TW: Self-harm
I tried posting this to r/askatherapist but it was removed and I’m not sure why because I’m pretty sure it follows all of their guidelines. I’d really love some input on this, so I’m attempting to share it here instead. Any input from therapists, people in the mental health profession, or just anyone who knows more than me about this topic would be so appreciated! I’ll copy and paste my original post below:
I was in residential treatment a year ago, and while I was there I self-harmed for the first time in 16 years. I was in treatment for trauma, and some repressed memories came up that were incredibly distressing and caused the relapse. I felt so much shame about it, but I chose to share it with my therapist at our next session the next morning because I was committed to my healing process and I trusted my therapist deeply at this point. He handled my disclosure very well which was a relief to me, but at the end of our session he told me he needed to walk with me to the nurse’s cabin to have them assess my wounds. For some reason the thought hadn’t even crossed my mind that disclosing could mean I’d have to show my wounds to someone, so him telling me this felt like a sudden shock and gut punch. I have trauma connected to a self-harm disclosure when I was in high school that involved the person I disclosed to making me show them my wounds and then touching them and kissing them (this was a married man and I was in high school), and I think this news sent me into an emotional flashback of sorts and I started to panic. I remember immediately basically begging him not to make me do that (I’m a pretty quiet and agreeable person so this was definitely out of character for me) and assuring him “it’s not that bad. I’m fine.” but he still insisted that they had to check. Once I realized I couldn’t get myself out of it, I felt myself start to dissociate and shut down, and I complied and let the nurse check me. Even though my therapist and the nurses involved were very compassionate and gentle with me, I felt completely humiliated and I couldn’t help but feel a sense of violation because of my past experience.
At the time, I felt like I ultimately understood why they needed to check me, and I wasn’t upset with them. I was honestly just feeling really dumb and mad at myself for not thinking about that prior. However, I have been thinking about this more recently and have started to wonder if maybe they could have handled this any differently in a way where I didn’t have to be put in a position that felt retraumatizing.
I guess my main question is, is this is standard practice in residential settings? I know that showing wounds is definitely not required or even expected when disclosing to therapists in outpatient settings, so if it is standard practice for residential, can you give me more information on why it is? I feel like I can understand why it would be, but i‘d still love to learn more about it from a therapist’s perspective.
Thanks so much in advance.