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Things to Bring up in Therapy – Even if they’re Kinda Hard to Talk about

Therapy is an interesting thing.  The therapeutic relationship between therapist and client - unique and unlike any other relationship.  We share about our past, our secrets, our fears, struggles, and our hopes and dreams...It's one of the few places we can go where no topic is off limits or too taboo.  Your therapist, non judgmental and acting with "unconditional positive regard" for you, provides not only an active listening ear, but acts to be as objective and unbiased as might be possible in their feedback to you.  They promote healing and growth, and sometimes take you to uncomfortable places - all within one of the safest and most protected of spaces...and even though there's no direction you can go that your therapist should not be open to exploring within the context of healthy boundaries, some things are hard to talk about in Therapy.  As with life and with our personal relationships outside of therapy, it's often the difficult conversations that we can be most tempted to avoid - as important as they might be.

Leaving things unsaid in therapy can create barriers that make it difficult to move forward or to get the kind of progress you ultimately want to see.  Here are a few things that are important to bring up to your therapist - even if they're hard to talk about. Conflict-avoidance is one of the most common issues people struggle with (and that we see in therapy), so working through these things in therapy will ultimately help you practice the kind of communication you want to have in your personal life and often prove beneficial to the therapy process.

  • You're not sure you're making progress.  This can be hard but is really important.  If you're not sure you're making progress in therapy, speak up.  Express your concerns and ask your therapist what they think about your progress.  We don't always see the progress we're making, so some feedback can be helpful.  On the other hand, the therapist may think you're satisfied with progress if you don't mention anything and may not know to make necessary adjustments to help you benefit. Don't be afraid of offending your therapist. They should WANT to know if there's more they can be doing to help you progress.
  • You haven't been completely honest.  It's normal to withhold information or to lie - especially in the earlier phases of therapy.  It's not always expected or possible to be completely open, honest, and transparent from the very beginning.  After all, you might want to develop a certain amount of trust before you feel comfortable enough to disclose some important details.  That being said, at some point it will be important to be honest about some things you may have been hiding from your therapist in order for them to get the full picture of what's going on and to understand how to help you best.  Just like doctors need to know about all of your symptoms and lifestyle behaviors to accurately diagnose and treat a problem, therapists need to know the same.  Therapists often expect that some things don't come out until later, so they shouldn't be upset about this and should in fact see this as a sign of progress and that trust has been built.
  • There's something you don't understand.  Therapists sometimes speak a "different language". They often consume large amounts of information about mental health symptoms & diagnoses, best practices for treatment, and interventions - and can sometimes forget that not everyone is as brushed up on Psychology and Mental Health concepts as everybody else.  I often have to have my accountant slow down and explain things in a way I can understand because certain things are over my head when it comes to taxes and accounting.  That's the world she lives in on a daily basis, but not the world I live in.  It's no different for therapy.  If your therapist is moving too quickly or explaining things in a way you don't understand, let them know. They should be happy to provide further clarity on anything you are not understanding in therapy.
  • Therapy is focused on things other than what you want to focus on.  Your therapist sometimes gets an idea of what to work on or where the direction of therapy should go based on some of the initial things you shared with them.  Additionally, they may help guide the process if you're not exactly sure where to start or what to work on.  If at any point in therapy you feel like the focus is on anything different than what you want the focus to be on, let your therapist know.  Ultimately, it's your time, money, and space - and you should have the opportunity to talk about whatever it is that's most important to you.  It's your agenda, not your therapist's agenda.
  • You're not feeling understood - When working with clients I like to reflect back what I'm hearing to make sure I'm most accurately understanding what's being said. I don't always get it right and I'm sure there are times I've dropped the ball and assumed a level of understanding without making sure my clients have been fully understood.  I value feedback and making sure I get it right.  Any good therapist should.
  • Something your therapist said offended you.  Sometimes therapists have to be brutally honest and provide feedback that's difficult to hear. The goal of this is often to help you build a certain level of awareness about yourself that you may not already have - or to help you understand what role you might be playing in some of your problems.  This should never be done to purposefully offend you, but it might feel so personal that it feels that way.  After all, we might not be hearing some of those things from other people in our lives.  Regardless of the reason you feel offended, it's good to work through it with your therapist.  Perhaps it will provide a learning opportunity for the therapist and help them become more sensitive to how their input affects you both positively and negatively.  Maybe they'll even see where they messed up if that's the case. Maybe you'll see that some of what offended you was rooted in assumptions, rather than what your therapist actually intended.
  • You're having a hard time affording therapy. People sometimes stop coming to therapy when it becomes a financial burden on them. It's good to talk to your therapist about any money concerns and to plan for termination without an abrupt end that may be disruptive to your needs.  In some cases, your therapist may be able to work with you on the fees or the frequency of sessions to decrease the financial impact.  In cases where this isn't possible, they may at a minimum be able to connect you with resources or referrals for lower-rate therapy.  Although therapy can be a valuable (and sometimes priceless) investment into yourself, sometimes it's just more than you can afford.

Although I've only highlighted a few of the things that you should bring up in therapy, this post represents a broader theme of communication and is intended to encourage communicating about whatever it is you might be experiencing good, bad, or neutral in therapy or in your life.  If you're not sure whether or not you should bring something up, it's probably worth exploring.

Even though it's important to speak up and to communicate concerns in therapy, there may be times when it's better to move on and to find a therapist that is a better fit for you - and even though some feedback will likely be helpful for them, you don't necessarily owe your therapist an explanation if you aren't comfortable enough with them to do so.  If your therapist doesn't seem open to feedback, doesn't remember anything you've been talking about, seems constantly distracted, spends your session focused on themselves, or is chronically late and missing appointments, you might just be better off finding a therapist that will value you, your time, and your money...and make you the priority you should be.

If you're considering starting counseling for yourself, send us a message directly or call/text 813-515-9602.  Float on Counseling offers in-office and virtual sessions.  Secure video sessions are available to anyone in the state of Florida.

Joel Schmidt, MA, LMHC

 

 

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