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Told doctor about self injury

To cut a long story short, I've been being treated for depression (fluctuates between moderate and severe) for a while now, and started citalopram 6 weeks ago. This past appointment, I told my doctor about the fact that I have been self injuring for 8 years. That was a fairly big thing for me to say, since it's not something I talk about in general.

He asked me where I did it, and after that said that unless I am willing to do cognitive behavioural therapy then I should just keep self injuring. Apparently in 6 out of 7 people it stops by the age of 30. He described cutting as an "immature coping mechanism".

I'm really scared of counselling in any form, because the other times I have tried it it made me feel considerably worse immediately afterwards (including suicidal ideation) which I generally try to avoid. However, just keeping going and hoping that it just stops seems kind of stupid. It hasn't stopped for the past 8 years, so why on earth would it suddenly stop now?

Not totally sure what I'm asking. Maybe just looking for support on how to make myself less scared by the idea of counselling/CBT? Is CBT less likely to trigger me than standard "just talk about your feelings" counselling? I've never actually done CBT before. Is there anything else my doctor could do? Is it normal for them to just be like "meh, you'll probably stop naturally"?

I feel like the meds aren't really helping, but he says that they obviously are because I am now able to engage in conversation whereas before I seemed dazed and spacey and just couldn't engage. However, I don't actually feel better in myself, so I'm not sure if I'm just missing myself getting better or what.. Just not really sure where to go next I guess.
Reply 1
:lolwut: Your doctor sounds like a right dickhead. If you're curious about CBT then I'd read up on it on the internet (with good old wikipedia :daydreaming:), and also check out moodgym, which is a free online CBT program. From those you should get a decent idea of what CBT is, and whether you might find it triggering or helpful.

I did CBT for a couple of months, mostly for depression but also self-harming, and although I got on with my psychologist I can't say I felt like it would work for me. However what goes for one person doesn't necessarily work for another, so I'd definitely at least research CBT and see if you think it could help you, as the NHS doesn't tend to offer much else in terms of treatment for self-harm.

I've tried to stop self-harming many times myself (unsuccessfully :sad:), and the times when it's gone slightly better have been: when I've had some major positive change in my life, like being happy to move to a new country, when I've got my depression more under control (mostly with meds, but also lifestyle changes), and when I've had someone else supporting me - I've tried quitting together with a friend, and I did last longer than usual before giving in. I also have one friend who stopped by sheer willpower - just decided to stop one day and now hasn't cut in over a year, but I think that's pretty damn unusual so we shouldn't feel too inferior in comparison. :tongue:

If you're unhappy with how your mental health is doing then you've got every right to try and change it, and I think your doctor's attitude is shockingly defeatist. Smoking is hard to give up too, but you wouldn't catch many doctors telling a patient not to bother to quit. Also, remember that antidepressants do take a while to kick in/get adjusted to the right dose, so even if you're not feeling any real positive effects now you might do soon.

Another thing you might want to try is looking up lists of distraction techniques for when you get the urge to self-harm - it shouldn't be hard to find websites with them on, or if you ask in the depression society - I think a few people have those lists kicking about the place (also it's a good place to hang out and have a chat/moan/get more advice [although possibly our coping mechanisms might be a little immature for your doctor's tastes :tongue:]).
Agreed with above, your doctor does sound like a bit of a dooooosh... Although, to try and turn it on it's head, I've had a lot of doctors and nurses telling me to keep on self harming because in the grand scheme of things, it's sometimes the lesser of two evils as a means of coping, and as long as you're not going majorly deep, and you're using clean blades then it's 'acceptable' because heck, we've all got to cope one way or another... Maybe this is what he was trying to say in a roundabout way and just didn't get his point across very well?
In answer to your question, yes I feel that your doctor could have done more, or at least gone about it a different way, as it is unacceptable for you to come out of a doctors appointment feeling worse, especially when it took a lot of courage to be able to admit about the self injury.

CBT works for some and not others, and if you're in a good place that you really want to the help then you could really benefit from it, it might help if you could talk to your therapist beforehand (or any therapist) and express your concerns, as I'm sure many people have them, and hopefully they'll be able to alleviate them somewhat and explain what CBT actually involves if you think it'll be beneficial.

Also give the meds a chance to work, and maybe in another month you still don't feel right within yourself make another appointment (you can request a different GP if you're not happy seeing that one again) and see if there's anything else you can do, or try another one? Many people go through a few before they find the one that works.

I hope things begin to pick up soon. X
I've never understood self-harming, I skipped that step and immediately went for the suicide approach, but I'd distrust any doctor (or indeed any person) who:
1. Advises you to keep self harming.
2. Calls you immature for doing so.
Reply 4
Just wanted to say thanks for all of the replies. Just to clarify, my doctor is a psychiatrist as well as a GP and I trust that he is very well qualified. I think that I took what he said badly at the time, but looking at it now I guess there really was nothing he could do except endorse CBT. I mean, he's prescribing meds and for his perspective what else is there? Ugh. I came out feeling very negative, but I'm not actually sure what else he could have said.

Original post by superwolf
:lolwut: Your doctor sounds like a right ********. If you're curious about CBT then I'd read up on it on the internet (with good old wikipedia :daydreaming:), and also check out moodgym, which is a free online CBT program. From those you should get a decent idea of what CBT is, and whether you might find it triggering or helpful.

I did CBT for a couple of months, mostly for depression but also self-harming, and although I got on with my psychologist I can't say I felt like it would work for me. However what goes for one person doesn't necessarily work for another, so I'd definitely at least research CBT and see if you think it could help you, as the NHS doesn't tend to offer much else in terms of treatment for self-harm.

I've tried to stop self-harming many times myself (unsuccessfully :sad:), and the times when it's gone slightly better have been: when I've had some major positive change in my life, like being happy to move to a new country, when I've got my depression more under control (mostly with meds, but also lifestyle changes), and when I've had someone else supporting me - I've tried quitting together with a friend, and I did last longer than usual before giving in. I also have one friend who stopped by sheer willpower - just decided to stop one day and now hasn't cut in over a year, but I think that's pretty damn unusual so we shouldn't feel too inferior in comparison. :tongue:

If you're unhappy with how your mental health is doing then you've got every right to try and change it, and I think your doctor's attitude is shockingly defeatist. Smoking is hard to give up too, but you wouldn't catch many doctors telling a patient not to bother to quit. Also, remember that antidepressants do take a while to kick in/get adjusted to the right dose, so even if you're not feeling any real positive effects now you might do soon.

Another thing you might want to try is looking up lists of distraction techniques for when you get the urge to self-harm - it shouldn't be hard to find websites with them on, or if you ask in the depression society - I think a few people have those lists kicking about the place (also it's a good place to hang out and have a chat/moan/get more advice [although possibly our coping mechanisms might be a little immature for your doctor's tastes :tongue:]).


Thanks. I might pop into the depression society at some point, just trying to figure out whether or not to use my username or go anon. The people I care about are aware of the depression but not the self injury, so I'm not sure. None of the distraction techniques have worked for me and I feel like I've tried them all in the past 8 years, but I might have another look and see if any have passed me by.

Original post by sophie_snail
Agreed with above, your doctor does sound like a bit of a dooooosh... Although, to try and turn it on it's head, I've had a lot of doctors and nurses telling me to keep on self harming because in the grand scheme of things, it's sometimes the lesser of two evils as a means of coping, and as long as you're not going majorly deep, and you're using clean blades then it's 'acceptable' because heck, we've all got to cope one way or another... Maybe this is what he was trying to say in a roundabout way and just didn't get his point across very well?
In answer to your question, yes I feel that your doctor could have done more, or at least gone about it a different way, as it is unacceptable for you to come out of a doctors appointment feeling worse, especially when it took a lot of courage to be able to admit about the self injury.

CBT works for some and not others, and if you're in a good place that you really want to the help then you could really benefit from it, it might help if you could talk to your therapist beforehand (or any therapist) and express your concerns, as I'm sure many people have them, and hopefully they'll be able to alleviate them somewhat and explain what CBT actually involves if you think it'll be beneficial.

Also give the meds a chance to work, and maybe in another month you still don't feel right within yourself make another appointment (you can request a different GP if you're not happy seeing that one again) and see if there's anything else you can do, or try another one? Many people go through a few before they find the one that works.

I hope things begin to pick up soon. X


I think you're right; he probably considered that if the self injury is what helps me cope and stops me committing suicide, I should keep up with it. Although I felt like the recent appointment was horrible, I did used to like him so I'll give it another appointment or two before I decide to switch. I'm going to do more research on CBT and hopefully reach the point where I don't think it will trigger me. Thank you. :smile:

Original post by BefuddledPenguin
I've never understood self-harming, I skipped that step and immediately went for the suicide approach, but I'd distrust any doctor (or indeed any person) who:
1. Advises you to keep self harming.
2. Calls you immature for doing so.


Most of the time, I don't want to die. I feel apathetic and horrible and quite often have suicidal 'thoughts' but not generally actual plans. I don't understand self-harming either, I hate that I do it, I don't WANT to do it, I don't have any reason for it and I can't really even find post hoc justifications for it, it just sort of happens and I don't feel like I have power over it. I can sort of see what he meant with the immaturaty thing - I don't think it was meant to be an insult, rather I think he was pointing out that it's not just a fine and normal coping mechanism (kind of unnecessary since I already know that!). I don't know. I have very mixed feelings and I can't help but play devil's advocate against myself. :rolleyes:
Reply 5
CBT helped me the first time I stopped SHing. We looked at lot at the thought patterns that triggered the SH thoughts and worked to change them. I also did lots and lots of distraction type stuff and worked on it a lot with my care coordinator. I think that time I was SH free for about 2 years. This time round I have been SH free for about 18 months but have employed many of the same techniques to help with the SH again.

I did find CBT a little triggering at times as we did talk about where some of the feelings had come from which did involve looking a little at my past but I was lucky to have a very good therapist who could recognise what was going on and help me through it. I have has some counselling, 2 sets of CBT, one set of group therapy and general support from various CPNs, social workers ect over the years and the CBT has been the least triggering for me, however everyone is different.

My partner was told by a CPN when he has his carers assessment that he should not pressure me to stop SHing as if it was working as a coping method and helping to ease my level of distress then to leave me too it and not add extra pressure. We both found that a bit odd at the time, but I did find myself SHing less once he took the pressure off me to stop and was more accepting of it.

I do think though that the biggest thing for me to stop SHing is for my mood to be better, when I am having a good day the urge to do it is less. Its not an easy journey by any means and you may find you have set backs but try not to let them put you off.

Good luck.
Original post by Anonymous
To cut a long story short, I've been being treated for depression (fluctuates between moderate and severe) for a while now, and started citalopram 6 weeks ago. This past appointment, I told my doctor about the fact that I have been self injuring for 8 years. That was a fairly big thing for me to say, since it's not something I talk about in general.

He asked me where I did it, and after that said that unless I am willing to do cognitive behavioural therapy then I should just keep self injuring. Apparently in 6 out of 7 people it stops by the age of 30. He described cutting as an "immature coping mechanism".

I'm really scared of counselling in any form, because the other times I have tried it it made me feel considerably worse immediately afterwards (including suicidal ideation) which I generally try to avoid. However, just keeping going and hoping that it just stops seems kind of stupid. It hasn't stopped for the past 8 years, so why on earth would it suddenly stop now?

Not totally sure what I'm asking. Maybe just looking for support on how to make myself less scared by the idea of counselling/CBT? Is CBT less likely to trigger me than standard "just talk about your feelings" counselling? I've never actually done CBT before. Is there anything else my doctor could do? Is it normal for them to just be like "meh, you'll probably stop naturally"?

I feel like the meds aren't really helping, but he says that they obviously are because I am now able to engage in conversation whereas before I seemed dazed and spacey and just couldn't engage. However, I don't actually feel better in myself, so I'm not sure if I'm just missing myself getting better or what.. Just not really sure where to go next I guess.


Im Lottie, and I'm 21. I self harm. And the idea that self harm is an "immature coping mechanism" is personally to me a friking JOKE, and I cannot believe that that came from a doctor! No doctor worth their degree should ever tell you to keep self-harming because you will grow out of it. I think you should book another doctors appointment with another doctor.
I have never gone to my doctor regarding help for this, because I feared a answer like this. Self-harm is not an emo trend used by immature teenagers. I dont self-harm because its cool I do it because it clears my mind and helps me to cope. I don't feel ready for counseling and I don't personally believe in anti-depressants because I don't believe that they address the underlying issue.
I also don't think the idea that you'll grow out of it is a particularly helpful approach. I think you should try all forms of available counseling but if you find that this doesn't work for you I think you should try and find less harmful ways of dealing with everything. I find that if I stick to bruises and using an elastic band around my wrist helps to prevent me from cutting.

Do you have anyone to talk to at home about this issue? My family don't know about my self-harming because they have repeatedly made it known that they think it is a pathetic cry for help and wouldn't understand that I don't do it to get attention, and I don't want to tell my friends. If you don't have anyone at home to talk to and find counseling isn't effective, then maybe you could talk about your feelings on here or start a diary to help get some of your feelings out in more constructive ways?
Reply 7
Original post by Wheek
CBT helped me the first time I stopped SHing. We looked at lot at the thought patterns that triggered the SH thoughts and worked to change them. I also did lots and lots of distraction type stuff and worked on it a lot with my care coordinator. I think that time I was SH free for about 2 years. This time round I have been SH free for about 18 months but have employed many of the same techniques to help with the SH again.

I did find CBT a little triggering at times as we did talk about where some of the feelings had come from which did involve looking a little at my past but I was lucky to have a very good therapist who could recognise what was going on and help me through it. I have has some counselling, 2 sets of CBT, one set of group therapy and general support from various CPNs, social workers ect over the years and the CBT has been the least triggering for me, however everyone is different.

My partner was told by a CPN when he has his carers assessment that he should not pressure me to stop SHing as if it was working as a coping method and helping to ease my level of distress then to leave me too it and not add extra pressure. We both found that a bit odd at the time, but I did find myself SHing less once he took the pressure off me to stop and was more accepting of it.

I do think though that the biggest thing for me to stop SHing is for my mood to be better, when I am having a good day the urge to do it is less. Its not an easy journey by any means and you may find you have set backs but try not to let them put you off.

Good luck.


Thanks, it's good to know that CBT helped you. I also SH less when my mood is better, but I still do it. I'm going to arrange the CBT - it must be worth a try. I do have some support network in university friends now, so I have somewhere to turn if I find it really triggering.

Original post by Anonymous
Im Lottie, and I'm 21. I self harm. And the idea that self harm is an "immature coping mechanism" is personally to me a friking JOKE, and I cannot believe that that came from a doctor! No doctor worth their degree should ever tell you to keep self-harming because you will grow out of it. I think you should book another doctors appointment with another doctor.
I have never gone to my doctor regarding help for this, because I feared a answer like this. Self-harm is not an emo trend used by immature teenagers. I dont self-harm because its cool I do it because it clears my mind and helps me to cope. I don't feel ready for counseling and I don't personally believe in anti-depressants because I don't believe that they address the underlying issue.
I also don't think the idea that you'll grow out of it is a particularly helpful approach. I think you should try all forms of available counseling but if you find that this doesn't work for you I think you should try and find less harmful ways of dealing with everything. I find that if I stick to bruises and using an elastic band around my wrist helps to prevent me from cutting.

Do you have anyone to talk to at home about this issue? My family don't know about my self-harming because they have repeatedly made it known that they think it is a pathetic cry for help and wouldn't understand that I don't do it to get attention, and I don't want to tell my friends. If you don't have anyone at home to talk to and find counseling isn't effective, then maybe you could talk about your feelings on here or start a diary to help get some of your feelings out in more constructive ways?


Thanks, Lottie. My mum found out about the self harm when I was 11, and she told me to stop (if only it were that easy). Anyway, she has no idea that I still do it although both my parents do know that I have depression and that I'm on anti-depressants. Sometimes bruising helps to stop me cutting, but elastic bands and ice cubes don't help, they just tend to make me feel frustrated. I do have a friend at university who knows about the self harm and has said that she's always there etc., so I do have some kind of support network. Thanks again.
Reply 8
what doctor in their right mind would tell you to carry on self harming?
Reply 9
Original post by MrHappy_J
what doctor in their right mind would tell you to carry on self harming?


I guess it sort of makes sense since stopping suddenly in the past has caused my depression and anxiety to get a lot worse, including suicidal thoughts. However, I would expect him then to tell me not to stop suddenly but to at least recommend something to help me gradually stop. I really don't know what to think anymore.
Some doctors just don't understand, however well trained they are - a psychiatrist once told me that I had no right to self-harm because I hadn't been abused, and yet another didn't believe me when I said I hadn't been, and responded with "but you must have been...you self-harm." :rolleyes:

It sounds like it would be a good idea to change doctors, and also look into other avenues of support, such as Mind - they might have counsellors you can see. Look into CBT and decide if you think it would be worth trying, although it isn't for everyone.

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