Do You Tell Your Therapist How Bad You Feel?

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I started seeing a new therapist recently. I'm wondering how much I can tell her about how I feel. If I don't, she won't understand how things are. If I do... I worry she'll call a mental health team on me. I don't know how she'd react. My trauma included being locked in and I just can't be in hospital.

My last therapist was shocked at the level of my depression, but for me it's normal. I can't kill myself because of my beliefs but it's my favourite fantasy. In fact, I've been wondering if I'm allowed to have "being dead" as my safe place. I like visualising absolute nothingness. If I was dead, nothing could harm me, right, so what could be safer? (It's just a fantasy. I believe things won't all stop when I die. I wish...)

I know I won't do anything, but I don't know if she'll believe that. She can break confidentiality and take action if she thinks I'm a danger to myself.

How much do other people say?


a friend with PTSD who is much farther along in her recovery than myself, told me that they best thing I could do was be honest to myself and to my theripist. And when I told my friend that I was afraid of getting locked up because I have suicidal thoughts, she told me again to just be honest. In the US, they theripist can only report you to be locked up if are a danger to yourself or others; so it's okay to be honest about suicidal thoughts, they won't lock you up for thoughts alone. They can not lock you up unless you plans to act on the suicidal thoughts.


I try sometimes, but how can words express the turmoil? The posts I put here take me hours sometimes to write. I can take time to chose my words. In person I speak quickly, hesitantly. I stop for periods searching for the right way to express myself, the right words to express myself. In sessions my T needs to be able to get past the intro into progress plans and such.


I haven't yet. I want to. But when I get in there, my mind goes completely blank and I don't say even 1/4 of the stuff I planned on saying. When I do think of it, I debate with myself about saying it because I don't want to bother the therapist with it. That is my thinking--I know I need to say it but it is hard. Building up the trust is very hard.


A really interesting and valid question Hashi.

And it's interesting to note that most of us tend to hold back on the extent of our feelings, 2nd guessing what our Ts will think and say and do. Interesting that so many of us fear losing control of our immediate destinies and fear being involuntarily committed if we're honest.

It's sad that so many of us equate honesty with being locked up, somehow equating our true selves/our true thoughts with something so horrific and dangerous that it needs to be segregated from the world.

And I'm not separating myself from any of this, believe me. I suppose I experience all of this, in spite of how much I claim to trust my T.

I do strongly believe that honesty is somehow almost always the best policy. Hashi, the way you have explained your current state here makes logical sense to me and, I'm sure, would not spark any intuitive and sensible T into knee jerk locking up behaviour. As I said, the way you've explained it makes sense to me and doesn't spark any alarm bells in me that say you're an immediate danger to yourself. Quite frankly I experience exactly what you do, and don't consider that I'm any danger to myself... most of the time.

I do think it's important to be honest, if only so that you do establish that baseline of what is "normal", or at least what is possible for you, in terms of your negative and destructive thoughts. Honesty always helps to build a stronger trusting relationship too and you may well find that she is actually more receptive to your feelings than you may think - any thoughts of self harm or suicide seem so dark and terminal to us, and are equated with such terrible outcomes, sometimes I think we forget that they are actually very common and chances are they are quite familiar to your T and not nearly as enormous as they feel to us.

Keep trucking Hashi, having said all that, I know they are borne of really deep and painful struggles and of bad times. I hope you feel a little better soon.

I started seeing a new therapist recently. I'm wondering how much I can tell her about how I feel.

I chose my therapist with care, & wouldn't be seeing her if I didn't trust her. I want to get all the help I can, so I'm as frank & clear as I can be, even if I preface disclosures with "It's really hard to tell you this, but..."

I'm in Australia, where the mental health services are (compared to general health) so underfunded you'd really have to be actively hurting yourself, or someone else, or acting very strangely to be locked up against your will. Much more often, people have begged to be admitted & been turned away. There is no room for all the desperate souls who need care - so no one's looking for more customers.

Having said that, I understand your concern. It might reassure you to know that generally therapists & doctors make a clear distinction between suicidal thoughts ("suicidal ideation"), suicidal impulses & suicidal intentions. Lots of people think about it sometimes. Lots of people have that awful, urgent flash of "being dead would be better than this." What makes a therapist professionally obligated to intervene is evidence of actual attempts, or of a plan, or sustained, intrusive thoughts without relief.

You might find it a relief to be more open about this. When admitting to these feelings I've often been asked "How would you do it? Do you have a plan?" I say no, I would never use pills again & no, I don't really want to be dead either - but when the pain seems unendurable & I can see no end, I think about death. Sometime I picture myself doing something about it, but I don't want to & I don't plan to.

This is more normal than you might think. Who wouldn't fantasise about an end to suffering, having suffered a lot for a long time? We can frighten ourselves, our friends or family with these thoughts. They won't frighten a therapist, if you are clear that they are just thoughts.

Nothingness would be safe place, & picturing that makes sense when you need to relieve distress. It needn't mean death. Some people do use this idea as a safe place - they look for it in meditation practice, & it helps them feel clear & calm.

If you like & trust your therapist, & believe the connection really is therapeutic - that at some level they do care about you enough to listen carefully, hear you, & support you, but not overreact - do tell them, & let them be useful to you, otherwise seeing them is pointless. If you don't trust them - well, they sound like the wrong therapist for you. There are others.

Best wishes to you.


I can't believe how much I relate to every response here - thank you so much.

jewel - I'm sorry this happened. I'm guessing you must really be feeling bad, and I wish there was something I could do other send good wishes to you, but since that's all I can do I'm sending you lots and lots.

Every response here has been helpful, but Metamorphasis yours is especially so. It's interesting what you say about nothingness and meditation - since I don't really believe death is nothingness anyway, maybe I'm giving this the wrong label. You make a good point also about ideation v plans. hmm... thinking....
to be honest, right now I'm thinking that I don't feel secure enough to disclose (I haven't been seeing my T for very long). But I know people are absolutely right about honesty and telling it like it is.

Thanks again for your responses. This is a very big question for me, so I'm grateful to hear other views and experiences. Will ponder.



I don't tell my therapist but I do have an agreement with my psychiatrist. I have been seeing him for over half my life though. Basically we have a written agreement that says I can tell him I feel like killing myself and he won't send me to the hospital. If I tell him that I am going to though then he would. It helps a bit knowing I can be honest with him about those feelings but I think I have an unique relationship with him because of how long we have known each other.


I think you have to tell them everything. There's no point otherwise. You aren't going there to make them feel good. You are going to get better. They can't do there job if they only have half the information. I'm not saying it's easy. You need to trust your therapist but you can't go and hold on to half of the stuff. Imagine going to see the doctor but not telling them the symptoms. They aren't magicians (unfortunately!). Good luck.
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