By Judith Acosta
It started one ordinary day, in one otherwise ordinary session: A beautiful young woman I had known for a few years wanted to cut off her breasts. (Details changed to protect identity.)
“What happened?” In my mind, the first concern was cancer.
“Nothing. I just hate them. I’d really like to be rid of them. I was just wondering what you thought.”
So I told her. She had a long history of abuse, abandonment, and self-mutilation. Given that, I suggested, didn’t it seem like another aspect of self-hatred and rage? I urged her to take time to really consider all the ramifications — its effect on her physiology, on her partner, on her children.
She bristled and said I was being unsupportive. I explained I couldn’t be supportive of something that was an extension of existing pathology.
She found another, more supportive therapist, and is now living with…
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