How do I tell my therapist I am not doing so good?



Every time I steel myself to try and tell him what’s going on and I just can’t seem to get past ‘fine’.

I am having horrible raging self destructive thoughts and am acting on a fair few of them. It’s taking all of my coping skills to not literally go to town on them. I want to discuss it with him. I guess I’m just afraid of him sending me to the hospital, or being totally revolted by me. I haven’t been seeing him long and the trust isn’t fully there yet.


No real wisdom I’m afraid.
I get that sick feeling and overwhelming panic before saying things are bad, and usually avoid it altogether or backtracking after I’ve said the words.

The best thing I have managed maybe is sending an email saying I’m not doing great a couple of days before the session and asking T to bring it up (then I don’t have to).


Thank you for your kindness.

He does know I self harm as it came out in a blurted messy breakdown about 3 sessions in.

He doesn’t know the extent of it which is the issue. I have disgusted therapists before that can’t handle it. I like this guy, I feel in time I could trust him. I’m so ashamed of myself and what I think/do that it feels like telling him will screw everything up again.

I will try and write something down for him. I think the actual thoughts/what I’ve been doing wouldn’t be possible but I could definitely tell him it’s worse than ‘fine’.


It took me almost two years before I could talk properly about self harm with T, so I get an idea of where you are coming from.

I was so worried about how disgusted T would be, and even now when I share aspects of that I hold my head in my hands and tell them how ashamed I feel saying the words, but T has been steadfastly brilliant at accepting me in all my messiness and pain so far.

The more I give them the chance to do that by sharing things, the easier it has become to share.

I don’t know how long you have been working with your therapist, but if you try drip feeding a little you might start to get a feel if it is going ok. And if he struggles with what you are sharing then maybe he’s not the right fit.

You deserve to be accepted and understood.

Just editing to add that self harm isn’t my most destructive issue which is why I can now talk about it fairly nonchalantly as it’s mainly in the past.

But if you are actively self harming that’s something you need to work through and your T can probably help you with it if you can get over the starting hurdle.

People have suggested I print out sections of threads like this to take for my T to read when it’s bad, so maybe you could try that?
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Not having a therapist you can trust hurts really bad, I've burned therapists before. But your efforts are something you can always be proud of, and you will find the right fit.