I have faced similar situations a few times with my t. I have found that journalling helped me to get my thoughts out and make some sense of them. Then I have shared it with my t. (sometimse I read them, sometimes I have her read it to herself)

This gives me the security of having the time to think about what I want to say, at a time and a place where I feel safe, but also knowing I don't necessarily have to show it to t.

I made a decision when I started therapy that the ONLY way I was going to get myself through this was to be open and honest in therapy. I can't continue to live my life like this so there aren't many other choices.

Once I walked into a session and before saying hi, I said to her "I have something I have to tell you so don't let me leave until I do". (you'd be surprised at what you will do when your bladder is screaming at you)

Remember, they are there for us.