Ways to open up to a therapist?

Of course if we don't clearly tell our therapist what the problem is, therapy will be of no use. Knowing I would be too shame-faced to open my mouth to tell the therapist exactly what I needed to tell him so he could help me, I'd decided to type it all up, print it off, and give him the sheet to read at the beginning of our first session. Though it helped, I found that I was still sensoring myself from saying other things he would need to know to help me, especially since the details of my addiction ran a high risk of contracting an STD (a compulsive fetish of having unprotected sex with menstruating prostitutes). Leaving out this crucial detail led to him focusing on the root psychological causes of the addiction rather than first looking at immediate physical solutions to controlling the behaviour to protect against STD's before moving on to looking at the deeper causes of the behaviour. Honestly, had he asked about any concerns over physical risks involved I would likely have mentioned STD's though I likely would still not have been able to tell him how risky outside of answering in a yes/no answer. This naturally caused me to turn to my own solutions with mixed results. A therapist could have advized on how best to approach a chastity-Keyholder relationship in the absence of a spouce or even offer to become the Keyholder himself; or educate me on better alternatives. For example, if he thought libido-suppressant medication would be preferable to such a relationship, to reassure me concerning any side effects, etc.

In the end though, we can't expect therapists to read our minds. What strategies have you used to help you to open up with your therapist?

Hi Shlosita,

This is an interesting point that you have made.

What I write now, is based on my personal experience only.

My therapist is only able to deal with what I disclose.

If I have not specifically stated something, it can not be addressed and I can't really rely on my therapist for advice for something which is not said.

Also, I tend to have a distinction between what I might consult a medical doctor about and what I might discuss with my therapist. Of course there can be an overlap between the two.

I am somewhat thinking that you may have consulted a doctor about STD, or you may not have.

This may be a good starting point - because you are quite right, there is concern over the physical risk that is involved here.

Remember, there really isn't much that therapists and doctors haven't heard before. That's what I remind myself when opening up to them. I have to remember that they are part of my care support team, and that they are knowledgable trained professionals to support me.

So my strategy is the constant remindering to myself, they're part of my network towards recovery and they can deal with what they know and I choose to disclose.

Good points. Recognizing the discomfort involved in discussing this face to face, I won't be surprized if in future as knowledge around sex addiction progresses, that addressing STD risks becomes priority. The therapist would not need to know the details or even ask the question, but might simply advize that if the male patient is concerned about STD risks that he would accept to be his Keyholder. Discussing the pros and cons of libido-suppressant medication as van alternative to such a relationship will likely become part of initial contact too before worrying about other factors.