I started off with my therapist working through PTSD issues. After i talked about that stuff, one would think everything else would be open floor. There have been a time or two when I have had something to express that I didn't want to say. I wrote it down beforehand and gave it to her at the beginning. She batted around a few other topics and came back to it. It worked. I am guilty of not saying everything, but I don't necessarily think that's right. The point of going is to get help. We recently talked about whether or not I go too much (once a week or so for 2 years). It was hard for me to even talk about that. Well, we scheduled an appt for the following week at the end of the session. My point, even though i like my T, if I don't open up, I don't benefit. I'm left alone in my own head to pick up the pieces that break. A suggestion. . . Write it (I'm afraid to open up to you) down and give it to her. If she doesn't have good follow-up questions after that, find a new one.

You may have another resource. I'm a cash pay for my T and my pdoc due to restrictions on who can provide my service. My insurance company does not reimburse me for their services, but they do have case managers who can be assigned to talk to me over the phone. I had one who helped me manage on some pretty rough days before I was diagnosed. Check to see if that's an option. I only found out about it because I knew someone who was hired to work at the company that provides the service.