Listening to a person talk about how they cut self is stress producing for most people including therapists. The therapist needs to be clear they do not fall into subtly pressuring the client into making the contract due to their own anxieties.
If one allows the client to avoid it for long periods of time and addresses it in a very a tepid way that may empower the shame.
However it is not uncommon for people to confuse the two. For instance if a mother see’s her daughter is cutting self it is understandable how she can then conclude that the daughter is suicidal. However this is not accurate.
Halloween make up, like these pictures, allows the teenage girl to release her sublimated urges to self harm, leading to a healthy outcome.
This allows the Free Child to again be re-experienced instead of cut off and thus one gains a sense of reconnection or wholeness in the personality. Unfortunately it’s only temporary. The intense stimuli can be cutting self with a razor blade, some sexual experiences or engaging in high risk behaviour.