4 Things NOT to Say to Your Therapist and 2 to Say Instead
Tips for Effective Communication in Therapy Sessions
Therapy’s a weird thing, you know. You meet a stranger and then you’re supposed to tell them all the things you possibly never told anyone about before.
It can be nerve-wracking, and stressful, and we often don’t know how to tell if they’re even good at their jobs.
Since most of what you tell a therapist is held in strict confidence, meaning, this is important, that they legally cannot tell anyone or they could lose their license, it’s safe to say that you can be honest with them, you can speak your mind, but there are some things that you shouldn’t tell them. Here are four things you should never tell your therapist.
1. Lies
Not telling us the truth about your situation or what you’re going through is only going to hold you back and make therapy either ineffective or slower than it needs to be.
I have had so many patients lie to me over the years, and I know that we can sometimes do it because we’re scared to tell them the truth, or we’re worried that they’re gonna judge us, or be upset with us, or maybe even abandon us.
So if you find yourself wanting to lie because of any of these reasons or more, let your therapist know about it.
That doesn’t mean we have to tell them the truth or share something we aren’t ready to share, but we can acknowledge the thoughts and defense mechanisms that are popping up because the truth is that there’s a reason for this urge or impulse to lie, and it’s helpful to figure out where it comes from and how to diffuse it.
2. Pretending to be better than we are
I have had so many patients tell me that they are doing great only to find out weeks or sometimes even months later that they aren’t.
And this has happened a lot with my eating disorder patients telling me that they’re following their meal plan and not overdoing it on the exercise, Kati, don’t worry, or managing any of our urges to binge or purge, which leads me to tell them that they need to see their regular doctor before we see each other again.
I often won’t even make another appointment with them until they do so, so they can figure out why they’re still gaining or losing this weight.
And this wastes their time and money.
And I’ve also had this happen with patients who are worried about upsetting me or stuck in their fawn or people-pleasing response.
Remember, therapy isn’t the place for judgment or blame.
We’re here to listen, meet you where you’re at, and help you move toward your goals.
It’s okay to slip up.
We expect it.
We’re human, we understand, but pretending it didn’t happen only hurts your progress and it doesn’t allow us to offer you the support that you need.
Oh, and if you’re new here, I’m Hala Alyana, a licensed marriage and family therapist. I talk about depression and anxiety, debunk myths about therapy, and all things mental health.
So if you’d like to follow, we would love to have you. I promise you will always leave with some helpful information for you or for someone you love.
3. Pretending to be worse than we are to continue getting help
This happens with my BPD patients a lot and it almost always backfires with me thinking that the help I’m able to offer isn’t enough and they need a higher level of care, so I try and refer them out, which is exactly what they didn’t want to have to happen.
Remember, a therapist can’t read your mind.
If we think that you’re just continuing to get worse or that the resources and tools we’re offering aren’t helping, we’re gonna look into other ways for you to get better.
This could mean that we think you need a day program, or maybe hospitalization, or possibly just a different therapist altogether.
And if this has been going on for a while it’s gonna be hard for you to convince us that you’re doing much better.
We can be confused by this and think that now you’re just pretending that you’re better to stay with us.
4. This is working great!
when it’s not.
If something isn’t going to work for you or the advice that we offered isn’t relatable, please tell us.
It’s our job to try to offer something that we think might help, and it’s your job as the patient to try and tell us if it’s helpful or not.
Or if you know that you aren’t gonna be able to do something, like if what I’m asking you to do or the homework I’m giving you is just too much, ’cause you know yourself, right, and that’s not something that you would enjoy, for example or something you even feel able to do, please let me know.
It doesn’t help anybody for you to pretend that you’re gonna do the homework or try out a new communication tool when you already know that you’re not.
And a good therapist isn’t going to have an ego about it either.
We wanna offer you things, a bunch of different things, that will really work for you, so just speak up and be honest about it.
But I do wanna also address the fact that if we find ourselves always shooting down any and everything our therapist is offering, we may wanna consider if we’re ready for therapy or if we’re being overly defensive because there is a balance to this as well.
But it’s normal not to like or want to try all of the things our therapist offers, and we expect that from you.
With that, let’s end with the things you may be nervous to share but definitely should.
Things to tell your therapist
1. Any thoughts of suicide.
I know, I know, everyone is so scared of being hospitalized, and I completely understand, but that’s why it’s important to know what your therapist’s protocol is for something like this.
You can ask right away, like in your first session.
You can ask them, you know, “Just curious, “when do you have to break confidentiality? “And if I have suicidal thoughts, what do you do?” It’s okay to ask these things.
It’s very important that you know so that if you’re struggling you know what their next steps are going to be and you feel safe sharing what’s going on with you.
And just to give you an idea of the process most therapists follow, including me, I first assess your risk and then put together a safety plan with you.
Next, I have you sign a safety contract for the time in between our sessions saying that you won’t harm yourself until I see you again.
Now if that’s not enough and you’re still at risk, I will ask who I can reach out to do a safety check for me if I can’t get ahold of you, right? If I try to text you and you don’t reply, who else can I get ahold of? And then I’ll do that.
And if that’s still not helping, then I will talk to you about taking yourself to the hospital, which is the last resort.
e know no one wants to be there, and most hospitals aren’t very therapeutic, unfortunately, but they can keep us from acting impulsively and harming ourselves.
Any abuse we, ve been through
2. Any abuse that we’ve been through
Just like the thoughts of suicide, we should ask our therapist about the reasons that they would break our confidentiality, and one of them will be if our patient is under 18 and is being abused, or if his previous abuser is still in a home with minors who could be being abused.
Essentially, we are mandated to report any acts of abuse on minors, dependent adults, or elders.
And I know it can be scary to finally share our experiences with abuse, but know that you are never in trouble for doing it.
The asshole who harmed you is, and if a report has to be made they are the ones who are punished.
I know it can be scary or stressful, but it’s not on you to keep that secret.
It’s secrets like that that grow and invade parts of our lives.
It’s like a virus, right, and that’s what leads to other mental illnesses and difficulty in future relationships.
So if you’re seeing a therapist you connect with, please speak up and know that you don’t have to keep that secret anymore.
I know therapy can be hard.
Trust me, I’ve been in it myself, and it’s some of the hardest work I’ve ever done.
But showing up, opening up, and doing the work is worth it.
You are worth it.
Follow for more like this. Have a wonderful week.
Hala Alyana
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