“Dear Client, you can tell me anything.”

Written by Stephanie Salo, Psy.D.

“I don’t know if I can talk about this here…”

As a psychologist, one of my favorite novels is “Lying On The Couch” by Irvin Yalom, MD. Not only does it have a clever title, it made me aware of how often clients choose NOT to disclose to their therapists. To be fair, how can a client explain one’s entire existence in a few sessions? What does one choose to include or omit? And yet, having those difficult conversations are essential to better understanding what one has been unable to solve on their own and helpful for long-term personal growth.

There are many reasons why clients do not share everything with their therapist. Many of us have a strong tendency for impression-management when meeting someone for the first time. Sometimes this is intentional as a form of protection. Other times it may be subconscious self-censoring due to shame, forgetting, or repressing difficult experiences. Here are some additional reasons clients may not share in session:

• Habit of talking about surface-level topics
• People-pleasing and avoiding sharing the parts of us that might not be likable
• The topic is embarrassing or feels awkward to discuss
• Not wanting to “burden” the therapist
• Fear of disappointment or judgment if they knew “everything”
• Avoidance of a very upsetting past experience that might feel overwhelming
• Saying aloud the secrets kept for years might feel “too real”
• Difficulty trusting others in general
• Lack of safety or rapport with current therapist
• Fear the information could be used against us somehow.
• Avoiding consequences of past actions or impact on others
• Procrastination: each week you may think, “I’ll tell them next session.”
• Uncertainty if anyone will care to hear it

I have heard, “I’m not sure if I am allowed to say this or not…” in session. This has always bewildered me. I am your therapist. You can tell me anything. The point of therapy is to share all the stuff. I am aware that people are socialized from childhood to filter what is said to others (sometimes with good intention, sometimes not) and it can be very difficult to over-ride the filtering to verbalize our innermost thoughts and feelings. When I explain that my role as a psychologist is making sure others feel safe, I emphasize to my clients that it is important to talk about taboo issues like suicidal thoughts, trauma, sex, love affairs, and substance abuse. How else can therapists uncover these types of underlying issues if they have not been disclosed?

So, taking time to develop rapport and trust with a therapist is incredibly important. Sometimes a therapist and client may not develop a good partnership; and that is crucial to communicate to your provider. Please bring it up with your psychologist if your therapeutic relationship does not offer the safety and comfort needed to share your truths or if it “just feels” off. As therapists, we are trained to receive feedback and reflect upon ourselves and our therapeutic work in a constructive way to provide the best care. We cannot adapt to your needs if we do not know that we’re not meeting them.

No topic ought to be off-limits with your therapist, including “silly” or “dumb” thoughts and emotions; the “negative” feelings such as envy, jealousy, resentment, and hate; painful emotions such as shame, helplessness, and worthlessness; family “secrets” or other sensitive topics. While we can refer you to specialists for specific issues, most therapists practice as generalists because our training encompasses all sorts of human issues and concerns. Sharing more about you will help your therapist unravel the complexities of your uniquely intertwined issues.

Take a few moments to reflect. What important topic do you actively avoid or delay in therapy? If something came to mind while reading this article, I encourage you to bring it up next session. It will likely deepen your relational connection with your therapist and advance you to the next level in your treatment.

Photo by Allef Vinicius on Unsplash