I think my therapist is a cutter.

By Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Should I be concerned if I think my therapist is a cutter or engaging in self-harm?

I had a therapy appointment earlier this week. My therapist has a PHD and specializes in sexual abuse. The weather has been unusually warm in my state and people are starting to shed their winter attire. My therapist wore a blouse that had sleeves that were 3/4 long. She got up to get something from her desk and I noticed what appeared to be cut marks on her upper forearm. One looked like an old scar and one looked relatively new.

It hurt my heart to think that she may be engaging in self-harm. Is this something I should concern myself with? I’m trying to think of other possibilities for the scars. Perhaps she has a new kitten and it scratched her. But that wouldn’t explain both an old and new scar. I by no means am under the delusion that therapists have carefree lives or that they don’t have their own problems to deal with, but I’m not sure how concerned, if at all, I should be about this. It was the presence of a new scar that has me most concerned. I’m a very shy person, an issue I’ve been working on in therapy, so I can’t see myself bringing any of this up with her, nor do I even know if it would be appropriate to do so. But I also don’t know how much she was actually trying to hide it. Again, should I be concerned with this or do I just ignore it? I truly hope I have read this whole situation incorrectly, but I work in a residential facility for mentally ill females and see old and new cutting scars all the time. Any help or advice would be greatly appreciated….thanks.

A: Your concern for your therapist is understandable, but the way to understand your responsibility in the relationship is to explain your process to her. A process comment to your therapist would sound something like: “I noticed scars on your arm and was concerned that you may be cutting yourself on purpose. It made me realize how much of a caretaker I am, but also that you might not be okay enough to take care of me.”

A good therapist will be able to manage this comment. Everything in therapy is grist for the mill…so a process comment gives an entree into the nature of your perception and family of origin. In other words, I would use everything about the therapist and her relationship with you for your growth.

The way to think about you concern is that you are in a relationship that is designed for your emotional and psychological growth. This relationship is highly unique in this regard because it is the place that can mirror all of your other concerns and issues in life. As such your observations and concerns about the therapist are part of the process. In therapy we would want to have your comment identified as a particular perception, not just concern about the therapist. The premise behind this is that others would not have noticed nor interpret the cut in the way you have, so the nature of your perception reveals information about your way of seeing others who are, or have been, important to you in the world.

Wishing you patience and peace,
Dr. Dan

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Last reviewed: By John M. Grohol, Psy.D. on 7 May 2010

APA Reference
Tomasulo, D. (2010). I think my therapist is a cutter.. Psych Central. Retrieved on October 31, 2014, from http://psychcentral.com/ask-the-therapist/2010/05/07/i-think-my-therapist-is-a-cutter/