Poll: What's Taboo to Say to Your Therapist in Session?

You might not be surprised that I would say it's not the therapists job to not upset the client. That's people pleasing. Maybe not what you meant!

Since half the training is their own therapy, the scope of training does account for some root causes, I believe. I would agree with you that lack of training or inadequate training leads to poor outcomes. Happens in other professions too, but harming humans is a different ball game, right.

I should say... not retraumatizing trauma clients

Seems to me that even setting basic goals that are measurable - and helping clients get there - is not widely practiced.

Not everyone wants this. The last thing I need is another set of basic measurable goals.

My basic goal is to feel better...but that's not measurable. At least not quantitatively. I think quantitatively is the right word. Kit

I totally think that’s measurable! Scales of 1 to 10 are pretty simple. Or those facial diagrams with degrees (happy faces down to crying). I really do think some therapists need to see this week after week to notice their clients are slipping or not getting better.

My T tried to get me to rate my mood on a scale of one to ten once and I just about ripped him a new orifice. If he showed me a bunch of cartoon faces I think I'd leave. I seriously hate that stuff.

I talk about everything with t including sex and masturbation and bad memories. even anger and my anger at him and how I wish to hurt him. he doesn't flinch at all.. ever... he is a strong safe presence for me!

I did tell my therapist I was in love with her once but then I sort of covered it up again by saying, of course, I don't really want a relationship and know it's just hypothetical and off limits. But I wish I could really tell her that's not true and that I am crazy about her but I also know that's just me being stupid and living in a fantasy world.

Also, I am afraid to discuss some sexual things because I don't want her to be disgusted with me.

I hate those questionnaires, too, and now refuse them.

At my the teaching hospital where I used to get my medical care, every single time I went to a doctor appointment I was given some kind of depression screening where I was asked if I felt like harming myself, if I had sui thoughts, etc. One time when my PTSD got bad, I did need to see a psychiatrist for medications so got the referral from my generalist and tried to set up an appointment. I was told that psychiatrists are only seeing patients on a cash only basis, and that it would cost $2000 to get a prescription. This included one evaluation and then one follow up appointment. Really?

At the next appointment when someone attempted to screen me for depression I said how dare you even ask me these questions when you offer no services for people who need help. Not the most tactful behavior on my part, but I was livid. I have refused their questionnaires ever since.

These kind of interventions can make people worse off. In this case, it gives the appearance something is being done to benefit patients, but in reality, no help is given. To me, giving an appearance that people are getting interventions when in reality they are not is worse than doing nothing.

Meanwhile, some researcher at that teaching hospital is writing a paper about how successful their depression screenings are in patient outcomes, statistics and all (which is effectively measuring only the wealthiest depression patients in the teaching hospital). And then that research is used to prove how great these interventions are, and it is then used to create new questionnaires and interventions.

I would have the same reaction, if my T was goofy enough to suggest rating my mood. Given the complexity of the work I do, which is really quite structured and focused compared to therapy, I have an appreciation for how different people can be. Suggesting that the cure for bad therapy is to "not traumatize" people or set basic goals and give them rating scales is the wrong approach. Some of my therapy has been in directing my therapist on how best to help me, which requires some skills before I could successfully pull this off. I dislike a version of therapy where the therapist is enacting things like goal setting and mood analysis on the client. I'm sure that works for some people, but not for me.

My T claimed he only used that form because insurance companies want reports like that. But he hasn't tried it a second time. Now he only brings it up as an example of things that get me really angry.

... so I guess rating my mood on a scale of 1-10 is a taboo subject in my therapy.

I despise those scales whether it is based upon mood. Pain or anything was. From my experience what I feel is a town is way different than most. So I always quantify it with a comparison like: if a 10 is giving birth to a 10 pound baby I rate this a "x".

Whenever either T or psych np ask me to rate my mood I remind them how much I hate that question.

I’m of a different mind about rating scales because my therapist and I found them extremely helpful. Because I dealt at times with such severe depression that I ended up hospitalized, it was helpful for us to have a system of sort of objectively communicating where I was. We really worked on defining what each level on the scale translated to, particularly is it corresponded to levels of suicidality (thoughts vs. ideation vs. planning vs. intent, etc.) He didn’t just randomly throw a 10 point scale at me. Instead, we developed the scale and defined each level together as a common language. That scale became part of our routine. The first minute or so, he often would simply ask where I was at. Because we had a clear, mutual understand of what my answer meant, it put us on the same page quickly. My pdoc learned that same scale over time, and that system went a long way toward getting me the right level of help at the right time and keeping me safe. I was know to deteriorate very quickly, so the more precisely we could be about our communication of my depression levels, the more effectively we could work together to help me through those depressive episodes.

In the abstract, I don't think any of these topics are taboo in therapy and I'm fairly confident that my current therapist would deal competently and compassionately with just about anything I brought up.

But of course in practice, there are tons of things I have an extremely difficult time saying in session.

None of the poll examples are appropriate to say to a provider. The psychologist is working in a professional capacity, not as a friend, lover, or family member. Thoughts are just thoughts. Anyone can have a strange or fleeting thought. Filter is important. I am a healthcare provider and I have also gone through my own psychoanalysis with professionals.

I've experienced many patients who said inappropriate things to me. I dealt with each situation case by case, calmly and professionally. But I don't think we'd be doing anyone (provider or patient) any favors to suggest that the examples on your list are a good idea to share with a provider. Provider-patient boundaries are essential...they help to keep everyone safe and respected. The boundaries are important on both sides. Providers must respect their patients' boundaries and vice versa. If a provider suggests putting aside boundaries, I would seriously question their integrity and professionalism. Peace, safety, and wellness to all

I can say whatever I want in therapy. However, somethings don't apply to me, or if they do, I respect my T enough to either not say it or say it politely. Like cursing at her? What good would that do? We do curse, but not at each other. I did tell T, early on, that I hated her. She said it hurt her feelings and made it difficult to work with me. I've talked to my T about sexual issues, but I don't have romantic feelings towards her. I have never had thoughts about harming her, but I have talked to her about having thoughts of harming others. I tell her everything. I tell her when I feel clingy with her, or that I love her, or when I'm mad at her. Nothing is off limits.

I found that sometimes people refer to psychotherapy as psychoanalysis and vice versa (incorrectly). Yes psychoanalysis most certainly wouldn’t require patients to extercuse restraint as it supposed to address our subconscious thoughts/dreams and feelings. But people might not know or understand the difference or confuse the words. I don’t think people are lying when they are incorrect about something though. I tend to think that people just don’t know. You could just explain

I just thoroughly disagree and it seems like even your own opinion is internally inconsistent. If "thoughts are just thoughts", fleeting as you say, I don't see the harm in people expressing what is on their mind. I think with therapists as opposed to other professionals, the value of filter is probably overrated, and so are the preachy must-dos.

My therapist always says EVERYTHING can be said and discussed about in sessions, there are no limits. She said threatening behaviour and harming someone are the only things that are not acceptable. The few things I marked, are my own boundaries, something I feel strongest not doing ever.

Nonsense. Sharing what's on your mind, without a filter, is literally supposed to be the patient's goal in psychoanalysis. There are other therapy modalities where there might be more restrictive boundaries, but psychoanalysis definitely isn't one of them. Filter is counterproductive in this context. Fleeting thoughts, fantasies, desires we think are inappropriate or shameful, etc., are all completely relevant and useful to share in many modalities of therapy.

I'm also a healthcare provider, and boundaries of appropriate content are different from specialty to specialty for a reason. It's extremely appropriate to tell your psychoanalyst about your sexual fantasies about them, and it's extremely appropriate to show your dermatologist the rash on your butt--regardless of the fact that telling the derm about your fantasies and showing the analyst your butt isn't a great idea.

Well, my post was deleted twice because I apparently used taboo words. But no problem, let me try again - let's see if this one goes through.

The therapy you went through most definitely could not have been psychoanalysis because psychoanalysis in particular is that type of therapy where the patient is asked to suspend any filters as much as possible and simply say anything that comes to mind.

By anything is meant really anything, including all those things that were listed in the poll. So yeah, in psychoanalysis the filter is important but in an opposite sense - the idea is to filter as little as possible.

These are the ones I chose.

While I dont think expressing these things is taboo I think therapists probably should be realy careful about how they respond to this sort of thing. And it should be worked THROUGH and not... well. Encouraged. Honesty about those feelings I personally think is ok- but boundries are important for the therapist to set I think.

I get kind of upset on here when I read about therapists... saying things like... they want to be a mother figure to the patient or they love them like a daughter. To me- sure- maybe thats really comforting to the patient while it lasts but... the patient is in a just naturally vulnerable position and- therapuetic relationships dont last forever. To say those things opens so many doors to hurt. Some attachment I think is necessary but... too much dependence is like putting someones arm in a sling, telling them that “dont worry Ill carry everything for you” and then one day leaving and that person being left with an arm that they didnt realize that- because they were neglecting it- it has atrophied and now they struggle to carry anything on their own. Its not even a bandaid- its hobbling in my opinion to say these things to someone in a vulnerable position- knowing the transient nature of therapy in general.

But... Just my opinion. Man. Tonight I really need to shut up! Hah. Wow. Sorry everyone if Im being too opinionated. Some people complain about this with me- which is why I usually try to just- stay pretty quiet. But once I get going... man.

Anyways. These are the ones I picked

I want to be with you in some kind of romantic way
I want to engage in nonromantic physical touch with you
I want a platonic relationship with you outside of therapy
I dream or fantasize about romance, touch, friendship with you
I want to do something harmful to you
I dream or fantasize about doing something harmful to you
Insulting or demeaning them as a person

Swearing in my opinion happens. People get angry. Is it very nice to scream at your therapist... no probably mot. But as long as you arent threatening them a person should be allowed to vent frustration- even if its in an unhealthy way imo. Sometimes doing that might actually be helpful too- breaking down barriers and maybe using the experience to work on healthier coping mechanisms.

That one to me- while questionable- isnt an automatic 100% of the time taboo.

Same with criticizing them as a therapist- to some extent again- frustration happens and a person might need to vent. Should they try to remember the therapist has feelings too- yes- and remembering that might help temper the criticism- but some people might just not be in a place to be able to do that yet- so occasional harsh critique- while not nice- is another thing that isnt 100% taboo in my book.

I have thoughts about hurting my T in therapy. Should I tell her?

my T has said the same thing multiple times.