hey there
i'm also familiar with some of those thoughts, thinking 'what's the point in even saying anything, there's no way out, they'll just think i'm dumb and attention seeking'....it held me back in therapy for a while and it still does with my family
i think sometimes that my therapist already has so many clients with issues that why would she want to deal with mine?? or how could she have the energy to deal with me? -- so i must just minimize it all.
with family, i wonder how much my mom's already dealing with. it causes guilt and shame inside of me (fueled by that stigma you mentioned)....sometimes it hurts so much i just HAVE to force it all out, write it down, like others have mentioned, sometimes even preface the conversation with 'i feel worthless saying all of this, you have to know that i feel that way, but here it all is....'
it's so hard. i know these feelings well, and it really is that annoying saying that i gets better with practice, over time, doing it again and again. true to some degree, but you ARE valid in what you're saying. i'm wishing you luck always.