I can't speak for anyone but myself, but I often feel unwanted, intrusive or that i am being a nuisance, when that is not the case. I also often feel guilty or bad when I am actually doing nothing wrong. These are engrained reactions and as far as I understand quite typical of depressive personalities. For this reason I did need to verify quite often with my T. So I would disagree about always knowing.

I also think a person's motivation can be quite baffling - even to that person. For instance, my T provided a purpose for living and a sense of security. There was also various types of transference going on. I was generally open about all of this and obviously he did not see me as much of a threat!

Editing to say - I obviously don't know the relevant details about OP or his/her T...