I pay my therapist $120 every other week. I should, theoretically, feel like I can tell her anything.But I don't.
Because I want her to like me. It's part of being a stage-four people-pleaser.
I didn't realize the extent to which I was holding back until, the other day, when I mentioned to my therapist something that I had told Dr. Smith--the psychiatrist that I see every four to six weeks--about positive thinking just not cutting it when you plummet to such a low depression.
My therapist asked me to back up and tell her more about that. Because either I hadn't said anything about that to her in the last month or so or else she had missed it.
I stewed on that for a few days: Did I omit my frustration with self-help books and cognitive-behavioral techniques or maybe not express how depressed I have really been? And I realized that I divulge more to my psychiatrist about the status of my depression and anxiety than I do with my therapist.
Why?
When I'm sitting on my doctor's couch, I believe the most significant culprit to my bad mood is my illness. I'm somewhat like a diabetic going in to get her insulin levels checked.
However, when I perch myself across from my therapist, I feel more accountable for my moods ... that I if I am unable to implement cognitive-behavioral adjustments, and thereby some find relief, that I am somehow to blame. Moreover, if I'm pulled back into addictive and destructive thoughts and behavior, I have gotten there by choice.
It's nothing she says that makes me feel that way. She's a wonderful therapist.
It's just the nature of therapy versus psychiatry. By far, the easiest part of my recovery is taking my prescriptions and getting blood work done once a month or so. The real warfare takes place at the battlefield of my mind, where I must adjust my thoughts constantly, sometimes as much as ten times a minute, so that they don't steer me into a dangerous and sticky place. My therapist is my coach, my captain, in that challenge. And so when I feel like the negative intrusive thoughts are winning 10 to 0 and it's only halftime, I feel as though I must have, in some way, let her down.
Crazy, really, isn't it?
But I'm not alone. According to a 2005 study published in the "Journals of the British Psychological Society," of the study's 85 respondents, 54 percent withheld significant information from their therapist, 42 withheld information related to depressive symptoms and behaviors. Nearly 75 percent said they did so out of shame. Like me, they wanted their therapists to think well of them.
If you lie to your therapist, especially about something important in your life or directly related to your problems, then you're wasting your and your therapist's time. If you tell your therapist all about your depression, but leave out the fact that your mom just passed away last month, that's an important, valuable piece of information that would be helpful for the therapist to know in order to help you better. If you tell your therapist you have low self-esteem or always feel insecure about yourself, yet leave out the fact that you purge after eating almost every meal, again, you're only impeding your own recovery and treatment.
These are plain and simple lies, called lies of omission. And they prevent a person from moving forward in treatment.
I believe the reason many people leave out this kind of information is the same reason we have trouble mentioning embarrassing things to our family doc -- we're embarrassed by what we need to say, and feel the doctor might pass some sort of judgment on us. Whether it's a rational fear or not doesn't really matter, does it? One of the reasons many people seek out psychotherapy in the first place is to help combat irrational thoughts and fears, so in that context, it makes sense many of share this fear of being judged or embarrassed.
And yet, if you do nothing else in therapy, you should find some kind of way to share this sort of pertinent information with your therapist. It doesn't have to be in the first session. But it does have to happen at some point.
Your therapist won't judge you, and they won't be embarrassed by what you tell them. They won't criticize you for not sharing this information with them sooner. All they will do is use it to find a way to better help you and help you move forward.
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ATT.: Editor/Writer
Thank you for this good article, however, the fluidity of my reading was tripped by the distracting mistakes in these sentences:
2nd paragraph after "WHY" -
"However, when I perch myself across from my therapist, I feel more accountable for my moods ... that I if I am unable to implement cognitive-behavioral adjustments, and thereby some find relief, that I am somehow to blame"
Paragraph 3rd from last:
...“One of the reasons many people seek out psychotherapy in the first place is to help combat irrational thoughts and fears, so in that context, it makes sense many of share this fear of being judged or embarrassed.”
What you have said is absolutely right. However, many of us try to manage with only a Psychiatrist, since Therapy is so expensive. And, if you are a woman, your Psychiatrist is male, and you need to 'vent,' about a male, heaven help you.
I find the best solution is a combination Psychiatrist/ therapist of the same sex as you, and the support of a well-informed family Doctor works beautifully. But hey! You can't always get what you want or even need eh?
I realize after reading this article that I have done this. You?
luB
t
hello fellow people pleasers. I was once a people pleaser and through my own mistakes and life experience I learned it is not because I want to be liked, it is because I didn't like myself enough to recognize what I call now: "What can I do for you friends' I learned you need to please yourself, learn to love yourself, and you won't have the need to have people like you for your honesty and the ability to say no. You may lose a lot of people in your life, but those are the people who really don't care about you. You need to be honest with your therapist so you can grow within yourself and he/she can help you get there. I by the way am a Mental Health Clinician.
This really set me to thinking. We clearly cling to barriers because it is how we learned to protect ourselves at a really primitive level. You don’t just announce to your amygdala that it’s time to change!
We are social animals, we needed acceptance and support as children, and frankly, we need it now. Like Iric, I learned early to fear exposing my needs because of the unpredictable consequences – generally not positive. Also, in any other public areas of our lives it might be a counter-productive thing to do.
People pleasers often were those hyper-vigilant kids who learned to attend to every fleeting change in the faces of parents or others that might signify anger or disapproval. So we are like human MRIs scanning our therapists for the momentary flash of irritation, impatience boredom, disapproval – anything to confirm our underlying fears.
In therapy, we have the opportunity to learn that you can be yourself safely – and the therapist creates the space where we can try this out and practice different behaviors. But therapists are human - while they are trained and determined to be neutral and accepting – they do have faces which do show emotions, and we (over)respond to their responses. So we (most of us) aren't intentionally lying, we are often deep in the struggle to present ourselves openly – and learning that we can thrive despite life’s “slings and arrows.” Reshaping how you perceive the world is a tough slough - it's easy to endorse a better way to be, but awfully hard to do consistently.
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