• Quote of the Day
    "The only normal people are the ones you don't know very well."
    Alfred Adler, posted by David Baxter

Sylvia

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I have written this letter to my psychologist hoping that she will help me overcome my problem with self injury. However writing the letter is one thing and giving it to her it is a completely different story. I'm afraid of exposing something I have kept secret for so long. I know that once receives this letter she will have to inform my parents of the problem which has the potential of making my life living hell. After all there is little chance they will understand.I would appreciate it if you could read the letter and me your opinion on it!I do not know when I'll have the courage to give it to her but knowing what other people think of it will be of great help to me. Thanks!

well here it is...

You have helped me more than anyone in this most difficult time of my life. You have shown me that there are good people in this world who give themselves to help others. I am very grateful for the care that you have given me in my darkness. Without which I would be truly lost. It is now however that I need more help and support than I would have ever suspected before this time.

There are moments when I feel such deep emotional pain that cannot be expressed in words. This degree of suffering is unbearable and I am unable to cope. Pain and self-hatred overwhelm me causing me to cope in the only way I feel that I can express the pain deep within. I cut myself. I ask that you please listen to me before you make any conclusions. I know there are endless thoughts racing through your mind at this very moment and that there are still even more questions. I can only do my best to fill in the blanks.

You must know that it is not easy for me to write those words. This letter possesses the courage that I have not had for months. I have no way of knowing how you will truly react to this. I have tried many times to anticipate numerous reactions but I know only that I cannot control how you or anyone will react to the dark truth of my pain. I ask you not to mistake my self-injury as an attempt to manipulate those around me because that is simply not true. My use of cutting as a coping mechanism was a way for me to have a sense of control over my body when I feel that there is no other way to gain control over my thoughts and myself. Emotional suffering can be one of the most frustrating forms of pain for it cannot be touched nor easily healed. Physical pain is not invisible however. I know the cause and the reason for my self-inflicted pain. As my wound heals I know that my pain has an end. My emotional pain is different in that there is no visible end to such deepness.

The cause of this nightmare is in direct correlation with my depression and self-hatred. Cutting releases emotional pain and helps me to feel when I am numb. It is a way of coping with life when I feel there’s nothing left. As much as it has kept me from doing further harm to myself it has only added to my problem of depression. Ultimately it has become a problem in itself. I know that if it were not for my depression then self-injury would not be something I face now. However I do not intend to play the victim of self-injury. Cutting is rather a symptom of my experience with depression. I have learned that it is an addiction and is certainly not easy to stop. Getting beyond self-injury is not simply done with willpower alone. I need support in order to overcome this. I have tried three times to quit but have only made it 1 ½ months without cutting. Alone my strength only last so long… As I feel myself breaking I give into the impulse that leads to the act of self-harm. I must make it clear that I have never acted with the intent to take my own life. If there is one thing I am certain of it is this: thoughts do not always become actions.

You have taught me to take risks and slowly I have come to do so. Giving you this letter is by far the greatest risk I have taken yet. I recognize the potential of losing many things that are dear to me. There in lies the reason for my secrecy. Misunderstanding and social stigma keep distance between others and myself. I fear that I will lose you as my confidant. It would be foolish of me to think that my confession of my struggle with self-injury would not change things. To the contrary I know it changes everything. I know there is a chance that exists for you to be so disgusted and repulsed by my behavior that you will no longer wish to have me under your care. It is my hope that you will think about the steps you will take as a result of my actions, however it is important that you do not rush to your decision and you are certain that it is fully formed. Self-injury was one of the first symptoms of my depression. I understand if you feel that you are unable to help me overcome my problem. If this is what you decide I will not easily except it but I will except it nonetheless. Upon first seeking your help I was uneasy and unsure, as time went on things changed… my depression did not lift but I came to trust you. The power of trust is never to be underestimated because in this case I believe it is the key to progress. You may be wondering why I felt I couldn’t tell you this before. I had believed that once I trusted you I could tell you anything and it turned out I could tell you almost everything. When I finally gained such comfort in your support I did not want to destroy the foundation that we painstakingly built together. I still do not wish that to be so but I understand that despite that wish some damage is done the extent of which I do not yet know. You have told me that I do not deserve the pain and anger of the self-hatred I place on myself daily. This is true and yet it took me so long to believe it. My hatred of myself has not changed but I want it to. I know that if it doesn’t this pattern will continue. I am all too painfully aware that such change will not be easy…setbacks may be inevitable but it is a necessity that changes occur.

I am aware that you are obligated to inform my parents of my problem. I am I so unprepared for the reactions of my family…be it anger, frustration, confusion, sadness, or guilt. I love them and in my sadness I hurt myself so that I did not spread my sadness to them. In trying to contain my depression I have failed. I could never truly tell them how I felt and this inability to communicate ultimately hurt me. My mother has noticed my wounds and my scars but I always change the subject. I have wondered if perhaps she simply denied the truth about them or if she never really made a connection. Regardless I know that by admitting I have a problem I will lose their trust and in all likelihood lose my privacy as well. It is my hope that I won’t lose everything by seeking the help that I know is necessary. I am aware that I may loose trust yet I need to be allowed to heal and I cannot do so if I am to be repeatedly punished. After all that is part of the purpose of cutting myself, as punishment for my feelings.

Please try to understand that my actions were not twisted or sick…I made them as a result of my inability to cope with unbearable suffering which I felt I could communicate in no other way. I know that the reactions I receive will be negative but somehow I need heal from this. I have disguised my pain in poetry but there are times when there are no words to say. Only pain to be expressed...when words are not enough. In my battle with depression I often think to myself: there has to be another way than down. For me cutting has been a way to keep myself from falling beyond recovery…a way to keep myself alive. I now need to learn a new way to live a new way to cope. Whether or not you decide to help me I still need help. If you are willing I will work with you during sessions to try and figure things out. If you think hospitalization is necessary I will do it but the decisions you make are not up to me. I have given you the information now you have to decide what to do with it. I am amazed at how painful it is to cry…I haven’t hurt this much in the long time. The tears rolling down my face hurt more then when I feel the blood running down my arm. I am so truly sorry if I caused you any pain but writing this letter was something that I had to do.
 

David Baxter

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letter of confession ~ opinions needed

That is a courageous letter, Sylvia. I think you should give it to your therapist. I also think you might be wrong about her obligation to tell your parents. And I doubt that hospitalization is a likely outcome.
 

Sea Swirl

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letter of confession ~ opinions needed

Hi Sylvia.

Great letter. I'm so glad you've decided to tell her. Thank you for sharing with us and making a good decision. :eek:D
 

ThatLady

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letter of confession ~ opinions needed

Your letter is a very profound statement of your pain, Sylvia. Give it to your therapist. There is no doubt in my mind that she will understand, and will take what you've said in the proper light. The sharing of your feelings will only serve to help her help you.

As Dr. Baxter said, it doesn't necessarily follow that she will be required to tell your parents. That may be a decision that you and your therapist can make together, at the proper time. For now, give her the letter and open the doors to a new, happier future for yourself.

Hugs, and best of luck to you. You're a brave girl.
 

Sylvia

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letter of confession ~ opinions needed

I really do appreciate your replies, they really are a great help.

it would certainly make my life easier if she wasn't required to tell my parents. She told me up front at the first session that the only time confidentiality would be broken is when I planned to hurt myself or someone else. sometimes I wonder if hurt means "kill" in the vocabulary of a therapist or whether it encompasses both self harm and homicidal intent. I like the idea of having an option of whether or not my parents are aware of myself injury...this may be feasible,however because I am 17 she may have the authority to decide whether or not my parents are notified.believe me I'm not in any way trying to prove you wrong because I want you to be right but I'm just trying to look at the situation without getting my hopes up.I know that hospitalization is not likely and I am glad of that. I don't believe I would fare well in that kind of situation. I just wanted her to know that I'm willing to use any resource to work things out. I am really hoping that she will be willing to help me and that she will do so without hospitalization. I read in a book on self harm that some therapists are very reluctant to treat such clients. Which is part of the reason why am so reluctant to give the her the letter. Prior to my knowledge of the stigma in the medical community I was more willing to come forward with my problem. the idea of seeking treatment would be much easier if people were so scared of those who self injure.

the thing is I know without her help I may never really want to or be able to stop cutting. Part of the reason I'm afraid to give her the letter is that I fear that I will not be able to cope without cutting. however I do know that in reality it is a necessity that I find new ways to cope so that I can move on with my life successfully.

I really wish that I didn't have so many conflicting thoughts inside my head. I know what's right and I know what have to do but I wish I didn't have this little voice telling me to keep hurting myself!

~Sylvia
 
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letter of confession ~ opinions needed

I know this must be very hard for you, but I think that your therapist is trained to deal with this kind of thing and trained to help you. If you don't tell, then the alternative is to not heal.

I don't know if she would be required to tell your parents. I do know that where I am if you harm yourself in any way you can be hospitalized for 72 hours even if it is just self injury and not a suicide attempt which I think is unfair. Self injurers do not tend to do well in the hospital. I think in my area it is a lack of information about this problem.

I do hope that you can get some help for this. It's a sad and tiring thing to deal with.
 

David Baxter

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it would certainly make my life easier if she wasn't required to tell my parents. She told me up front at the first session that the only time confidentiality would be broken is when I planned to hurt myself or someone else. sometimes I wonder if hurt means "kill" in the vocabulary of a therapist or whether it encompasses both self harm and homicidal intent.
When used in that generic sense, "hurt" means a life-threatening act, or one that is likely to cause permanent damage to brain or other organs. A competent therapist will understand that "cutting" is something different.

I like the idea of having an option of whether or not my parents are aware of myself injury...this may be feasible, however because I am 17 she may have the authority to decide whether or not my parents are notified.
You might ask her, without telling her what the issue is, whether she would feel any obligation to inform your parents if you told her about something that was non-life-threatening or whether at 17 she considers you to have the right to choose whether and what feedback your parents receive. In most jurisdictions, it is considered that at or around the age of 16 adolescents have the right to make those choices. However, when I am discussing this with teens or parents, I do use language similar to what your therapist uses -- along the lines of "If I receive any information at any time of a significant risk of imminent harm to self or others, I will take whatever steps are necessary to prevent that from happening". In my opinion, most cases of cutting would not fall into that realm -- though I might well talk to a younger client about finding a way acceptable to the client to inform the parents and enlist their help, I would not in most cases do it without the client's consent since that would be a breach of confidentiality.

By the way, I have had questions in the past about "but my parents are paying the fees for me to see you -- doesn't that give them the right to receive information?". The answer is no. They will expect some sort of general feedback regarding how they should react in certain situations and regarding reassurance that their teen is not going to commit suicide, etc., but my practice is to make sure at the outset that the teen is the client and that his or her confidentiality must be respected. I usually point out to the parents that if they don't agree to that they are wasting their time and money anyway, because what teen would confide in a coiunelor/therapist who was relaying all the information back to the parents? what would be the point? if I were the teen in a situation like that, I wouldn't say anything important to my therapist either...
 

David Baxter

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janetr said:
I do know that where I am if you harm yourself in any way you can be hospitalized for 72 hours even if it is just self injury and not a suicide attempt which I think is unfair.
Who told you that, Janet? I don't think that would happen in most places, if the therapist is at all competent...
 
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A community health services counselor that I talked to told me that if a person has harmed himself or herself within the last 24 hours they can be forced to be hospitalized. They view it as a suicidal gesture.
 

Sea Swirl

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janetr said:
A community health services counselor that I talked to told me that if a person has harmed himself or herself within the last 24 hours they can be forced to be hospitalized. They view it as a suicidal gesture.

They must take that on a case by case thing. "Harming yourself" can mean a lot of different things; I'm inclined to go with what David is saying. Cutting is usually just not serious enough to lead to hospitalization (and it seldom indicates suicide, as any educated, professional person knows). It's just the public that has this idea that it's life-threatening.

I was watching ER with friends one day, and they had this girl in the show who was cutting (not even that seriously - just your usual cutter) and they confronted her about it. Well, she started crying and wanted to leave the hospital (she was just there to visit a friend or something. She hadn't even come there for help!), and they actually sedated her and had her admitted.
It seemed pretty silly and unrealistic. I was sitting there rolling my eyes, and tried to convince my party that they don't actually do that kind of thing for cutting - they just over-dramatize it for tv. People didn't believe me, though... They were like, "well, it's dangerous because it could get infected or something."
And of course, there was no way to tell them that I knew about this sort of thing from experience. :eek:X

I think the key words are these: "view it as a suicidal gesture." IF something is viewed as a suicidal act, they can hospitalize a person. But superficial cutting is supposedly not viewed this way.
 

David Baxter

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"A community health services counselor" is a rather vague term too that could mean anything from a nurse who took a few counselling courses to a fully trained and experienced therapist... less well-trained and less experienced health care professionals do sometimes overreact, but when it comes to hospitalizations there is another layer of professionals to go through before one can sign an order for involuntary commitment, and that extra layer will include psychiatrists or psychologists who will be trained to evaluate actual risk and not act on hysteria or misinformation.
 
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I think, not sure, that she was a nurse, but who wants to even risk that? I mean if there is even a chance of being hospitalized I would rather keep the information to myself. And she did have the power to recommend involuntary hospitalization. Who could be open and honest with that threat hanging over you even if it most likely wouldn't happen?
 

Sylvia

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letter of confession ~ opinions needed

Dr. Baxter

I really appreciate your feedback having your viewpoint on the situation really helps me. I thank you very much.

it really helps to know how things are defined.so there may be a chance that she won't have me tell my parents...but there may be a chance that she will have me sign a pact to stop. The thing is that I want to stop but I don't know if I'm strong enough. Of course there are bound to be setbacks. Do you have your clients sign agreements not to cut?... Or do you just work with them and teach them how to change.

I feel really stupid in my attempts to anticipate how people would react if I told them about my self injury. I really don't know what will happen. I know she's a very well-trained professional but tolerance may vary from person to person. Please forgive my foolishness and tell me when to just shut up and listen. Maybe I'm trying to hard...all I know is that I'm trying to avoid making my life a living hell so that I can heal instead of being yelled at for all the mistakes I made.

what is one to do?...

~Sylvia
 
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letter of confession ~ opinions needed

Sylvia, I apologize for taking over your thread. I'm really sorry. I shouldn't have said anything about my experiences.

You're not stupid at all for trying to anticipate how people will react. I think that's a very normal and human thing to do, especially when dealing with such a subject that is very sensitive to you. And you're not foolish at all. You 're just trying to figure things out which I think is good and healthy. You have a desire to take steps to get better and I know it is so very hard, but I think you're brave. (You may not feel that way, but I think writing the letter took a lot of courage.)

This part of your letter stood out to me as proof that your therapist will be understanding.

You have told me that I do not deserve the pain and anger of the self-hatred I place on myself daily.

She sees the pain you are in and is helping you understand that you don't deserve the suffering you go through.

She may already have an idea of the self injury and has been waiting for you to bring it up. I think that is a sign of a very competent therapist.

Anyway, I just mainly wanted to apologize. I wish you the very best with all this. I am sorry that you have to deal with all this pain and hurt. Please, if you feel like it, keep coming here and expressing yourself.
 

David Baxter

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janetr said:
she (the nurse) did have the power to recommend involuntary hospitalization
Anybody has the power to register a concern -- so do you, for that matter. Or a neighbor. Or a taxi driver. But the form of commitment (which is a legal document) must be filled out and signed by a practitioner with the training and the authority provided to him/her by law -- in most cases, that would be a physician.

That said, I understand why such statements worry people. I would only reiterate that the people who do have the authority to make such decisions are also the people who are aware of the shortage of beds and who do not want to "waste" them on people who don't need to be there. In many regions of North America, we don't even have sufficient beds for people who meet all the criteria for involuntary hospitalization (e.g., actively suicidal or actively psychotic) -- if a doctor can't find a bed for someone like that, do you really think they'd want to "waste" a bed on someone who doesn't need to be there?
 

David Baxter

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Sylvia said:
so there may be a chance that she won't have me tell my parents...but there may be a chance that she will have me sign a pact to stop. The thing is that I want to stop but I don't know if I'm strong enough. Of course there are bound to be setbacks. Do you have your clients sign agreements not to cut?... Or do you just work with them and teach them how to change.
I never ask a client to promise something that black and white -- it would be tantamount to setting them up for failure and I just don't see that as helpful. I try to treat clients in a way which lets them know that I have faith in their sincerity when they say they want to change and in their strength and courage in continuing to strive toward making that happen. None of that means their can't be slips or setbacks from time to time -- that is just being human.

I feel really stupid in my attempts to anticipate how people would react if I told them about my self injury. I really don't know what will happen. I know she's a very well-trained professional but tolerance may vary from person to person. Please forgive my foolishness and tell me when to just shut up and listen. Maybe I'm trying to hard...all I know is that I'm trying to avoid making my life a living hell so that I can heal instead of being yelled at for all the mistakes I made.
No reason for you to feel stupid at all. This is your life, your trust that you are risking. It's understandable that you have some anxieties about it...
 

Diana

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Well, Sylvia. I don't think your letter could be more descriptive of your feelings. That's what's great about letters. You can take your time and express exactly what you want/need to express. It's not like in a conversation when you freeze up or forget to say something, or say the wrong thing. I think your therapist will appreciate your letter, because you are trusting her with a thorough account of your emotions and your problem. You deserve to be able to express yourself like that. I say Go for it!
 

Eunoia

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hi Sylvia.... I think your letter is amazing in expressing your feelings and fears. your therapist should be very proud of you taking that 1st step and letting her know. it's normal to worry about people's reactions but you won't ever know what that will be unless you go for it and tell her, right? she sounds very competent and I think if there is any reason why she cannot help you w/ this ie. lack of knowledge etc. she will 1st of all appreciate your initial steps to get help and let you know, so that you can find someone who will have the resources to help you. but as Janet said, keep in mind that she may already know about your si too. therapists are generally trained to know about depression and everything that relates to that... so I think she will be able to help you, definately. have you given her the letter, yet? good luck.
 

Kate

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Sylvia-

Your letter is incredibly brave. I really admire you for being able to bare your feelings in that way, let alone express them so clearly despite the obvious pain it causes. I've never been able to do that as well as you did here, and so it's really good that you're able to- hopefully just writing it out also helped.

I'm not sure how long you've been seeing your therapist or where you are (the US? Canada?), since I haven't been reading here actively since November. However, I do want to warn you. It sounds like you have a very close relationship with your therapist, which is good. My first psychologist found out on my first visit that I had been cutting myself, and unfortunately she saw my arm at a time when some of the wounds were still very new. It was not a good experience. Not only had I never visited a psychologist before- and thus was quite disoriented and frightened- she didn't even give me five minutes to calm down and stop crying before she brought in my parents and declared, "Kate has been cutting herself with an exacto knife. This must stop." It was one of the worst experiences of my life to date.

I'm 17 now- I was 16 at the time- and my psychologist interpreted it as harmful enough to myself to merit telling my parents. On the other hand, I now see a psychologist whom I trust and love very much. It comforts me a lot to be able to turn to her when I've been harming myself, and to be able to tell her my problems. Though she does sometimes feel obligated to tell my parents, she's very gentle about it, and makes sure that she won't make things even worse.

It sounded in your letter like you have a very close relationship with your psychologist. If that's the case, and you feel like you trust her, I think maybe you should go ahead and give her the letter. It -will- be very hard. Making that kind of admission is very tough.. goodness knows I can't really seem to do it, except in some circumstances. I think it might help you, though, to be able to talk to her about it. I know it's helped me. If your psychologist is going to tell your parents, try to make sure that she does it on your terms- be calm, and ask your psychologist to request that your parents not make your life miserable for this. Even though your parents may be hurt or worried about your actions, they don't have the right to make you feel even worse because of them.

I hope your decision helps you feel better, whichever way you choose.

-K
 

Sylvia

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letter of confession ~ opinions needed

think you Kate...

writing the letter alone did help me a great deal...it was a huge step for me to write that letter. and yes I have not had the strength to put in the hands of my psychologist. to answer your question I live in New England in the United States.

you are right I do have a close relationship with my therapist. I'm sorry to hear that you had a difficult experience with confiding your self harm. It must've been awful! I myself fear an experience like the one you had. Which is perhaps why I have not yet given my psychologist the latter. I also have had other issues lately with suicidal thoughts...I feel like I'm going mad!

I'm glad that you found in you therapist that helps you and supports you. I am so deathly afraid of getting her the latter because I may not be greeted with warmth and supported as you have the second time around. I don't know what to do! I can't seem to make the right decision!...

I really do appreciate your reply and your advice Kate. I hope to correspond with you again. Perhaps you can send me a message? I hope that I will be able to help you out in future....I hope that maybe we can help each other out. It's nice even to have someone who understands...thank you so very much! I hope to hear from you...

~ Sylvia
 
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