Therapists with Lived-Experience of Self-Injury as Wounded Healers: Dilemmas of Disclosure with Clients, in Supervision, and in the Workplace

Background: Therapists with lived-experience of self-injury occupy a complex and often stigmatized position within the mental health field. As “wounded healers,” their personal histories can both enrich and complicate clinical work. Although therapists with lived-experience of mental health difficulties may offer unique empathy and insight, they also face fears of judgment, doubts about competence, and suspicion regarding professional boundaries. Despite growing interest in the figure of the wounded healer, there is little research on therapists with lived-experience of self-injury specifically. Self-injury, as both a psychological phenomenon and a potentially visible wound, presents unique challenges shaped by shame, stigma, and professional identity. Scarring complicates disclosure by making the wound visible, while still associated with stigma around mental illness. These attributes merit further research. 

The professional identities of therapists with lived-experience of self-injury, and the dilemmas they face, remain under-explored in literature. Of particular interest is the question of self-disclosure: whether, when, and how they share their experiences across different professional contexts. This study explores the experiences of therapists with a lived-experience of self-injury, focusing on their professional identities, and the dilemmas of disclosure in three domains: client work, supervision, and the professional workplace.

Method: To explore these issues, this study employed a qualitative, phenomenological approach, using semi-structured interviews with nine social workers who self-identified as having lived-experience of self-injury. Participants were recruited through professional networks and had at least two years of clinical experience and regular supervision. Interviews explored their subjective experiences, focusing on the relationship between personal history and professional identity, and on disclosure dilemmas. Data were analyzed using thematic analysis. Reflexivity and bracketing were applied throughout.

Findings: Four main themes emerged: (1) Lived-experience, (2) Professional Identity, (3) Stigma, and (4) Self-Disclosure. These were interrelated, reflecting the complex interplay between personal histories and professional roles.

The first theme captured participants’ accounts of self-injury, often rooted in emotional dysregulation, trauma, and unmet relational needs. They reflected on the personal meanings of their experiences and described a non-linear coping trajectory through disclosure, treatment, and recovery.

The second theme examined professional identity. Many participants were drawn to the helping professions to transform pain into purpose. Their histories shaped both therapeutic style and client focus. Lived-experience was often seen as a clinical strength, enhancing empathy and attunement, but also brought challenges such as self-doubt, over-identification, and imposter syndrome. Some integrated their experiences into professional values, while others maintained strict boundaries for emotional distance. This theme also addressed the challenges and insights of treating self-injury while holding similar personal histories.

The third theme, stigma, revealed persistent fears of being perceived as unprofessional, unstable, or impaired. Participants described feeling a lack of safety when disclosing their histories—especially in cultures where mental health issues are equated with incompetence. While some who disclosed received support and validation, others faced suspicion or pathologization. This was particularly pronounced regarding self-injury, seen as highly stigmatized.

The final theme examined self-disclosure dilemmas across three domains. Workplace disclosure to managers and colleagues was rare, often avoided due to concerns about stigma, credibility, and job security. Those who disclosed in supportive settings reported greater authenticity and less isolation. In supervision, disclosure was shaped by perceived openness and power dynamics; although all participants valued supervision, most withheld information out of fear of consequences. With clients, disclosure was used cautiously and framed as a clinical decision, balancing authenticity with boundaries. It was typically general and non-specific, intended to instill hope.

Overall, the findings suggest a relational model in which professional identity, stigma, and self-disclosure are mutually influencing in the context of lived-experience. While stigma may inhibit disclosure, disclosure can also foster visibility and help reduce stigma.

Implications: This study offers initial theoretical insights into the experiences of therapists with lived-experience of self-injury, showing how such experience can enrich, inform, and complicate professional identity and clinical practice. Self-disclosure emerges not merely as an ethical or clinical decision, but as a relational act shaped by stigma, power dynamics, and institutional culture. The findings emphasize the persistent stigma surrounding self-injury, and highlights the negative impact this may have on clinical practice. Clinically, the findings emphasize the value of lived-experience in shaping empathic, recovery-oriented care, and the need for supportive supervisory and organizational practices. Promoting safe, stigma-free spaces for disclosure and help-seeking in workplaces emerges as critical. The study advocates for recognizing experiential knowledge as a resource in clinical work and for creating frameworks that enable its ethical and supportive integration. 

Conclusion: This study highlights the intertwined roles of stigma, professional identity, and self-disclosure in shaping the experiences of therapists with lived-experience of self-injury. Stigma emerges as significant barrier to self-disclosure, hindering professional development and ethical practice. The findings call for cultural and institutional change. Supporting reflective, stigma-free environments, can enable therapists to work more authentically and effectively, enriching both practice and the profession.