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Ask A Therapist: How Much Will My Therapist Tell My Parents About My Self-Injury?

As a minor, how much of what I tell a therapist will my parents hear? Recently my parents have discovered I struggle with self-injury. After discovering this, they are going to send me to see a therapist to help with the issue. They, of course, know I struggle with self-injury, but I would prefer if they did not hear about it if I tell the therapist when I self-injure. Is this possible, or is it required that they inform my parents when I cut? As a minor, do I have any confidentiality from my parents?

A: Excellent question and an important concern to bring up in your first session with your therapist. Watch the full answer below.

Take good care of yourself!
Julie Hanks, LCSW

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Ask A Therapist: I Hate Myself And I Don’t Know Why

I hate myself and I don’t know why. How do I learn to love myself? Even though I believe I’m a daughter of God, I feel like believing and knowing is different than feeling. I don’t FEEL like that. I have urges to cut myself and sometimes give in, and I make myself throw up off and on. I hate being like this. I was sexually abused by a family friend for about six years. Even though he stopped when I got older, I never said anything to anyone. I feel like this might contribute to my feelings of hatred toward myself. Sometimes, I even think that my life has no purpose and that the world would be better off without me. I hate myself for doing things like spending money on a nice haircut. Every time I treat myself nice, even if it’s something like a bubble bath or chewing a stick of gum, I feel guilty. I treat other people well. I give people more energy than I have and it’s not fair to them or me. I know that if I treat myself better, I’ll have more energy to not only give to myself, but to others too. However, every time I try to do this, I end up cutting or throwing up because the urge to do so is overwhelming. How do I learn to treat myself well? What is your advice? Is there something I can do without therapy? I don’t have a lot of money and am out of a job.

A: Thank you for writing in and trusting me with your story.  I want to suggest to you that you look into the mental health resources at your college and so you can start on a path to healing. Many schools offer free or reduced fee counseling for students. I want you to know that you are not alone. You are not crazy. You have suffered years of sexual abuse. I’ve worked with many young adults who’ve been sexually abused and who’ve expressed similar feelings of self-loathing, cutting, eating issues, and emptiness.  Watch the video for more suggestions on how to start healing from your trauma.

Take good care of yourself,

Julie Hanks, LCSW

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Ask A Therapist: Will PTSD Symptoms Jeopardize Military Career?

Q: I’m 23 years old and in the military. Recently I was raped while on duty, I haven’t been handling it well it brought up a lot of childhood stuff. I started seeing a psychologist, but I’m having a really difficult time opening up. She’s nice and I like her, but I don’t want to tell her too much, hurt my career and depend on her to keep my confidences when she can’t. I don’t know how to tell her about the purging or even if I should, she’s asked about the cutting but I don’t know what to say. I’ve been diagnosed with PTSD but I don’t want to tell her that when I have a nightmare when I wake up I can still see and feel what was happening in the dream. How do you open up and not come off as crazy? Please help me I could really use the guidance.

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Ask A Therapist: I Deal With Abusive Boyfriend By Cutting And Binging

Q: Hi, I am 19 year old girl in my 2nd year of college. I currently live with my boyfriend of 4 years who is 25 years old. Our relationship used to be really good, but now all we do is argue. A few years ago I was flirting with other guys and he has never forgiven me for it. He constantly tells me he doesn’t trust me, and when he gets mad he tells me he hates me, that I should crawl in a hole in die, that he can’t stand to look at me, and many profanities. He spends no time with me so I spend the majority of time home all alone, which is the main issue because that gives me all the time alone I need to self-destruct.

I can’t stand myself, I hate everything about me. I’m fat and ugly, sometimes I don’t even know why I bother trying to make it through life nothing ever goes as planned. I feel like I am constantly starving myself or if not eating ridiculous amounts of food and then feeling guilty so that I either make myself puke or cut myself. I can’t control it, I feel like if I can make myself attractive my boyfriend will love me again but I can’t even take care of myself. The worst was when he caught me binging and freaked out along the lines of “No wonder I’m always starving, you eat all the food. For once I wish you would save some for me instead of stuffing your face all the time.” And despite hearing that I still continue to stuff my face… I can’t help myself… maybe I deserve to be fat. I can’t even decide what is worse, the purging or the self-harm. Both cause me discomfort and to feel like a failure, but in the end neither make me prettier…they just make me uglier. This also causes me to spend way too much money on food…I am $20,000 in debt with my bank because of all the money I waste on food. I eat too much so now I cant even barely afford anything…which my boyfriend also blames me for…rightfully, it is my fault.

I just don’t know what to do. I have thought about trying to see a therapist regularly but I’m too embarrassed. I don’t want to make known just how disgusting I am. I don’t want anyone to know how much I eat. I don’t want anyone to know how my boyfriend treats me. I just want to be a normal person… I want to be happy, and loved…what do I have to do to be okay?? 🙁

A: Even though you’re embarrassed, please go see a therapist ASAP. Licensed therapists are trained to help individuals and couples in crisis resolve your problems and help you, not to judge you. Just by reading this letter I can sense the depth of your pain, I have empathy for you,  and I want to help you. This is how your therapist will feel too when you meet with him or her face to face. If you’re not sure where to find a therapist in your area click the Find Help tab at the top of this page for a listing. There are likely earlier roots to your self-destructive eating patterns, cutting, and dysfunctional relationship that can be explored and healed in therapy and are beyond the scope of what I can offer here.

What you’re describing in relationship with your boyfriend is verbal and emotional abuse. No one deserves to be told by their lover “I hate you” or “You should just crawl in a hole and die.”  That is heartbreaking to hear and needs to stop if you are ever going to gain self-esteem and confidence to change your life. Your therapist can help you to build  relationships skills and to help you come up with a plan to stand up for yourself when your boyfriend becomes verbally abusive.

In addition to meeting with a therapist regularly, I suggest you start seeking out books, blogs, and other resources and start arming yourself with more knowledge and tools to help you feel stronger and more competent. Here are some excellent resources right here at Psych Central to help you get started:

Weightless Blog
Eating Disorder & Binge Eating Info
Self-injury Forum
Relationship & Communication Forum
Eating Disorder Community Forum

Take good care of yourself!

Julie Hanks, LCSW

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Ask A Therapist: Will My Therapist Have To Tell My Parents When I Cut Myself?

I am 14 and recently my parents have discovered I struggle with self-injury. After discovering this, they are going to send me to see a therapist to help with the issue. They, of course, know I struggle with self-injury, but I would prefer if they did not hear about it if I tell the therapist when I self-injure. Is this possible, or is it required that they inform my parents when I cut? As a minor, do I have any confidentiality from my parents?

A: First of all, I’m glad that your parents are going to take you to a therapist to address your cutting. Your cutting is a warning sign that something in your emotional life needs to be addressed. While there is confidentiality between client and therapist, there are limits to that confidentiality.  Therapists are required ethically and by law to intervene when a client is threatening serious harm to self.  Since cutting can  range from minor surface scratches to life threatening wounds, and I don’t know how serious your self-injurious behavior is, I am not able to fully answer your question. Your question can be best answered by your specific therapist when you meet with him or her. At your first session, I suggest that you ask your therapist how he or she will handle your disclosure of self-injury.  Because you are a minor, it is likely that your parents will be involved in some way in your treatment. Many therapists will require family therapy  when working with minors because family dynamics often play a part in a child’s distress, and because parents play an important role in the healing process.

My biggest concern regarding your question isn’t whether or not your therapist will tell your parents, but why you don’t want your parents to know the full extent of your self-injury. Is it because you are embarrassed of what they will think? Is it because you don’t want to upset them? Is it because they will be angry with you? Is it because they will overreact? I hope you will address this important question with your therapist.

The fact that your parents are taking you to therapy to get help tells me that they are concerned about you, that they care about you, and that they acknowledge that you are in pain and need professional help. Consider that they may be able to help and support you through this difficult time as you sort through your emotions and resolve the pain underlying your self-harming behavior. You are 14 and it’s their job to make sure you are safe.

Take good care of yourself, and let your parents take good care of you, too.

Julie Hanks, LCSW

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Ask a Therapist: Depression, ADHD, Self-injury, & No One Cares

Hello, I am a 16 year old Sophomore in high school. For the past 5 years I have struggled with addiction to self injury, depression and ADHD. My parents refuse too believe anything is wrong with me and every day scream at me and break things as well as insult me about how useless I am and how I am always ruining their lives! My friends all say that I’m amazing and such a good friend but I have a hard time believing them when my OWN parents seem to hate me…My grades have gotten a lot worse because my parents deny that I am ADHD even though my doctor has said I need therapy and medication.

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