What not to say during therapy

A lot of people, especially teens, walk into therapy worried about saying the wrong thing. Here's the honest answer: the things that hold therapy back are usually the things left unsaid.

Can you say anything in therapy?

Pretty much. Therapists hear about anger, jealousy, embarrassing habits, sex, substance use, family conflict and thoughts people have never said out loud. Your therapist's job is to understand, not judge. Therapy is also confidential, with some exceptions (below) that a licensed therapist must explain to you at the start (CCPA Code of Ethics, B2 and B4).

What people most often hide in therapy

In a survey of 547 therapy clients, 93% said they'd consciously lied to their therapist at least once. The most common things people held back (APA Monitor, 2019):

• How bad they really felt (54%)
• How severe their symptoms were (39%)
• Thoughts about suicide (31%)
• Insecurities and self-doubt (31%)
• Drug or alcohol use (29%)
• Pretending to like the therapist's suggestions, or that therapy was working better than it was (29% each)

If any of those sound familiar, you're not alone, and your therapist can only help with what they know about.

The real limits: when a therapist has to share

Therapists keep what you say confidential, with legal exceptions. Common ones are:

• A serious risk you might harm yourself or someone else
• A child (or vulnerable adult) being in danger, including if a young person discloses abuse or neglect
• A court order for records

Even then, a therapist shares only what's needed, and usually talks with you about it first. Saying you're having dark thoughts doesn't automatically mean anyone is called. It means your therapist will work with you on staying safe. For teens, see Can teens go to therapy without parental consent?.

How to say hard things in therapy

• Start with "This is hard to say, but…" That alone tells your therapist to slow down.
• Write it down and read it out, or hand it over.
• Say part of it. "There's something I'm not ready to talk about yet" is useful information.
• Ask about confidentiality first if you're worried about what happens next.
• Tell them if therapy isn't working. It's one of the most useful things you can say.

Things that are actually worth not saying

Very little, but a few habits get in the way:

• "I'm fine" when you're not
• Saying what you think your therapist wants to hear
• Agreeing to homework you know you won't do (say so, and adjust it together)

Frequently asked questions

About the author

Courtney Cribb, MEd, RCT, CCC, is a Registered Counselling Therapist in Nova Scotia who works mostly with teens and young adults. Her research on teens and sexting is published in the Canadian Journal of Counselling and Psychotherapy. She offers online sessions by video or phone across Nova Scotia and, where permitted, elsewhere in Canada. Learn about teen therapy with Courtney.