In sex therapy and couples therapy, the importance of full disclosure is a very important one. Many people come to therapy with the notion that their problem is isolated from the rest of their lives, and so they sometimes omit the most important pieces of information. Even the most thorough of intake sessions by the most seasoned and discerning therapists cannot weather the fact that clients often hold back very important information during treatment.
I see this in sex therapy and couples therapy quite often. People will like to leave out very important details, such as their profession and/or how much money they make, because they wrongly assume it doesn’t have anything to do with why they are coming to see me. True, most people present for sex therapy or even couples counseling in my office because they are having some sort of difficulty with intimacy in the relationship. Whether it be an arousal issue, a discrepancy in arousal issue (one partner wants sex more or less than the other), a sexual compatibility issue (different tastes in the bedroom), or a sexuality lifestyle issue, as a psychotherapist I do look at all aspects of one’s life to treat the individual or the couple holistically. What this means is that, for example, an arousal issue may often in fact be indirectly or directly related to a job situation or a money situation.
Let’s take a closer look. If a person loses his or her job and therefore income is tight, this may put a strain on the relationship in a number of ways. The person whose income has decreased may feel a sense of inadequacy, lowered self-esteem, and lowered confidence overall, and if those things are going on, one is not necessarily going to feel sexy or desirous of intimacy, connection, and/or sex. Or this may put more pressure on the other individual to make more money, pay more bills, and be more responsible in the relationship; this change in lifestyle could mean a shift in balance or power, which can definitely put a strain on the desire to be intimate with one another. In much the same way, people’s professions and how much money they make can be a factor in why people’s intimate lives are suffering. If someone makes a lot more money or is a lot more successful than the other partner, this may make the other person feel insecure, dependent, inadequate, emasculated (if male), and so on, and it’s these very imbalances that take a toll on people’s intimacy levels, communication, and sex.
Sometimes things are left out in session because of a person is not comfortable and may fear being judged. Granted, for many people, building a rapport with the therapist, coupled with the knowledge or feeling of the therapist being nonjudgmental while also being able to carefully explain why certain behaviors and patterns may be surfacing is key in getting people to fully disclose in therapy. But sometimes, people are so used to avoiding certain subjects because of personal issues or past experiences that they will automatically do it in therapy, too. For example, if people are embarrassed about how much money they make or have been extensively judged for what they do for a living, then it is even more likely that they will leave this information out in treatment and also very likely that it is playing a pretty big role in the very issue they came to therapy for.
This is why successful treatment can take a while. A therapist can ask all the right questions, but the client may inadvertently leave the most important piece of information out for weeks or months, which can be the key to successful treatment and therapy.
Therapy is not a place to censor oneself. Therapy should be a place where one feels comfortable being open and honest. When an individual or couple decides to take that leap and go to therapy, naturally everyone wants to get the most for their time and their money. Therapy and treatment will be a lot more effective and useful if the client is completely honest with the therapist, goes in with complete trust, and is able to recognize the elephant in the room.
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