In any relationship, whether personal or professional, open communication is important. It helps you establish boundaries, express your wishes, and lets you know how the other side feels. When you’re in therapy, it’s just like being in a relationship. It’s important to have that open communication with your therapist. But like in any relationship, sometimes you have to work at it.
It’s no surprise that many people aren’t completely honest with their therapist. Some people might want to be polite or avoid upsetting their therapist. Some people might feel uncomfortable talking about a particular topic. But when you are open and honest about your needs and what you’re feeling, it fosters a mutual trust, respect, and caring relationship with your therapist.
If you’re feeling uncomfortable with opening up to your therapist, that’s very normal. Being honest in therapy is easier said than done, but here are some tips to help make it easier.
Write it down
Write down your thoughts and what you want to say before your session. You can go the old-fashioned way and use pen and paper, or if you prefer digital you can use your notes app on your phone. The goal is to use whatever works for you. Writing down any questions you have or what you want to say helps you mentally prepare to talk to your therapist and makes sure that you don’t forget anything. And if you do forget, it’s okay. You can always contact your therapist in between sessions or bring it up at your next appointment. Journaling is a good way to keep track of your thoughts, practice self reflection, and organize what seems like a ton of disjointed thoughts through writing.
It’s no secret, therapy can be hard work. Being able to open up about your feelings and experiences during therapy sessions takes courage and strength. The truth is, you don’t have to tell everything all at once. Talk to your therapist about what’s comfortable for you. If you feel uncomfortable talking about something, let your therapist know. Your therapist will not feel offended. In fact, by letting your therapist know, they can help guide the conversation toward something that best fits your needs.
Don’t hold back
When you go to see your primary care doctor, you let them know everything that is going on. That’s because with a holistic view of you, they can provide you the best care. And your primary care doctor has probably seen and heard it all, so nothing will surprise them. Same goes for your therapist. The more your therapist knows about you and how you’re feeling, the more they can tailor their care for you. Plus, your therapist has likely seen and heard it all too.
Let your therapist guide the way
It’s okay if you don’t always know what to say. You might be feeling awkward or uncomfortable. Or you might not have the words to express yourself. Or you might come from a culture or family where it’s not the norm to talk about feelings or mental health struggles. That’s what your therapist is there for — they’re trained to create a safe space for you to ask your questions, talk openly, and to guide you into a conversation.
Therapy is a collaboration between you and your therapist. Your therapist will guide you in the conversation and will also let you set the pace. If you are having difficulties with your therapist, it is important to talk about that directly with them.
Rest assured about your privacy
Maintaining your privacy is part of your therapist’s professional code of ethics and a condition of their professional license. Your therapist will not share what you share unless it is in these situations:
Open, honest communication is key to a successful relationship with your therapist and to meeting your goals. The therapeutic relationship [link to therapeutic alliance article] — the relationship you have with your therapist — should be a safe place for you to experiment with navigating the problems and challenges you may encounter. If at any point you are not comfortable, you can always talk to your therapist. And if you want, it’s always okay to change therapists and find one who you feel comfortable opening up to.
American Psychological Association. (2022, March 16). Understanding psychotherapy and how it works. https://www.apa.org/topics/psychotherapy/understanding
Blanchard, M. and Farber, B. (2015, September 23). Lying in psychotherapy: Why and what clients don’t tell their therapist about therapy and their relationship. Counselling Psychology Quarterly. https://www.tandfonline.com/doi/abs/10.1080/09515070.2015.1085365?journalCode=ccpq20
Kleiven, GS.; Hjeltnes, A.; Rabu, M.; Moltu, C. (2020, December 15). Opening Up: Clients’ Inner Struggles in the Initial Phase of Therapy. Frontiers in Psychology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769763/
Knobloch-Fedders, L. (2008, January 31). The importance of the relationship with the therapist. The Family Institute at Northwestern University.
Lebow, H. (2021, June 15). How to Open Up to Your Therapist and Why It Matters. PsychCentral. https://psychcentral.com/blog/how-to-open-up-to-therapist-and-be-honest#how-to-open-up
Love, M. and Farber, B. (2018, January 2). Honesty in psychotherapy: Results of an online survey comparing high vs. low self-concealers. Psychotherapy Research. https://www.tandfonline.com/doi/abs/10.1080/10503307.2017.1417652