You write that you’ve been meeting with your counselor since September. The first part of therapy usually has to do with developing a relationship of deep trust, and that takes time, as it should. Even though you understand that your counselor is experienced and qualified, you are still getting acquainted and learning to have faith in yourselves and in each other, too. So your first step is to have patience and let the treatment develop.

It’s also important to understand what a good therapist does. A good therapist has compassion for the parts of you that are destructive, the parts you’re most ashamed of, and can help you see that those parts are protective and well-intentioned—even when it doesn’t feel like it, even when the strategies behind them produce unwanted behaviors and harm.

Sometimes, before we are able to talk about what we fear, we have to learn ways to handle feeling afraid. Your counselor might be able to help you become less blown about by the winds of your powerful emotions and more able to navigate your feelings and use that feeling energy for your well-being. Right now it sounds as if you are being controlled by gale-force winds of feelings—at their mercy, really, with little ability to grab the rudder and set out for a particular direction of your choice.

The first part of therapy usually has to do with developing a relationship of deep trust, and that takes time, as it should.

You write that you “can’t find the words to start the conversation.” I think that when you are ready for the discussion the words will come—it sounds to me like you have them already. In the meantime, maybe you don’t need words anyway.

“How can I not need words?” you might ask.

Maybe at this point in your treatment, words are less important than simply being comfortable with the person who will help you learn how to live with your strong feelings. Could you ask the counselor if he or she might know some methods for calming the self, centering the self, soothing the self? Breathwork, for example, is one way to calm down, but there are other ways that you might know of already, and with a little encouragement, you can use them.

These are important issues about caring for yourself. An important part of therapy is learning how to care for yourself. Maybe you could ask for help in self-care, then later get to know who you really are, deep down. Therapy is an exploration, done with a guide who will walk the deep walk with you and protect you in your journey. Feeling safe and good self-care come first.

Eventually you will feel safe enough to speak up and communicate your fears and needs more directly. Even now I think you are beginning. Soon you might tell your counselor that you are afraid, that you have a secret and you’re afraid to say what it is. That’s the truth, and the truth is a good place to start.


Lynn Somerstein, PhD, NCPsyA, C-IAYT is a Manhattan-based, licensed psychotherapist with more than 30 years in private practice. She is also a yoga teacher and student of Ayuveda—the Indian science of wellness. Her main interest is in helping people find healthy ways of living, loving, and working in the particular combination that works best for them, connecting to their deepest energic source so their full range of abilities can be expressed. Lynn's specialty is understanding and alleviating anxiety and depression.
  • Leave a Comment
  • Charla

    March 27th, 2015 at 10:35 AM

    Even if there is no one else that you feel comfortable talking to about this, this should eb the one safe place that you can go and let these feelings out. This is someone who is not going to judge you for those actions, but will only help you come up with some solutions as to how to make these problems better. I know that this can feel very intimidating, but this is someone who hopefully only has your best interests at heart, and so try to open up and see that you can get some resolution to your issues that you are going through. I think that you will feel such a weight lifted off of you if you decide to let someone else in and help with that pain.

  • Kathleen F

    March 27th, 2015 at 3:59 PM

    I can really relate to your comment Charla as I have two wonderful therapists and although I’ve talked about suicidal ideation and self harm before I have had more intense thoughts lately; almost at peace with making a decision to not live. I am reluctant to talk about it not because of trust but because I’m reluctant to want anyone to talk me out of it and with self harm it was the same thing. I was afraid of stopping the behavior because it was my “go to” thing that I did when my feelings were most intense; didn’t wanna give it up! I recommend talking to your therapist because it will always be a barrier to getting better if you don’t…good luck…

  • Piper

    March 28th, 2015 at 11:21 AM

    Please I hope that you can find someone that you feel safe and comfortable with. Most of the time this is not something that we can go through and manage on our own without some help.

  • sierra

    March 28th, 2015 at 1:33 PM

    Someone in a counseling position has heard it all before and will be well prepared to help you get through this! They are not going to judge you!

  • ELI

    March 30th, 2015 at 12:29 PM

    Do you think that this could possibly mean that this is not the right counselor for you? There are so many good people out there that you could open up to, it’s just that maybe this is not the one.

  • Phillip

    March 31st, 2015 at 1:40 PM

    So you know that this is a problem that needs to be addressed… the crucial thing is figuring out why the hesitation and how you can begin to share this with this other person. I think that he probably senses that there is something that you are not sharing and he is working on that with you in a slow kind of way. I think that you will know when the time is right to start sharing some of this, and it will feel so good to finally be able to talk about it with someone who fully understands those urges and feelings.

  • lisa m

    April 4th, 2015 at 10:10 AM

    Lynn- thank you for such a kind response to this reader with this problem. It sounds like it is very much something that they are struggling with and how wonderful for the contributors here to know that there is a trust being built with your readers, that they feel comfortable about opening up about the things that might feel impossible to do in another setting.

  • Lynn Somerstein

    April 6th, 2015 at 9:58 AM

    Thanks Lisa and “Holding Back,” and all other members, administrators, readers and writers of Good Therapy–a safe and healing space that’s been created for and by all of us.

  • Maryjo

    April 14th, 2015 at 5:57 AM

    Many thanks for sharing with us, I think this site definitely
    stands out.

  • Lynn Somerstein

    April 14th, 2015 at 11:34 AM

    Thanks Maryjo.
    Take care,

  • Kara

    April 16th, 2015 at 3:05 PM

    I agree with Dr. Sommerstein’s suggestion that you are not yet ready to broach the subject of your self-injurious behaviors. It’s ok. Ideally, this therapist is providing you with an extraordinary experience. They are providing you a “judgment-free zone” where you can say ANYTHING that you are thinking and feeling, and also, it is your emotional safe place. You can cry, laugh, stomp your feet in frustration, and no one minds. So, when the two of you have developed a relationship where all holds are barred, and you are comfortable in doing these things, you will be ready. It will not be an earth-shattering experience, because the relationship is what this is all about. I might even guess that the words will come much more easily, and it won’t feel as though it was such hard work. Give yourself a break. How long have you been struggling with these issues of self-harm? They didn’t happen in a day, so you can take the time to build the relationship, and test the waters. Dr. Sommerstein is spot on, where you can talk about mindfulness, or relaxation techniques, and self-care. By practicing some of these things, you will begin to feel less out of control, and once you feel more able to control a few things in your life, you will probably be glad that your struggles have led you to this therapist.

  • Lynn Somerstein

    April 16th, 2015 at 4:12 PM

    Well said, Kara, thank you! Your understanding is great!
    Take care,

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