So you have gotten over the biggest hurdle to starting therapy- you have gone through the often arduous task of finding a therapist. You are a little excited and a little anxious before your first session (totally normal). You sit down on the couch- or wait for your virtual session to start at home and realize, what can I actually tell my therapist?
Well, the good news is in your first session your therapist should answer this question when they go over the limits to confidentiality and their role as a mandated reporter.
Then they might say, as I often do, "other than that, everything you share in this space is confidential."
You might think, awesome, confidentiality is great, but that still doesn't answer the, "what can I say," part, that just says that what I say will (with the above exclusions) be confidential.
Therapy is meant to be a safe space, one of nonjudgement and care. However, that can still make some topics uncomfortable to talk about. AND just because something might be uncomfortable, does not mean it is inappropriate to discuss in this space. Below are a few common topics that tend to be hard to breech.
sex and intimacy
details of trauma (especially sexual trauma)
race based stress and trauma
political opinions/human rights issues
religion/spirituality
shame and guilt
ruptures in the therapeutic relationship
ending therapy or decreasing session frequency
crying and the fear of being judged
the fact that your therapist is a person too
This list is by no means extensive, however I hope from seeing this list it becomes apparent why these are important things to talk about in therapy. Often times therapy is one of the few places we can talk about these topics and because sometimes the goal of therapy is to process one, if not all of the above! Let's start by addressing topics 1-5.
It is absolutely okay to talk about sex. Sex is a basic biological function and hopefully your therapist has done their own work on de-stigmatizing sex so that they can model that for you. It is also okay to talk about sex even if your therapist is the opposite gender as you and/or a gender you are attracted to. This one can be especially difficult, often times due to stigma around sex/sexuality, however it needn't be. Sex is often an important part of our lives and it deserves the space to be discussed, nonjudgmentally.
Survivors of trauma often fear burdening others or traumatizing their therapist with details of the trauma they have experienced. This is one of the effects of trauma- because we feel burdened/dirty/overwhelmed, we assume others will feel the same way upon hearing about what we survived. Remember, your therapist is trained to hold space and take care of themselves. You are not dumping them, or burdening them. Hopefully, together you can work through that fear and navigate these topics at a pace that feels safe for you.
Race based Stress and Trauma (as named by Dr. Gail parker) is extremely important to discuss in therapy due to the impact it has on our perception of safety, how we navigate the world and our mental and physical health. If you are uncomfortable talking to a therapist who presents as a different race/cultural back ground as you, and are struggling to find someone who you feel like will understand your experience, please check out this article to find websites that are trying to do just that. You can also use the search function on Psychology Today to set a preference for gender/religion/race/sexuality etc...
I have found people are often hesitant to discuss politics in therapy due to fear of offending the therapist if they have different political views. One way to avoid this is to address these concerns directly in the initial consultation call or first session. You can say something like, "X is important for me to be able to discuss, is this a safe place for that?" It is important to feel safe discussing these topics, because the consequences of political events/decisions can directly effect our sense of safety and mental health, and access to basic human rights.
Our belief systems are often extremely important to how we view the world and our place in it, so being able to talk about them in therapy is integral. Perhaps you are learning more about Buddhism and want to focus on spiritual work, or perhaps Judaism is a big part of your life and you want to work with a therapist who is also Jewish. You can search for specifiers directly as noted above on websites like Psychology Today, as well as use the above question in topic 4 as a script in the consultation call. You may not feel the need for a therapist to have the same spiritual or religious back ground, and that is okay too. What matters is that you feel safe.
Remember, it is your therapist's job to be nonjudgmental, and if they have beliefs that would inhibit their ability to be that for you, then they have an ethical obligation to inform you and provide other referrals.
I hope that by fleshing out these topics so far, we can normalize them as universal human experiences, and hopefully decrease that pre-session anxiety. Look out for the next blog post where I address topics 6-10.
If you are interested in working with me, please contact me through my website, email me at samantha@artsomatictherapy.com or call me at 818-465-8516.