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What Are You NOT Saying In Therapy

Recently, my Clinical Supervisor Dr Mary Welford, author of The Compassionate Mind Approach to Building Self-Confidence, highlighted some research that suggests a high percentage of people who come to therapy don’t say or talk about the very thing that has brought them there in the first place.

People come to therapy for many reasons, but it’s often because they’re experiencing psychological distress. The issue underlying this distress is often a secret and may have been for years. It’s an untold story that’s been boxed away. I’ve even worked with people who have forgotten parts of their story before coming to therapy which says a lot about how well we can hide things, even in our own minds.

Why Is This a Problem? 

It’s not always easy to share what’s going on in our minds. In fact, it’s really tough which is why many people avoid therapy altogether. But not saying what you need to can lead to holding on to difficulties, tough emotions or trauma. If you don’t work through these things, they can continue to have power over you and impact your day-to-day life. 

If you don’t open up completely in therapy, you may not get the best out of the experience. Therapy is an investment in yourself, your future and your mental health. It’s worth getting it right.   

So, What’s Holding You Back?

There are lots of reasons you might struggle to voice certain issues in therapy.

One of the biggest predictors of a successful therapeutic outcome is how safe and comfortable you feel with your therapist. It can take time to build up trust. As you get to know your therapist, you should feel confident they’ll hold what you say without judgement, but with respect and compassion. Read my post about how to choose a CBT therapist for more information and advice.

Sometimes people feel they shouldn’t be struggling in the way that they are, and this stops them from voicing their problems. There’s so much distress in the world and they consider their problems insignificant in comparison. But who are we to judge whether we should be struggling with something or not? If it feels difficult for you, it is difficult, no matter what your circumstances are. We all deserve help and compassion.

When things are tough, we avoid them. It’s human nature, but it can mean we don’t work through or process things that are troubling us. We can also worry about feeling embarrassed or judged for our inner thoughts. There’s a saying in the therapy world that when we shine a light on shame, the shame dies. Saying things out loud can be very powerful and healing. 

Sometimes therapy goes down a certain path or takes a strong focus. It’s nobody’s fault, but you can end up failing to discuss what you really need to. This is what we call ‘therapy drift’ and it just means your therapy has gone off track and the important stuff isn’t being talked about. A good therapist will manage this and help you get the most out of your sessions.  

When you start therapy, if you’re not being open or you’re only showing a certain side of yourself, it can be difficult to suddenly show up in a different way. Being open, honest and as authentic as you can be from the very beginning will give you the best chance of success. If you find this hard, don’t beat yourself up. It might not be the right time for you. 

Strategies to Help You Address the Tough Stuff

If there’s something you’re struggling to say, let your therapist know. You don’t have to discuss it straight away, but they’ll know there are other things you need to explore. 

If it’s too difficult to say something fully, try giving clues. Start with ‘I’m struggling to say everything I need to…’ 

Having good therapy is not just beneficial for you, it will impact everyone else around you. When it feels hard, remember you’re also doing it for the people you love and care about. This can be really motivating when you’re struggling to open up. 

Reflect on the therapy experience. What do you most want to get out of it? What are the things that are important to talk about to get you where you want to be? If it’s hard to say these things out loud, write a list and share it with your therapist.

Try keeping a therapy journal. This is a place to document your anxieties, reflections and hopes about the therapy journey you are on. It can help you keep moving forward and get the most out of the experience.

Finally, give yourself permission to be cared for. If you say the things you need to in therapy, you’re more likely to experience all the potential benefits.   

You’ll find more information and advice on this subject in Episode 23 of my podcast, Ask the Therapist.

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Sarah Rees

Sarah is a fully accredited Cognitive Behavioural Therapist and mental health writer delivering Modern Mental Health for you and with you in Mind. Sarah is the author of ‘The CBT Journal’ which helps you write for your wellbeing incorporating CBT techniques. For more information and to keep in touch have a look at sarahdrees.co.uk.