Masochism versus self-harm?

[brungerbulb]

I had a check-up with my medicine lady this week (can’t remember the professional term) and she asked me the usual questions, “any recent breakdowns, any suicidal thoughts, etcetera-etcetera”, and I responded “no, no, no”, but the problem is I still said “no” when she asked if I had self-harmed recently. I don’t think I had, but at the same time, I had a bruise on my thigh from where I had hit myself a few days earlier. Let me explain.

I don’t call hitting myself that way “self-harm” since it’s not for the same reasons. Though never serious, I have self-harmed in the past, and it was usually when I was frustrated or anxious; kind of like a nervous tic. Since I know how to identify what urges to self-harm look like in myself, I know that what I do nowadays isn’t anywhere close to it. I always make sure I’m calm and in private beforehand. I also don’t do anything that might do any long-lasting damage. The bruises, even if I like the way they look, will definitely fade after a few days. But I’m not really sure how to justify that to any medical professionals.

I’ve talked this other a little with my therapist, and she came to the same conclusion that I did, that what I do doesn’t constitute a real issue. All the same, when the medicine lady asked, I thought about confessing to her. In the end, I decided that we’re not very close, and I absolutely did not want to make her feel uncomfortable. I did feel a little deceitful, then. It’s not really something I want to share about myself, since it’s basically another form of masturbation for me, and the only person I’ve ever spoken to about that is my one therapist. Even so, am I still obligated to tell any other professionals who ask? If I’m remembering correctly it’s the law, and they’ll tell my parents, but by god there is nothing I want less than my mother knowing about this. She’s against me locking my door at night, since she’s paranoid about self-harm, and I just don’t know what she’d say if her worst suspicions turned out to be true, especially in the sexual context which they are. Even worse, she’d probably connect the dots and figure out that this is what I’m doing when she and my brother are at church. Yikes. I don’t want people to be weird about it, is all! It’s just a bruise or two!

TL;DR, do I have to confess my masochism to medical professionals, even if it isn’t really self-harm?

[Elise]

Hi there brungerbulb, what you tell to healthcare professionals in your life is in the end, your own decision, and whilst it isn't a good idea to lie, but since you and your therapist agree that this behaviour is not self harm but rather something you do safely, for pleasure, then you don't need to disclose it under the prompt of "self harm" with other health professionals (the word you might be looking for regarding the other professional, if she is a specialist who prescribes mental health medicines to you who isn't a GP, could be psychiatrist, does that sound right?).

Since you have a background of self harm, I think it is a good idea that you have disclosed this to your therapist and are able to talk to her and have a sounding board about the safety of what you're doing and whether it fits the definition of self harm. If you ever find yourself questioning where that line is and whether you might be falling back into the older patterns, then it is good to be able to have someone you feel comfortable talking to about this. Also, if this is something new to you, as well as taking care of your psychological safety, do make sure that you are educating yourself as to safe impact zones and not going harder than you need to, and engaging in good after care (icing bruises etc.) so that you stay safe and well. If you have any questions, thoughts or curiosities about this, please don't hesitate to ask.

[brungerbulb]

Alright, that’s good to know. Mostly, I just wanted to make sure I wasn’t stepping out of line by maintaining my boundaries like this, even to a psychiatrist or someone similar. It’s nice to have my secrets, but I know it’s also important to have people you can confide in— in case I step out of line, which I might, since I am so young— which is why I’m glad to have the therapist that I do. There are some therapists I’ve had in the past who I’ve never even gotten close to admitting myself to, since I worry what will happen if someone who’s as influential in my life as a healthcare provider misinterprets me. Anyway, thank you for your time.

[Mo]

I'm definitely glad you have a therapist you feel comfortable talking to about this! I agree with Elise that it's fine that you didn't disclose the bruising to the healthcare practitioner you saw earlier, since you know there's already someone who's aware of the situation and looking out for you.