Suppose you’re coming to therapy for the first time, or have sensitive or embarrassing topics to discuss.
In that case, you may be wondering how much you should share with your therapist—and whether there’s anything you should actively avoid sharing.
You might be asking yourself questions like:
- What if I embarrass them with this topic?
- What if they judge me or think I’m weird?
- Will they tell anyone else about my personal life?
- Will I annoy them by talking about the same thing over and over?
In other words, you might be wondering what you shouldn’t tell your therapist.
Take a deep breath. These are questions a lot of people have, and there are no taboo topics in a therapy session!
You should feel free to discuss whatever you need to with your therapist, says Nicole Ernst, a licensed mental health counselor with Grow Therapy.
“Therapy is a safe space to share your thoughts and feelings, so there is nothing that ‘shouldn’t’ be brought up in therapy,” she says. “Sometimes it may take a while to feel comfortable enough to share certain things with your therapist, but when you are ready, the therapist is ready and willing to listen.”
And, in case you’re worried about “oversharing,” Ernst says, when it comes to therapy, there’s no such thing.
“Your therapist may help you stay on track with a certain topic at times; but in therapy, no topic is off limits,” she says. “If you have any concerns about this, feel free to bring that up with your therapist so you can have some reassurance if you need it.”
Although no topic is off-limits, poor communication and certain behaviors can make it harder for a good therapist to help you. Here are some of the most common things that can slow down your progress in therapy.
Things You Shouldn’t Tell Your Therapist
1. Lies
Lying to your therapist is counterproductive. If your therapist doesn’t know the truth of what you’re going through, they’re limited in their ability to help you. The advice they give may not be useful if they don’t know the true nature of your situation.
There are plenty of reasons why you might be tempted to lie to a therapist.
- Maybe you don’t want to experience the unpleasant emotions that come up when you candidly discuss something painful.
- Maybe you’re afraid of getting overwhelmed if you open up a certain topic.
- Or, you might be worried that your therapist will judge you for your decisions or feelings.
Ernst says that while these worries are understandable, you shouldn’t let them stop you from telling your therapist everything that might be relevant to your condition, other stress you experience in your life, and your treatment.
“There’s not much a therapist hasn’t heard before,” Ernst says. “They will not be upset or offended by a question or concern, and they want you to be comfortable to communicate openly.”
2. Omissions and Half-Truths
Sometimes, you might be tempted to leave out details of your story. This is understandable, especially if the things you choose to leave out are stressful or embarrassing. But half-truths can also make it harder for your therapist to help you.
Nevertheless, it’s okay if you don’t feel like divulging everything in your first therapy session.
It may take time to develop a relationship with your therapist, and you might be ready to tell new pieces of your story as your trust grows. If something comes up that you don’t want to discuss, don’t beat yourself up.
Just mention to your therapist that there is more to be said but you don’t feel comfortable talking about it in full right now. You can bring it up at a later session when you feel ready.
3. Pretending to Feel Better
It’s natural to want to please a therapist that you like and trust.
However, don’t let this understandable urge lead you to downplay your mental health struggles. If you are not feeling better yet, or are having trouble implementing the ideas your therapist suggests outside of treatment, it’s best to be honest.
Remember that a therapist’s job is to help people, not judge. If things aren’t going well, they want to know so that they can adjust your treatment plan accordingly. They won’t get their feelings hurt if your mental health condition doesn’t respond right away to their first treatment attempt.
Just as you would tell another mental health professional, like your dentist or doctor, a therapist needs to know if treatment is not helping promote your mental wellness.
The right therapist wants you to get the best possible care no matter what.
If the current treatment plan you have together isn’t working, an honest conversation about how you’re doing might lead to shifts in the treatment that can help.
These shifts might include adding an adjunctive treatment, such as group therapy, changing therapeutic modalities, increasing the frequency of sessions, or referring out to another provider whose specialties may be a better fit for your particular goals.
What If I Don’t Trust My Therapist?
Sometimes people don’t tell their therapist everything because they don’t trust their therapist entirely. If you don’t trust your therapist, it’s important to ask yourself why.
- Have you had experiences with them that gave you pause?
- Have they broken your trust?
- Or, have trust issues in intimate relationships become a pattern that shows up frequently in your life?
Being able to answer these questions will help you decide whether you want to find a new therapist or work through your concerns openly with the one you have.
Research is clear that a positive patient-provider relationship yields better results. Give yourself the best chance for progress by seeing a therapist you are fully comfortable with.
Will My Therapist Keep Sensitive Topics Confidential?
Some topics may feel very difficult to discuss. Difficult situations that are often hard for patients to talk about include upsetting or traumatic incidents from childhood, sexual assault, self-harm, an eating disorder, embarrassing thoughts or feelings, and sexual orientation, among others.
A licensed therapist is obligated to keep your personal information confidential. Their progress notes are stored confidentially and will never be shared with others, except in rare circumstances, such as a legal subpoena.
Therapists often seek consultation or supervision from other therapists about the patients they are treating, but in these circumstances, they leave out any identifying information so that their colleagues won’t know who the patient is in the first place.
However, you should be aware that there are a handful of circumstances where a therapist might be required to break confidentiality.
“By law, therapists are required to break confidentiality under a few specific circumstances,” Ernst says. “One is if they believe you are an immediate threat to yourself or others. The other is if a minor or vulnerable adult is suspected of being abused.
If you have concerns about which circumstances fall under these categories, please ask your therapist about this as well.”
Appropriate Boundaries with Your Therapist
Part of the trust that allows you to be honest in therapy comes from the professional boundaries that you and your therapist will observe. These boundaries protect both of you and help you to feel safe being honest about your life.
“Therapists and patients are not allowed to be ‘friends’ outside of sessions in real life, or engage in romantic relationships,” Ernst explains. “Healthy boundaries also include respecting your therapist’s policy about how and when to contact them, such as not calling in the middle of the night or showing up to the office when you don’t have an appointment.
Keeping healthy boundaries between a therapist and patient helps everyone have the best therapeutic relationship possible.”
Your provider is also responsible for stepping back from treatment if they think their personal feelings will interfere with their ability to provide adequate healthcare, or if they think a conflict of interest might cloud their judgment.
The therapeutic relationship is unlike any other, which can take some getting used to. Your therapist still cares about you even if they can’t be your friend or have any kind of relationship with you outside of the therapy space.
Healthy Communication with Your Therapist
The best tips and tricks for succeeding in therapy have to do with communication.
“A good way to foster communication with your therapist is to go at your own pace,” Ernst says. “You can do this by sharing what you are ready to share when you are ready to share it. Another way is to tell your therapist your concerns about the sessions.”
Be upfront with your therapist regarding what you want to get out of therapy. Then, once you’ve committed to it, try to eliminate distractions that might take your energy away from the work of the therapy room.
Schedule treatment either in-person or online therapy sessions at times when you’ll be able to be fully present.
Additionally, don’t check texts and emails during the session unless it’s an emergency.
You will probably get more out of therapy if you enter it with a mindset of collaboration. Your therapist wants to work with you to meet your goals. You want to learn from their expertise about managing your mental health.
When both people understand the goals, the boundaries, and the expectations, you can develop a strong rapport and experience phenomenal results for your mental well-being.
