I think that if all there is to the therapy session is talk, your paranoia and lack of trust would flare up in the form of your interpreting what the therapist says in ways that would confirm and strengthen the paranoia in your mind.

Oh Hammy. You are so insightful. You saw my communications from inside me, and that is an amazing gift.

You totally hit the point. I did/do think that it is just talking, and I will admit, I have major trust issues. I was worried that if it were all talk, I would close up.

I never even thought of communication in the form of art.