How do I start talking about a deeply embrassing secret?

June 22, 2012 8:30 PM

I occasionally struggle with self-harm. While my support system knows this has been a problem in the past, they do not know that I sometimes still self-harm. I am deeply embarrassed, but would like to start talking to my therapist about this. How do I get over the embarrassment and proceed?

Some background: Between ages 11 – 16 I regularly engaged in self-harm. Between ages 15 – 16 I was admitted to a psychiatric hospital twice, and received a total of four months inpatient treatment and four months outpatient treatment. I have been in therapy since (going on 10+ years) and have grown into happy and relatively healthy young woman. I’ve completed my undergraduate education, am gainfully employed, and have been in a loving and fulfilling LTR for the past several years. I regularly see a psychologist, the same psychologist that has treated me for the past ten years. We have an excellent relationship.

The problem is that I have continued to self-harm. In the last three years I have burned or cut myself around six to eight times. I have been unable to discuss this with my family, my partner, or my psychologist. I am deeply embarrassed by my behavior. I am able to discuss all aspects of my life and mental health with my support system, but this is something I cannot bring myself to talk about.

Part of me has accepted that this is a coping mechanism that will be with me for the rest of my life. The instances where I have cut or burned myself in adulthood I have done so to prevent escalation to disassociation and/or more dangerous and destructive behaviors. I get to a certain point where it’s like, well either I hurt myself or I go off the deep end (not suicide). I do a superficial cut or burn, am able to collect myself, and go about my business.

Yet, recently I experienced something very traumatic and I had the feeling of “cut, burn, or loose it” but after several days of emotional pain and turmoil I was able to stabilize without self-harming. I found myself wanting to celebrate and analyze this triumph with my psychologist but have been unable to do so, as I have not told him about any self-harm for the last four years or so. This makes me really sad. I think if I were able to discuss this in therapy I would have the chance to learn a lot about myself.

The question:
How do I begin to talk about something that is so incredibly embarrassing, and have been hiding for the past three years? I have no idea how to even begin.

posted by Meat Puppet to human relations (13 answers total)

Could you write it down? Maybe write a letter, similar to this post, where you give a brief history of the self-harming and give it to your therapist at your next session? You've expressed yourself really clearly and really well here. It would probably be a good start.

I don't know if this will help, but your therapist will not be shocked, horrified, or think less of you for this. He or she will not immediately jump up and call 911. He or she will not be upset. Self-harm is not uncommon. It happens.

Also, you SHOULD be proud of yourself for getting through a difficult situation without harming! That's awesome and it shows that you've learned some other coping skills. This isn't something that you have to hide out of shame or guilt, if you don't want to. It seems like you want and are ready to share this with your psychologist. Good luck!
posted by Aquifer at 8:41 PM on June 22, 2012 [3 favorites]

Call your therapist's voicemail when you're sure they're not going to answer the phone and just say you've got something important to tell them at your next session.
posted by facetious at 9:02 PM on June 22, 2012 [1 favorite]

A good psychologist will know that it takes a great deal of courage to admit to something that carries such shame for you. It is sign of the progress that you are making and your trust in your relationship with her that you are finally able to share this.

Writing down way you want to say and handing it to her in session is a good way to start the conversation. It doesn't need to be long or detailed. Just let her know that you have been using cutting to manage difficult situations and that you are starting to see other options. Once she knows, it will be much easier for you to talk about details. If you are afraid you will chicken out, you could send her an email (or leave a voice mail if that is easier) giving her the two sentence version and then letting her know that you would like to discuss this in your next session.
posted by metahawk at 9:05 PM on June 22, 2012 [1 favorite]

Composing this question is a good start. You could even print it out and hand the paper to your psychologist if you think they'd understand the context with a brief explanation - or maybe reframe it into a simple letter, as Aquifer suggests.

It's great that you recently coped without harming yourself. If you think you can start the conversation off verbally, you could try opening up with your accomplishment, and then explain why it was such a big one for you. Start off with the positive, you know? Then, every time that shame comes back, you can remind yourself about the good part.

If you think you're going to not be able to say the words, write them down and bring them with you and read off the cards, or hand them to your psychologist. You can practice saying them out loud in the mirror, you can record yourself and bring the recording to your session and hit play, you can leave a voicemail. But no matter how you communicate it, it'll be good to get it out there so you can start working on it with support.

You don't have to tell anybody beyond yourself and your psychologist. If you find that you want to share it with others, you might be surprised at how calmly others might handle it. It's not, as you probably know, uncommon in the least. But if you don't want to tell others, you don't have to feel guilt about that. Just working with one other person will be an excellent step.
posted by Mizu at 9:22 PM on June 22, 2012 [1 favorite]

I'd like to say that you've taken a first step here. You are talking about it. We are not judging you. And we're happy for you- genuinely. I am honestly excited for you. I know that is not easy, and it's an amazing step towards a life in which you don't self-harm anymore. Congratulations!

One way you could break into it with your therapist is to start off with what you told us about this most recent incident. Tell her, "I felt this traumatic event and I wanted to harm myself, but did not!" And when she asks how you feel about it, in the aftermath of that, you tell her, "I've been doing it occasionally." Then, as you realize it's okay to talk about that, admit the extent of it. Ease into it slowly.
posted by corb at 9:22 PM on June 22, 2012 [1 favorite]

What a huge breakthrough!

My guess is that your psychologist has not been taking it for granted that you have not been harming yourself.

He may be embarrassed not to have intuited it when you were actually performing these acts (assuming he did not), but he will not blame you and you will not lose his trust.

Tell him. I bet he'll be very excited, and will share your sense of triumph, just as he has shared part of the enormous work that helped prepare you for such an achievement.
posted by jamjam at 9:34 PM on June 22, 2012 [2 favorites]

I know exactly what you're talking about, using self-harm as a coping mechanism to deal with overwhelmingly shitty feelings. You're not alone. This is really, really common.

Even though it's unhealthy, self-harm is a really effective coping mechanism, and you've learned that it works for you. That all makes sense, and there's nothing to be ashamed of.

But there are a lot of better coping mechanisms out there. Ones that you won't be ashamed of; ones that you can discuss freely with your family, friends, partner, etc; ones that don't have the ability to lead to infections or other physical harm. There's lots of coping mechanisms out there that can build you up instead of tearing you down.

I bet your therapist knows a lot of them. I bet they have no idea that your current toolbox of coping mechanisms isn't sufficient for you and that you two need to be working on better solutions. I bet they would be grateful and not judgmental if you were honest with them, so that they could help you better. There's a reason why they chose this profession; there's a reason why they've been helping you for a decade and that you have such a great relationship. They are there to help you. Let them do their job.

This was a "how do I talk to my care provider" question, not a "how do I stop" question, but as someone who has pretty much the exact history as you (cutting since prepubescence, serious residential psychiatric help in mid-teens, "has it together" but still struggles with backsliding into self-harm in times of great stress) having a partner who I'm accountable to, who would know if I cut myself has really helped me resist the temptation. So has getting rid of everything I use to self-harm. Forcing myself to walk to the dumpster to throw out my x-acto blades while sobbing and wanting to cut was one of the hardest things I've ever done, and one of the things I've done in my life I am very, very proud of.
posted by Juliet Banana at 9:41 PM on June 22, 2012 [8 favorites]

Don't wait to get over your embarrassment or try to figure out a way around it. Just be embarrassed and tell your psychologist. You could even say that you're terribly embarrassed, but you've got something really important to say.

This is very hard, but much easier than trying to figure out a way to stop feeling embarrassed.
posted by jasper411 at 9:47 PM on June 22, 2012 [1 favorite]

BIG BIG HUG.

From your timeline, I'm estimating you are still in your 20's, yes?

Guess what? For some reason, nearly everyone is almost cripplingly self-conscious at that age, in certain and individual ways different for every person, which you will absolutely grow out of as you get older and realize that, seriously, people aren't nearly as scary or judgemental as you imagine them to be right now.

What I'm saying here is that you can feel confident disclosing this to your therapist. Really! I'm not just writing this to placate you. I wish daily I had the confidence in my twenties I had in my thirties, and now in my early forties. Oh! If only someone had told me!!

Therefore, I am telling you.

I can't change my past, but I can help your future - reach out. You will not be sorry you took this step.

A better way of coping is out there. Make yourself available to receive the help you are craving.

*More hugs*

I've been there. I'm telling you the truth.
posted by jbenben at 10:48 PM on June 22, 2012 [3 favorites]

Print this out. Mail or hand deliver to therapists' office. E-mail may be an option too. I'll grant that it's hard to talk about, so put it on his/her radar so they can get the conversational ball rolling.
posted by Ys at 6:08 AM on June 23, 2012

Nthing the letter idea - I used this when I went to my family doctor years ago and had to admit I had depression - I wrote the letter beforehand and just went into my appointment and gave it to her. It meant I didn't have to deal with the emotions then and there - I could take it in steps whilst writing, and because the doctor's head was downwards whilst reading the letter I think it made it harder for me to see her reaction. Actually she was much kinder and more supportive than I was expecting, so I need not have worried, but like you I was really embarrassed and was having a hard time not listening to the awful voices inside my head.

If you're not into letters I've heard people indirectly approach a difficult topic by asking "on behalf of a friend" or giving a hypothetical scenario. That might be a way to guage your therapist's reaction and start the conversation off. You can always admit later you were talking about yourself, when you're ready.
posted by EatMyHat at 8:15 AM on June 23, 2012

PS Well done for having the courage to take the first steps towards bringing this up with your therapist, and good work on your most recent triumph in not self-harming. I think what you've written shows signs that your are making real progress and I think you will be pleasantly surprised if you talk with your therapist about it.
posted by EatMyHat at 8:21 AM on June 23, 2012

The times when I've had something that I really dreaded even mentioning, I started out by saying, "There's something I need to bring up, but I feel very _______ about it." Even if that's all you say, and then decide not to continue, it's a good thing. Just eke it out.
posted by wryly at 4:03 PM on June 23, 2012