Because the intrusive and unwanted thoughts, images, urges, and feelings that characterize OCD are often disturbing, it can be very difficult to tell anyone about them. And even once we take the huge first step of starting therapy, it’s confusing to sort out what to share. That’s why lots of people write to us with questions about what they can and can’t tell their therapists. Here are some answers.
What can I tell my therapist?
The short answer is that you can tell your therapist anything - and they hope that you do. It’s a good idea to share as much as possible, because that’s the only way they can help you. There’s no denying the courage it takes to tell them about your most unwanted thoughts, but their job isn’t to hear only pleasant things. Only by explaining the things that bother you will you be able to work toward solutions.
You should know that therapists are required to keep the things you tell them confidential– with a few exceptions. For example, if they have reasonable cause to suspect you’re a danger to yourself or someone else they may need to involve a third party to ensure everyone’s safety.
Because confidentiality can be complex and laws may vary by state, your therapist should discuss it with you at the start of your first appointment and anytime thereafter. Once you understand the role of confidentiality in your therapeutic relationship, you’re ready to tell them what’s going on.
What shouldn’t I tell my therapist?
There’s not much in this category– as we discussed above, your therapist will be more able to help you when they have detailed information about you.
To put it bluntly, the success of your therapeutic relationship rests on a willingness to disclose information that’s difficult to share. It’s okay to tell them you’re finding it hard to share something. Therapists have been there with other clients, and will work with you to help you feel comfortable.
Are a lot of people in therapy?
Tons of people are in therapy. It’s hard to measure exactly how many, but according to one small survey, 42% of American adults have seen a counselor or therapist at some point and an additional 36% would be open to it.
We wrote a more detailed post in February about the difficult but important process first step in telling your therapist your scariest thoughts. You’ll find lots of tips on how to actually do so: