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“How do I talk about difficult things in therapy?”

Updated: Mar 25, 2022

One of therapy’s impossible tasks is to help build resources that

make it possible to tolerate therapy.” - Michael Eigen

Self-disclosure is an essential ingredient to psychotherapy. It just so happens that self-disclosure is also one of the most difficult and nerve-wracking components to psychotherapy. We don’t enter many new relationships with the expectation to trust the other fully, reveal all parts of ourselves, and hold nothing back. It’s no wonder plunging into such a unique relationship will be cause for anxiety!

Feeling safe is crucial to being able to talk freely and openly in therapy. If you take the time to scroll through a handful of therapists’ bios I’d wager that the majority of them will indicate something along the lines of “creating a safe space.” Some would argue that this phrase is overused, but it’s mentioned for a reason. As therapists, we know that one of our tasks is to create an environment where patients feel comfortable expressing and exploring the range of experiences, thoughts, feelings, and fantasies they have.

Therapists create safe spaces by clearly establishing “ground rules” for your sessions. If you are confused about confidentiality, ask your therapist to clarify. Perhaps you are unsure why your therapist asks you certain types of questions; feel free to ask them how that benefits you and your therapy. As you feel more comfortable with the framework of therapy, your anxiety about discussing difficult topics will quell.

Establishing a comfortable and collaborative relationship with your therapist is also key to discussing difficult things in therapy. Trusting that your therapist accepts you and has your best intentions isn’t something that just occurs overnight. Give yourself time to build trust in the relationship with your therapist.

It can also help to remember that your therapist is a trained professional. Similarly to how we disclose sometimes embarrassing physical symptoms to our primary care doctor and trust that they are trained to hold this information and utilize it to help us, so too is the therapist trained to hold and accept the range of human experiences, including those experiences that feel especially painful, “bad” or embarrassing.

As with any experience that brings us anxiety, it can be helpful to remind ourselves what we do have control over. Share what you require from your therapist to feel safe. You can say, “I’m going to share something that feels scary. I’m going to need to pace myself. Please don’t interrupt me,” or, “If I can’t talk easily, I will want you to try to ask me questions and help draw me out.” Let your therapist know if there is any way they can help you talk more freely in session.

Another helpful reminder is that your job isn’t necessarily to “report” to your therapist as if they are an authoritative figure who demands to see all parts of you. Instead, it can be helpful to consider disclosing and sharing during sessions as a vehicle for your healing and transformation.

Talking about difficult things with anybody is hard. But therapy can be a safe environment where you can express yourself freely.

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