If you have trouble saying these things - why not write her - or print up this thread you started and let her read it. I know in therapy I turn in a journal of my feelings every week and the following week my T goes over what I have written that he thinks is significant (either positive or negative) - especially if I did NOT mention it during the therapy session. (He knows those are the things I am trying to avoid so he gently brings them up to talk about). You are right - you are paying for a service - would you withhold from a doctor the fact that you were in pain somewhere in your body? Well, you are in pain from inside your mind. It is important for your T to know these things in order to provide you with the best possible treatment.