Q. I self injure through ways of cutting. It’s never gotten me hospitalized, I’ve never done it as a suicide attempt, and I don’t do it every day or even every week. I can go months without it, or I can do it many times in a week. It all varies. Thing is, I want to tell my therapist about it but I’m terrified. I’m so scared she will tell my parents, want me hospitalized, make me sign something promising that I won’t cut or just plain tell me that I have to stop and that be the end of it. I’m also afraid of the questions she might ask. Basically, is there any way you could clue me in on the types of questions she might ask me if I tell her so I can be prepared? I’ve heard a lot of therapists are very uncomfortable with the idea if SI and all that it entails, which is another thing that worries me. I’d hate to tell her and have her be disgusted with me. So, again, anything you could tell me about the process I’ll go through after telling her?

A. I cannot tell your for sure what your therapist would ask you but if I were your therapist and you told me you were cutting, I would ask questions like “how long has this been going on?”, “what happens just before your cutting?”, “did something happen that day to cause you to cut?”, “what were thinking about that made you cut?”, and more questions of this nature. I would ask these types of questions to find out why this cutting behavior is occurring and gear treatment towards stopping the cutting. Cutting is not exactly SI [suicidal ideation]. You cannot be hospitalized for simply cutting. You can only be hospitalized if you are an imminent danger to yourself or others. It varies state to state, but basically this means a person must have a plan for suicide or homicide and the means to carry out the plan and that without hospitalization, the person is likely to carry out their plan. In most cases, the only way you can be hospitalized is if you have a plan to hurt yourself or someone else. I encourage you to tell your therapist about your cutting behaviors so that she or he can help you stop cutting and stop the emotional suffering that leads to the cutting.