Therapy is a strange thing, you know. You meet a stranger, and then you’re supposed to tell them all the things you might have never shared with anyone before. It can be nerve-wracking and stressful, and we often don’t know how to determine if they’re even good at their jobs. Since most of what you tell a therapist is held in strict confidence—meaning it’s important to note that they legally cannot disclose any of this information or risk losing their license—it’s safe to say that you can be honest with them and speak your mind. However, there are some things you shouldn’t tell them. Here are four things you should never disclose to your therapist.
Number one: lies.
Not telling us the truth about your situation or what you’re going through will only hold you back and make therapy either ineffective or slower than it needs to be. I have had many patients lie to me over the years, and I understand that we sometimes do this because we’re scared to tell the truth, worried that we’ll be judged, or concerned that we’ll be abandoned. If you find yourself wanting to lie for any of these reasons or more, let your therapist know. This doesn’t mean you must disclose the whole truth or share something you aren’t ready to discuss, but we can acknowledge the thoughts and defense mechanisms that are surfacing. The truth is that there’s a reason for this urge or impulse to lie, and it’s actually helpful to figure out where it comes from and how to diffuse it.
Number two: pretending to be doing better than we are.
I have had many patients tell me they are doing great, only to find out weeks or sometimes even months later that they really aren’t. This has frequently happened with my eating disorder patients, who assure me they’re following their meal plan and not overdoing it on exercise. They might say, “Kati, don’t worry,” or claim they’re managing their urges to binge or purge. This often leads me to suggest they see their regular doctor before our next appointment. I typically won’t schedule another appointment until they do so they can figure out why they are still gaining or losing weight. This wastes their time and money. I’ve also encountered patients who are really worried about upsetting me or are stuck in a fawning or people-pleasing response. Remember, therapy isn’t a place for judgment or blame. We’re here to listen, meet you where you are, and help you move toward your goals. It’s okay to slip up; we expect it. We’re human and understand, but pretending it didn’t happen only undermines your progress and prevents us from offering you the support you need.
Number three: on the flip side of number two, pretending to be worse than we are to continue receiving help.
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