Triggering (SI) - used to cut, now I work in psych...

[only2fail]

I was an SI'er from age 13-22... now I'm 26 and next month will be my four year anniversary.

here's the thing... I have worked in inpatient psych for a number of years, now, and I've never been sure about something...

Is it "professional" to mention my past to my patients? I've only ever 'admitted' it to two patients, and only because they were having trouble with SI'ing and I wanted to give them hope... to let them know I really *did* understand. With both patients, it really seemed to reach them. The only thing I'm unsure of is if this undermines my position. I mean, former alcoholics who are now CD counselors have no problem admitting their recovery... should I have to keep mine hidden?

I can't really ask my boss, because he doesn't know about my past, either (I mean, really... how do you bring it up?) so I'm just not sure what's kosher. I don't want a co-worker to find out and tell me it's not really "proper" for me to be talking about myself... that I should just be there for the patient. I guess I also don't want to undermine myself in front of my co-workers, since I'm sure only a few of them have seen/noticed my scars.

what do you think?? would it be easier for you if you knew your counselor had been where you are? that they really do *know* and don't judge...?

I guess I don't know what to think... sometimes it's almost harder because I can see/know it from "both sides" (so to speak)..........

thoughts?

[Life Must Go On]

hey

i don't know about it being proffesional etc

but i personally think i'd be more comfortable if my counsellor said that she used to, i think it helps to open up more if people have been through similar

Caz xx

[effervescence]

well, my counsellor does a bit of "self-disclosure" as she calls it sometimes, just to let me know she understands some of the things i say. not about SI, she doesn't really understand that, but about other things.
and she's very experienced in psychology.

i think it's ok, as long as you only do it when you feel it's neccessary, and you ultimately keep the conversation focused on the patient.

i also think it's better for older patients, ie18 and up. not really sure why, it's just a feeling i have. maybe as we get older we are more able to recognise that professionals and adults are able to have personal lives and problems, without letting the novelty of "knowing secrets" about them undermine the respect in the patient-professional relationship.
sorry if that's inarticulate.

[Stellata]

There're ways around, of skillfully empathising with how they're feeling, without necessarily disclosing that you self harmed. Like, being attuned to the different feeling states they get into when they self harm, and responding in an understanding way, letting them know that you can understand how that feels.

[Tomorrowwillcome]

I think, personally, that when it feels right that a bit of "self discloser" can be helpful, makes the therapist that bit more human. As long as it is not said in order to reverse the rolls and the patient, as said previously, is still the focus then it can be a good thing to know your therapist has also struggled with life so you know they can truly empathise.

I had a health visitor who would use any opportunity to devalue your problems by letting you know how bad her life had been, her tales were always worse her treatment always worse and she always had stronger prescriptions now that was really irritating and I felt worse after she had gone.

[only2fail]

^^ that is something I work hard to make sure I stay away from! I never want to turn the focus away from the patient and their immediate need(s).

Thanks to everyone for their thoughtful responses. I don't think I would ever reveal this to anyone under 18 (or anyone too emotionally immature), though I know one teen who asked me about my scars.

The reason I asked is because I was working with a girl tonight who was having a horrible time trying not to SI. She even did it while I was sitting right there, watching her. She was expressing such an extreme lack of hope... she wanted "proof" that she could be hopeful for her future... that it *did*/could get better. I couldn't resist telling her that I had her proof... that I *was* her proof.

I think I made the right decision [to tell her]... I think it really did help [her]. I think it just scares me because it is uncomfortable for me to talk about it... and when I get uncomfortable, I feel like maybe it's a sign it's something I shouldn't be doing.

who knows........

[Popple]

I think it depends on the individual.
But when I was in the unit some nurses told me about their past and they were the one I was much closer too and trusted more.

But I think you should only tell them if you feel happy with it and don't mind it, if it's making you feel uncomfortable or bad in anyway then I wouldn't because it's not worth causing yourself any upset.

Take care
Katy
xx

[MidnightApology]

I hated it when I had to talk to my school nurse about my SI'ing because I felt like she was being paid to care about me and that although she sounded like she knew what I was feeling, I didn't think she had any idea whatsoever.. It's put me off professionals for life. So for me, it'd really help if someone turned round and said "I've been through this, I understand." Even teachers I talked to & felt okay with.. They always said they believed in me & that I'd be okay and everything.. But it would've been nice for them to say "I know you'll be okay cause I was like you." You know? It'd certainly give me more hope, because they'd really know that you'd relate to how they're feeling..

But I agree that it does depend on the person. If you've found it helped the people you've told though, then it surely can't do any harm?

[Stefanie]

I've worked in an inpatient unit for the last 4 years and I have never disclosed my past to my patients as it is not appropriate. When I go to work, it is about my patients not me. I have worked with women who SI and I use my own history to inform my clinical practice, ie, I speak as someone who knows how it feels. I don't need to overtly state what I have experienced as it speaks for itself in the way I work with patients.

One patient asked me outright if I had self harmed/been in hospital. We had got to know each other well and she trusted me so I would not have lied. I said 'I couldn't possibly comment!' and she knew I had sat where she was. But I felt very uncomfortable, and felt it had moved our relationship from therapeutic and professional to something that felt wrong. I won't be doing that again.

I would ask why you feel like you need to disclose your own past? For me, if I want to tell a patient that, then I am not approaching the situation with my clinical head on, I am letting myself get too emotionally involved and find myself looking for answers/ways to help that sometimes aren't there. As much as it sucks, sometimes there isn't anything I can say which will help - whether I've been there or not, and I think handling that comes with experience.

[Snow White.]

Stefanie has some interesting points, there.

I will say I cannot comment on professionalism, however if you don't want your staff to know you are doing it, that would lead me to believe you feel it's inappropriate.

That said, it could still be of benefit to a patient despite your views on it. I know I have worked with a psychologist who let nothing about her out to her client - not even the type of car she drove. She was a great therapist but it was hard to connect with her, very hard.

I met another one who let slight personal things into therapy - stories that where related, for example, or little jokes and things, and it made her a lot more personable.

On the contrast, I had a psychiatric nurse who used her depression in her defense and patients never really cared she was depressed because it felt like she was rubbing it in our faces.

I think, honestly, you have to be careful. When people are very vulnerable and at a point where they don't see hope, if you mention something like that it can go two ways. They can either realise there is hope, or they could project themselves further into hopelessness by comparing themselves to you and what they "should" have achieved and etc.

So; personal decision. And I think it would vary, too, between some patients and others, depending on their mental state.

[Steel Magnolia]

I really think it depends on the patient. It would be ok as long as your co workers dont find out I suppose. My psych told me she used to SI and showed me the scars. It gave me only inspiration to quit and a new found respect for her as she was 20 years recovered. It really showed me what she has achieved and that recovery is possible! Check out my post in the mental health discussion and support forum on the appreciation thread for doctors (or something like that). It shows that I really do respect her and because of her SIing I feel like she understands me very well.
x

[Bleeding Angel]

i would have thought it would be unprofessional. Because it does chage the relasionship, and make it more about you, esp if they start asking about your life.

And also because these people could talk about it and be overheard by staff, esp if you havent told them.

i duno it just seems wrong

[fragile as glass]

I am currently training as a counsellor and I also find it difficult to know how much to disclose to colleagues or patients. The difference with me is that I still SI really bad and im still anorexic. I feel a bit of a hypocrite sometimes and I do wonder if I am doing the right thing by working with vulnerable clients while still ill but I figured that if I waited till I was *well* I could be 50 before doing anything with my life (im 26 now).

I do believe that it is about the patients story not the counsellor/nurses story and therefore ALL my scars have to be covered when I go to work (which is hard because Im scarred everywhere apart from my back)

I darent tell my colleagues in case they think its inappropriate to work when im still so ill and i get the sack but its hard watching what I say all the time.

My advice would be, Think about why you want to disclose to a patient and if the disclosure is going to be beneficial to them. If youre not sure then dont do it.

I do think that there is a place for self disclosure but only if you know your patient very well.

Hope this helps

[TinkerDebs]

i think it depends on the individual really
if you feel it could give them needed hope - then maybe just hint at it

to be honest i kinda always though that the college councellor was paid to be nice and caring - but the other day - i told her how i'd helped my friend and felt good about it - she told me it does make you feel good to help people ...... long silence followed...... then she randonly said "why do you think i do tis job - its not for the money trust me; i like helping people and it's job satsifaction; i do feel quite privalidged when people such as yourself can open up to me and let me see into your little world" <- that beared no meaning on what we were talkig about - but it was nice to hear

i realised she did actually care - and that made my fear of her shrink a bit

so i do think if its something you think would be helping/ give hope i think it's okay [but as with most above - more emotionally mature people would maybe benefit more]

[Jlynn]

I think its great if worker in the si jobs talk about there past it really does give hope

Well done on your hard work :)

[ems]

i would find it extreemly useful..

[ruthhardy]

The first person I told was my teacher (before I started seeing a psychiatrist), and I was really freaking out about it, and thinking he woul think I was messed up, and he told me that he knew how I was feeling, since he'd used to do it himself- it helped me so much, as it made me feel that I wasn't alone- and it helped me to open up more to him.
So I'd say, if the patient is in a bad way, and you think it would help them to tell them, and as long as the attention stays focused on them, then it would be a good thing

[Steel Magnolia]

There are a lot of mixed opinions and its a really good question! Maybe a poll would make it easier to reach a decision..

[Ami]

i think it would be helpful, but not sure if it be professional...
x

[pixiedust]

I"m not sure about professionalism or anything but I know once when I had to go to hospital because of cutting bad I was really scared and the paramedic in the back admitted to me that she used to do it which calmed me down a bit because I thought they'd hate me. Personally I think it would help give someone hope and show that you understand but I guess it depends on the situation etc.