- 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-racking, 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.
(cheerful music)
Number one: 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 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 so many patients tell me
that they are doing great only to find out weeks
or sometimes even months later that they really 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 telling 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 really worried about upsetting me
or stuck in their own fawn or people-pleasing response.
Remember, therapy isn't the place for judgment or blame.
We're there 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 Kati Morton,
a licensed marriage and family therapist.
I talk about depression, anxiety,
debunk myths about therapy
and really anything mental health related.
So if you'd like to subscribe, we would love to have you.
I promise you will always leave
with some helpful information for you
or for someone you love.
Moving on to number three, on the flip side of number two,
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 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 actually 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.
And the fourth thing we shouldn't tell our therapist
is that 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 and offer something we think could help,
and it's your job as the patient to give it a try
and let us know 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 actually ready for therapy
or if we're being overly defensive
because there is a balance to this as well.
But it's normal to not 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.
(cheerful music)
And number one, 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 thoughts of suicide, what do you do?"
It's okay to ask these things.
In fact, 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 really going on with you.
And just to give you an idea of the process
most therapists follow, including me,
I first assess your risk
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
in order 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.
We know no one wants to be there,
and most hospitals aren't very therapeutic, unfortunately,
but it can keep us from acting impulsively
and harming ourselves.
The second thing we might be nervous about
but we definitely should share:
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 those is gonna be
if our patient is under 18 and being abused,
or if they're past 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 totally worth it.
You are worth it.
Thank you so much for watching.
Have a wonderful week.
(cheerful music)