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7 Things I Want to Tell My Therapist

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Diagnosed with a mental health issues 15 years ago, first with bipolar and finally with schizoaffective disorder of the bipolar type, I’ve been in therapy off and on for that same amount of time. I’ve cycled through many therapists, some with a great grasp of what it’s like to have a mental illness, and others who didn’t have a clue. Therapists go to school for years, but how can anyone possibly understand mental illness without actually having a mental illness? Isn’t that like learning to swim without any water?

As someone in therapy, I’ve always wanted to say these things to therapists in order to help them understand me, and to let them know how I feel about them:

1. You’ve Experienced a Lot of What I’ve Experienced

Everyone has good days and bad days; everyone gets manic, depressed, or paranoid at times. I didn’t always have a mental illness; it was first brought on by drug use and the stress of 9/11, so I know that even before the initial onset of my mental health issues, I still experienced emotional shifts. We all get in a good mood when we get a raise, or depressed when a family member dies, and sometimes we’re paranoid that someone doesn’t like us. Take those experiences and use them to understand my mental illness, realizing that those with mental health issues experience these same emotions—except that theirs often come without reason, or for irrational reasons.

2. I Want Your Guidance, Not Your Advice

In his article The Best Advice a Therapist Could Get? Stop Giving Advice, Justin Lioi, LCSW discusses the importance of not giving advice to people in therapy. As a client I can tell you that most of the time I want therapists to just come out and tell me what to do, and a lot of other people want the same; however, as a therapist you don’t always know the full story—only what we want to tell you. So it’s best to leave direct advice up to close friends and family of the person in therapy. That being said, I consider the ability to provide guidance a key element for a great therapist. Guidance isn’t about giving answers; it’s about guiding people to come up with their own answers. Just asking questions is often enough to help us see things from a different perspective, and to come to our own conclusions.

3. I’m Human. You Should Be, Too

There’s nothing worse than talking to a therapist who doesn’t seem to care: their answers are halfhearted; they seem disinterested; and half the time it feels like I should be giving them advice. Mental Health Workers May Not Recognize Their Own Burnout, by Zawn Villines, explores the emotional and mental exhaustion health workers face as a result of their jobs. I imagine it’s not easy listening to other people’s problems, which can weigh heavy on the heart and mind and can wear on a therapist or cause compassion fatigue.

You need to understand that no matter how hard you try to cover up your burnout, it carries over into your work. People see it during their therapy sessions, and it affects them. Therapists have important jobs, and I know from first-hand experience that they can change lives. You’re as human as I am, and despite the pride that may come with being a mental health worker, sometimes you may need to work on improving your own mental well-being, too.

4. I Want to Get to Know You

I’m not really sure what therapists are taught in school about maintaining distance between themselves and their clients, but I don’t want therapy to feel like a one-sided relationship. Sometimes I feel a little selfish talking about myself for 45 minutes straight, and it’d be great to hear a little about your life to break up the monotony of my own voice. It doesn’t have to be personal—just a little back and forth that feels like a real conversation. If I know you, I can more easily trust you, and trust is the foundation to successful therapy.

5. You’re the Expert, but I’m the One with First-Hand Experience

As discussed in Justin Lioi’s article, empowering people is important during therapy sessions. Because I’ve been through a lot—that’s why I’m seeing you—I want to feel like I can teach you something, and I want to get the impression that you’re eager to learn from and about me. Simple questions about how my experiences felt give me a sense of knowing something you don’t, and that helps me open up and also helps build our relationship.

6. This Stuff’s Embarrassing … and Kind of Funny

When I started going to therapy I was mortified to talk about the things I thought when I was depressed and the things I’d done when I was manic. After all, who wants to admit that they were once certain they were the Son of God, and also the devil, and also the reincarnation of Jim Morrison, and also a rat? Not me! The thing is, though, with a little perspective these things are actually kind of funny. If I genuinely laugh at them, don’t be scared to break a smile (but don’t ROFL!); that confirms that these memories are harmless and not really that serious in the long run.

7. We Can Get Through This

Over the years my therapists and I have been through a lot: depression, mania, anxiety, suicidal thoughts, confusion, anger, hopelessness, etc. While at times our sessions seemed like nothing more than spinning car wheels in mud, over time I learned the coping mechanisms needed to manage my mental illness, thanks to the help of my therapists. Once despondent, depressed, feeling hopeless after three manic episodes resulting in hospitalizations, and living at my parents’ house at the age of 30, I now own two businesses, manage over a dozen people, and have written numerous books. It may take time, but we can get through this.

g.h. francis sys articleGH Francis is the author of Icarus Redeemed: A Schizoaffective Story, a memoir about his experiences with schizoaffective disorder of the bipolar type. Diagnosed over 15 years ago, he has spent years learning to manage his mental health issues, and gladly shares those management skills with those who are also experiencing mental illness in some capacity.

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  • Leave a Comment
  • Clay

    February 16th, 2015 at 5:13 AM

    I think that any good therapist knows all of these things, but they are human exactly like the rest of us and they just need a little gentle reminder about it every now and then.

  • ashleigh

    February 16th, 2015 at 9:09 AM

    They should be making me feel like I have things in common with them, not that I should have to do that with them

  • Ann

    February 16th, 2015 at 9:42 AM

    What a wonderful post. I totally agree with your fourth point. I find it much easier to trust my therapist when he is able to share a small part of himself. That may not be true for all clients, but I think many therapists would be surprised how important shared information is to establishing trust. Of course a therapist has control over how much and what type of information to share which is necessary to keep appropriate boundaries. Unfortunately, I believe many are still trained to keep their distance and present a false front.

  • Amber

    February 16th, 2015 at 12:00 PM

    I want to tell him to please not judge me, this is hard enough without feeling like Ia m going to say the wrong thing and be embarrassed.

  • Teresa

    September 16th, 2016 at 9:45 PM

    I agree with you 100%

  • Nervous

    February 16th, 2015 at 7:37 PM

    So my therapist know some of sexual incidents that happened to me as a child. But I held back emotion. There is still a sadness hidden beneath which I feel like I’ll never be comfortable enough to share with her. I trust her and I want to tell her how the abuse has messed up my thoughts on sex, and yet how very confused I am about needing sex now even though I’m still single with a 12 yr old. Got to get it out of my system but it’s so personal and embarassing. I feel an empty place in my heart.

  • Vicky

    February 17th, 2015 at 9:22 AM

    i know you’re scared to tell her but she won’t judge. That’s what therapy is there for to air those thoughts no one else knows about or our deepest fears. They won’t tell anyone else about what you’ve said so it’s confidential. Once you are able to share those thoughts you will feel a huge weight off your shoulders and your therapist will help you examine those thoughts in a logical manner and try and help you combat them.

  • rebecca

    February 17th, 2015 at 1:50 PM

    Your therapist is unlikely to judge you, especially for emotions related to sexual abuse. And there’s certainly nothing wrong with still wanting sexual fulfillment; that’s a very basic human need! If you can risk opening up about the emotions and the turmoil in therapy, I think you’ll be glad you did. Wishing you comfort and healing…

  • Orla r

    February 17th, 2015 at 3:51 PM

    Hi try meditation:cutting energy cords , you will find on u tube , you have the power to heal yourself of mental illness , abuse , old patterns beliefs , believe in this , maybe look for ur 6 th sence !

  • Justin Lioi

    February 17th, 2015 at 3:25 AM

    What an inspiring article. I wish all people approaching therapy could read this. It provides hope, one of the most important ingredients when approaching this work, as well as expressing all the things that often go unsaid in the room. Thanks for writing.

  • manson

    February 17th, 2015 at 6:34 AM

    It’s hard opening up like this to someone you barely know

    give me so e time and I will eventually come around

    but don’t push things too fast

  • Deb

    February 17th, 2015 at 9:24 AM

    I think it is time to rethink “the blank slate” concept in therapy today. Revealing too much has its own risks but knowing absolutely nothing about your therapist, the person with whom you are suppose to have this deep intimate relationship, and they don’t appear human.

  • Anon

    February 17th, 2015 at 10:01 AM

    wow we need more pieces like this that give voice to the patients. Not just with therapists but with doctors too. We are all people at the end of the day and there can be so much misunderstanding between the patients and the clinicians that it leads to pain and confusion for all I think.

    well done you for putting this out there, I hope lots of people read this

  • Alan

    February 18th, 2015 at 11:01 AM

    I know more about the life of my current therapist than he knows about me! This is not, I hasten to add, because i’ve asked him any personal questions. Unforunately in the UK with the NHS you are kind of stuck with the therapist given to you until another can become available.

  • Pat E.

    February 18th, 2015 at 11:30 AM

    This was an interesting article to read and helpful. Thank you.

  • Kelly

    February 18th, 2015 at 5:39 PM

    This is great! Thank you!!

  • Nervous = Strength

    February 20th, 2015 at 2:15 PM

    I applaud you @Nervous for having the strength to put your emotions and feelings in a post (of strangers). That in itself shows your capacity for seeking a better existence and ownership of your experience.

    I was sexually abused, molested, taken advantage of -how we chose to phrase it- as a child. I cried, yelled and role-played with multiple therapist (and in the mirror) only to conclude that the more I expressed the easier it was/is to forgive myself for my own poor self image and the person who started me on my path of self indulgence; once “diagnosed” as a sex addict.

    Nonetheless, you are well prepared to begin again. Thirty five years later I’m still letting the 6 year old child in me have a voice… It can be done!

  • Anna

    February 23rd, 2015 at 9:53 PM

    I think this is a great article with some awesome points. The one thing i would somewhat challenge though is this – you can’t always assume your therapist doesn’t have mental health issues of their own and that they don’t have more of an idea than you may think of what you’re going through.

  • Teresa

    September 16th, 2016 at 9:49 PM

    Exactly. I think at certain appropriate times its ok for a therapist to share a piece of their experiences.

  • Hurting

    March 18th, 2015 at 7:48 AM

    Made a list of abuse incidents to give my psychologist. Moved to tears last session but stopped before it got bad. Regretting that now. Thinking of telling her that o should of let go. Hope she isn’t overwhelmed by the note I give her. She told me I need to talk about incidents to let someone in. Does that mean I have to share emotional parts for her to be let in. Feeling nervous for tomorrow. I haven’t felt like this in awhile.

  • Jill Dean, LPC

    March 28th, 2015 at 10:14 PM

    A good therapist will provide a safe environment for you to begin expressing and processing issues from current or past incidents. As a trusting therapeutic relationship builds, a good therapist will also judiciously self-disclose small bits of information about him/herself. But it is your session, so a therapist who spends the time talking about him/herself is not staying within ethical guidelines.

  • Hurting

    April 13th, 2015 at 5:41 PM

    One session had to be rescheduled due to snowstorm and by the time I got to it I wasn’t feeling anything. But last week I told my therapist what I wanted to get off my chest. Wrote out the stuff. Although emotionless except for the nervousness which she picked up on, she said I pulled my weight and did it. I was worried about wasting time, money etc but she kept reminding me of what I told her about how I regret not telling her everything I wanted to say. And it worked. I wouldn’t want anyone else for my therapist. She is finally the one who gets me and can see and hear the things I spit out and try to avoid. It takes someone like her to keep me grounded and I definetly feel better when I do cooperate and do the work with her

  • Maggie

    March 28th, 2015 at 7:50 PM

    Maybe you just haven’t found the right therapist. After 15 years of going through different ones, I finally have been seeing one consistently for the last four years and I haven’t had to “tell” him anything. We have experienced most of the list above but it came naturally through our conversation and meetings.

  • C.A.Mccoy

    May 25th, 2015 at 3:37 PM

    It sounds like she did not have a quality therapist.
    I hope she is happy now and at the same time, is making progress through her issues

  • Arnold

    June 12th, 2015 at 5:39 PM

    CONTACT Concerned Veterans for America you don’t have to be a Veteran to listen how they want to improve VETERANS HEALTHCARE YOUR organization will gain something take my message not the mess……..once you get in contact with Concerned Veterans for Veterans email me to tell me what did you learned please email back i need help no bull email me back….Thanks. ….STAY SAFE and healthy ffrom my house to your house.

  • R. Hammel

    February 27th, 2016 at 5:15 PM

    Wonderful article. Having a “real” and “authentic” therapist that is engaged and actually interested in your life is so important to the therapy process! An engaged therapist is real, empathetic, develops a functional rapport with the client, and really understands and shares the weight of the client’s therapy goals.

  • Pmitc22

    April 23rd, 2020 at 11:54 PM

    Suicidal Thoughts- “The Left Unsaid..”
    Many patients do want to confide in their therapist about the suicidal thoughts they’re experiencing. However, it is known that if it is expressed the thoughts are happening “at current time,” the therapist must have the patient admitted. The patient can be in a terrible position & truly need a professional to vent this out to for them to lift the weight off them as they do not want to & do not plan to act on the suicidal thoughts they’re experiencing. Just speaking about the thoughts & talking through the underlying issues for an outlet to be caught by a professional to assist them sorting out & working through what’s identified, is more than effective for many individuals. Again, the don’t & won’t because they can’t afford the heavy expense of a 72hr hold in a mental institution. Left without saying, they may internalize it & it form into the next level, or they may turn to an individual that is not equipped to be that outlet. There should be a more manageable way of dealing with such issues rather than the medical professionals having to admit someone.
    How much is the legal aspect of being mandated by law to admit someone who verbally says they keep thoughts of not wanting to be alive, suicide, etc.. yet does not intend to or want to act on the thoughts [vs.] covering one’s self from having potential legal issues if the person did say such things, later attempts or succeeds suicide?

  • Zelda

    May 25th, 2020 at 8:02 PM

    “everyone gets manic, depressed, or paranoid at times”…No, they definitely don’t.

  • Lori

    June 10th, 2020 at 12:20 PM

    Thank you for writing and sharing this awesome list. It’s helpful for me, as a counselor, to hear feedback from clients–even when they aren’t my clients.

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