Your therapist's office (or virtual office) should feel like a safe space to say whatever is on your mind.
While no topics are off-limits, there may be some habits you pick up along the way that end up detracting from the value of your sessions.
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"The process of therapy can be long and complex. A curious thing that we encounter as therapists is what our clients are doing (or not doing) that at times can sabotage the therapeutic process," says Alana Carvalho, LMHC, a New York City-based family therapist and author of Raising Empowered Children.
So what are these habits? We chatted with Carvalho and other mental health professionals to get their take on things they wish clients would avoid, and how to make the most out of your therapy experience.
1. Not Sharing About Previous Therapy Experiences
While the handful of therapy sessions you had 10 years ago for anxiety may not feel relevant today (or may feel uncomfortable to bring up), they are important to mention to your current therapist.
"Knowing what has and has not been helpful therapeutically, as well as issues that've been worked on, can help inform a therapist of what interventions to use as well as where to focus their efforts," Carvalho says.
What to Do Instead
If you've been to therapy before, be up front about it. Your therapist won't judge you. In fact, having a full picture of your history can help them better help you.
Having "nothing" to share is often code for feeling like you don't have anything big or important to share.
"Sometimes people are self-conscious about what's important enough to bring into therapy, and so they may choose to not share much," Carvalho says.
"The reality is that anything a client shares in therapy can be helpful and gives an understanding of larger patterns and issues at play," she adds.
What to Do Instead
Share whatever's on your mind when you're in therapy. If you're thinking about it, it matters to your therapist — big or small.
3. Multitasking During Therapy
Thanks to the popularity of virtual sessions, therapy has become more accessible to more people.
But talking with your therapist from home, your office or even the car can set the stage for distractions.
"While I completely support the option of telehealth sessions, it can be easy for clients to treat virtual therapy similarly to how they treat their work Zoom calls, putting themselves on 'mute' while trying to escape their kids or barking dog, or squeezing in lunch," says Sunita Osborn, PsyD, a psychologist based in Houston, Texas.
All that can make it harder for you and your therapist to focus on your mental health.
What to Do Instead
Plan ahead so you can have private, uninterrupted time for your virtual sessions, Osborn recommends. Block out the appointment on your calendar, and try not to complete other tasks during the session.
Enlisting your partner or other supportive person can be helpful here, especially if you've got young kids who tend to burst into the room whenever they need something.
4. Not Challenging Your Therapist When You Disagree
There may be times where you don't agree with something your therapist is saying or doing, which can make you feel misunderstood. If this happens, you can challenge or disagree with them.
And don't worry — your therapist won't get mad or offended.
"As therapists, we're trained to be open to feedback and welcoming of any concerns, especially about your treatment," says Allie Kidd, LISW-S, LCSW, a licensed therapist in New York and Ohio.
"Being able to speak up to your therapist, especially when it's about them, is of the utmost importance to the relationship and your healing," Kidd adds.
If you don't feel like you can speak up, it only reinforces internal beliefs that you're not important enough to be heard. (Which is not true, by the way.)
What to Do Instead
Let your therapist know when you disagree with them. For instance, if your therapist summarizes your point by saying, "It sounds like you're feeling really confused by this situation," but you feel disappointed or angry instead of confused, let them know, Kidd says.
5. Not Discussing Suicidal Thoughts
People who have suicidal thoughts may worry that telling their therapist will lead to judgment, an end in sessions/the relationship or cause them to be hospitalized.
"Though these worries make sense, therapists want you to share when these thoughts arise," Kidd says.
And "generally speaking, therapists do not have to report or call anyone based on thoughts of suicide. It takes a very specific set of circumstances for a therapist to break confidentiality and is not something we take lightly," Kidd adds.
What to Do Instead
Let your therapist know if suicidal thoughts come up, how often you have them and if they're accompanied by other symptoms or thoughts. "Ignoring or avoiding the topic often leads to increased isolation and worsening of symptoms," Kidd says."Therapists want to know about these thoughts so they can explore them with you and allow you to feel seen."
Warning
If you're having suicidal or distressing thoughts, reach out to your therapist or call/text 988, the U.S. Suicide and Crisis Lifeline. There, you can get help and resources from someone who understands and is trained in mental health support.
6. Ghosting on Your Sessions
There are countless reasons why people decide to stop therapy, and all of them are legitimate. Maybe you feel like you've worked through your issue, or you'd prefer to try another therapist.
That said, ending it without letting your therapist know isn't a great move from a mental health perspective.
"So many of our relationships throughout life end abruptly or passively. When clients ghost therapists without any warning, they may be consciously or unconsciously replicating a past pattern of ending a relationship without speaking to how their needs went unmet, or speaking to their desire to avoid the pain of saying goodbye to a close relationship," Osborn says.
In other words, ghosting could be an unhealthy avoidance tactic, which may benefit from continuing to see your therapist.
What to Do Instead
Let your therapist know during a session that you're thinking about ending therapy. They won't be mad or offended. "If this feels too hard, you could say, 'I have something to tell you, but I need help sharing it," Osborn says.
If an in-person conversation feels too uncomfortable, at least give your therapist a heads up with a message. "This then allows your therapist to offer the opportunity for a closing session," she adds.
And keep in mind, it's always an option to go back to therapy (with the same therapist or a different therapist) if you feel you need it down the line.
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.