I don't generally swear at all, but I do at times. So I don't go out of my way to swear, it has to fit and come natural. I am mindful of the therapist and have a pretty good filter with ones I should probably keep G-rated. But I'm sure they heard it all, it's just manors and respect. Once you get to know your therapist you will get an idea or feel for it. And if you never or rarely swear like, it will help the T understand that you feel strongly about the subject you swore in. I can't see any get up set unless you go in there sounding like a truck driver or sound like the Sopranos, you may make some T's feel a little uncomfortable