Therapists Are Sharing Things People Are Usually Embarrassed To Tell Them, But Are Things That They’re Actually Commonly Told
"I have heard some variant of it more times than I can count."
Note: This post mentions sensitive topics including sexual assault, substance abuse, suicidal thoughts, abuse, and PTSD.
Just because someone has made the decision to go to therapy and found a therapist they connect with doesn't mean it's easy to suddenly lean back on the couch and open up about their deepest thoughts.
Here are 31 responses from mental health professionals who have heard it all and are working to normalize the conversation:
1. "Basically, anything having to do with sex. There's so much shame. Sexual abuse. Sexual fantasies and fetishes. Erectile dysfunction. Infidelity. Becoming sexually assertive."
"Psychologist here. I try not to have a strong reaction to normalize the discussion." —u/MyDogCanSploot
2. "I'd say a common one is believing that there's something innately, irreparably wrong with them that makes them unable to ever truly 'fit in.'"
"For a lot of people, it's such a deeply ingrained belief that it can be extremely painful to acknowledge or express, regardless of the level of personal success in their lives." —u/GuidedBySteven
3. "Unwanted intrusive thoughts are normal and do not mean you are a bad person. By definition, these are thoughts that are unwanted because they go against your own values and highlight what you don’t want to do. However normal these thoughts are, the moral nature of these thoughts means that often people experience a lot of shame and take many years before they first tell someone about them."
"Yes, even intrusions of sexual/religious/moral themes, e.g. a religious person having unwanted blasphemous images pop into their mind, or a new parent having unwanted sexual thoughts about their new baby.
The occurrence of these thoughts/images/urges is normal. The best way to 'manage' them is to accept that they are a normal (albeit unpleasant) brain process and that they are a sign of the opposite of who you are and are therefore very unlikely to ever do.
Let the thought run its course in the background while you bring your attention back to (insert something you can see/feel/hear/taste/touch). I usually say something like, "Ok, mind! Thanks for that, mind! I’m going to get back to washing the dishes and the sound/sensation of the water while you ponder all the nasties. Carry on!' I literally say it to myself with a slightly amused tone because I am always genuinely amused at all the wild stuff my brain can produce!" —u/cbearg
4. "The number of people I see who feel like they should be grieving a 'certain way' and are afraid that they 'must not have loved someone,' or, 'must not have cared.' People grieve in all sorts of ways. The five stages of grief are bullshit."
"I was consulting with another clinician who was seeing a couple whose daughter had died. The wife was convinced that the husband must not have cared about her because he 'wasn’t grieving out loud.'
In reality, while she had been going to support groups and outwardly expressing, he had been continuing to work in a garden that he and his daughter had kept when she was alive, using that time to process and grieve as he did.
Both were perfectly fine ways of grieving; however, it is expected that one's grief is more than the other. They both ended up working it out. He began driving her and others to their weekly support group, and she attempted to work in the garden with him on the condition that they didn’t talk. Really sweet." —u/sredac
5. "That they 'hear voices.' I've found that a lot of people aren't familiar with their own internal dialogue or 'self-talk' and that this is typically 'normal' internal processing. A lot of people think that they are 'hearing voices' and hallucinating. There are some pretty simple questions we can ask to determine if it's hallucinations or just internal dialogue, and most often it's the latter."
"I want to clarify that not everyone has an internal 'voice.' Some have none at all; some have more of a system of thoughts that aren't verbal, feelings, or images. That's normal too!" —u/whateverlolawants
6. "As someone in the substance abuse field, I know that it's difficult for clients to tell me they got high with a parent, but it's something I get told fairly regularly."
7. "That they do not know what they enjoy doing. Often they have people in their life, including therapists, say, 'Try to do something fun today,' or ask, 'What do you like to do when you have free time?' Many people I work with do not know what those are. I couldn't even try to count how many clients I've had this conversation with."
"Once I explain to them that I dislike these statements and questions because they assume people should know the answer and that many people don't, I can watch as they relax, take a deep breath, and say something to the effect of, 'That's so good to hear. I have no idea what I like to do. That's part of the problem.'
More often than not, they feel like they should know and that everyone else their age has it figured out. They are embarrassed to say that they don't know, when, in fact, not knowing is very common." —u/ljrand
8. "Clients become quite fearful of admitting that they weren't successful since the last time they had a session. This could include not succeeding in using a coping skill that they're learning about, or not being able to complete a homework assignment I gave them. Humans aren't robots, and therapy is a lot of work."
"That being said, I don't expect people to be perfect as they start to work on themselves in a positive way. It takes time to really commit to change, especially in relation to trauma or conflicted views that an individual holds.
I feel as if the client doesn't want to let me down as their therapist, but these 'failure' events are just as important to talk about as successful moments!" —u/DnDYetti
9. "I have heard some variant of, 'This is probably weird, but I feel if I am my true self around others, then they won't like me,' more times than I can count."
"As I explore the formative situations to this belief alongside my clients, it definitely pulls at my heartstrings." —u/oreganick
10. "I work with a lot of anxiety and trauma clients. Whenever I ask if they would describe their experience as being anxious about being anxious, I get a lot of, 'Omg, yes.' Anxiety has such a physical impact on the body (heart pounding, trouble breathing, feeling faint or cold, tunnel vision, etc.) that we become aware of our body's reaction before we even notice the anxious thoughts triggering the reaction. Then we panic about why our bodies are flipping out when we're not even aware of feeling threatened, and the anxiety compounds on itself."
"Anxiety is like an alarm system in our bodies to signal the presence of (real or perceived) danger. What would you do if your alarm was going off at your house?
Check to see if there's a real threat (scan your environment/situation to ground yourself in the present), turn off the alarm (breathing exercises do help, along with mindfulness techniques like body scans), and then investigate what tripped the alarm (process thoughts around the situation that read like a danger to you).
It's also important to note that danger doesn't need to be getting a gun pulled on you. Panicking during a presentation that could impact your job and threaten the way you pay your bills and afford your life can feel pretty dangerous if you think about it." —u/pomp_le_mousse
11. "I do a lot of trauma work. Many people who have experienced molestation or sexual assault feel ashamed and confused because their bodies responded. Having an erection/lubrication or even an orgasm does not mean you wanted the sexual contact, and it is still assault."
"Clients often hold a lot of shame and confusion about this. They wonder if it means they wanted it or if there is something wrong with them. It is a tough thing to work through because of this.
Assault is assault. Sometimes human bodies respond to sexual touch even when we don't want that touch." —u/roomforathousand
(And a response to this, "Someone once said it’s like tickling. You laugh when you get tickled even though you don’t want someone to tickle you." —u/Doofus_is_the_Name)
12. "I work in an older adults service for people with dementia and mental health problems. I see a lot of family members/carers feeling ashamed of the fact that they are finding it incredibly difficult to care for someone that has dementia or a chronic mental health problem. Carer burnout is a real issue, and people need to know that it’s not easy to see someone you love struggling every day or slowly fading away month by month."
"Carers and family members desperately need time for themselves and need to know that it’s okay to feel the way that they do. No one is superhuman, and we all have our own needs.
It’s why we have therapy groups for carers. It’s okay to struggle to look after someone, and you should in no way feel ashamed of having those feelings." —u/aron24carat
13. "Intrusive thoughts about sex with family members or — in their mind — 'nymphomania' as a result of childhood or adult sexual trauma. Hypersexuality isn’t often discussed as one of the PTSD symptoms, so people walk around with so much shame about it."
14. "To name a few: 'compulsive' masturbation; fears of being a pedophile/rapist (this is a common OCD fear); hoarding; sexual performance difficulties; history of sexual abuse or sexual assault (unfortunately, it is VERY common); drug use; the amount of money spent on various things; having an ASD diagnosis; going back to an abusive relationship or staying in an abusive relationship; grieving years and years after a loss; self-harm of all sorts..."
"...wanting to abandon their current lifestyle (for example, to have more sex, to escape responsibility or expectations); history of gang violence or crime; their sexuality (or asexuality); gender identity; the impact of racism and racial trauma; paranoia; hallucinations; feeling uncomfortable in therapy; not believing in therapy; difficulty trusting a therapist; fear of psychiatric medication; fear of doctors in general.
I'm a psychologist in the US. At this point, I don’t recall a time a patient said something in therapy where I was shocked or even thought, 'Oh, that’s new.' And, in my opinion, if you surprise your therapist, that is okay." —u/ImAPsychoLogist
15. "A common one is simply, 'I don't know.' You'd be surprised how reluctant people are to admit that they don't know why they're feeling how they are. But that's exactly why you're sitting there with me; so we can figure out why together."
"It always put me in mind of a line from "America" by Simon and Garfunkel:
'Kathy, I'm lost,' I said, though I knew she was sleeping. 'I'm empty and aching, and I don't know why.'" —u/kutuup1989
16. "A common one is 'secret feelings.' Private daydreams and sexual fantasies. Seemingly every time someone tells me, 'I have this really weird daydream I'm always having...,' they tell me their variation of the Suffering Martyr Daydream. It's so common it has a name!"
"Other secret feelings include resentment towards a spouse or the difficulties of being a parent. Lost attraction in a spouse." —u/my_other_throwaway90
17. "OCD gets misunderstood a lot. It’s not just having a clean house or liking things to be organized. Common intrusive thoughts can include violent thoughts of harming children and other loved ones, intrusive thoughts of molesting children, fear of being a serial killer, etc."
"My clients can feel a lot of shame when discussing the thoughts or worry I will hospitalize them." —u/darkblue15
18. "Some of the most common ones have been visual and/or auditory hallucinations and suicidal thoughts. I usually hear, 'I don’t want to be put in the hospital,' or, 'I don’t want you to think I’m crazy.'"
19. "With adolescents, they are extremely anxious to tell me if they've relapsed or aren't doing well. They're worried I'd be disappointed in them. It usually turns into a discussion about policing other people's feelings and tolerating emotions. I explain that I care about their well-being, and it's my job to monitor my emotions and reactions, not theirs."
"For example, they cut one night, or they were suicidal. They're having a lot of negative self-talk or panic attacks. They'll come in, pretending everything is okay.
It's usually in the last 10 to 15 minutes of the session that they'll say something. And they'll reveal that they worried they'd let me down." —u/MyDogCanSploot
20. "Two topics come up with regularity: when someone discloses to me that they were sexually abused as a kid, and/or when some is experiencing suicidal ideation. Both are something I hear from clients every single day, and so I don’t find it weird at all."
"But when I have someone in front of me who’s talking about it for the first time, I know it’s important to validate the fact that, even though I might be talking about this for like the fifth time that day, they have never talked about this EVER, and are in need of gentle care to feel safe." —u/HighKeyHotMess
21. "I’ve had clients too scared to tell me their accomplishments. They think they should only be bringing their problems to case management and that if we see them getting better, we won’t care or prioritize them as much."
22. "Recurring intrusive thoughts about harming others. Can be hurting/killing someone or sexual fantasies about children or relatives. Usually, people take a while to admit those. You probably are terrified that you might be dangerous, but the reality is that if you are having them frequently you aren't dangerous."
23. "Hidden sexual dreams and fantasies about family members. They are more common than people think. They often stay that way and don't really interfere in the person's close relationships unless they allow it. Many things we dream or think are unconscious and involuntary, and the root of such things is often nonsensical."
24. "That they haven’t had sex with their partner in years and don’t know how/if they will ever have sex with their partner again. There is so much shame around sex in the US that a lot of people are scared to talk to their partner about their sexual needs. Time goes by, and suddenly they haven’t had sex in 3, 5, 10 years. It starts for a lot of people in their forties and fifties."
"A lot of people (falsely) believe there is something wrong with their marriage because they fantasize about people other than their partner." —u/Chininja1
25. "That they don't like their family members, are angry, want to stop communication with their parents, etc. There is deep and profound shame in this, and when we find that line of, 'Oh, it might be that your parents are toxic to your mental well-being or trigger your trauma,' many of my clients get visibly angry with me."
"We deal with this almost on a daily basis. I work in Ukraine, which is more culturally collectivist, so not wanting anything to do with your parents makes you an asshole in the current cultural sense.
Cultural psychology is so important. When I first moved here, I had my American/European hat on and, oh boy, did I need to adjust." —u/leonilaa
26. "Being tired of being a mother. There's this social thing of loving your kids and them being the first thing in your life, but having a child is messy and really hard work. It is normal to just want to take a break once in a while from all that responsibility."
27. "Usually it’s sex-related. Shame about their desires or kinks is common. Gender questioning is another. Some people are ashamed of things they did in childhood or adolescence and haven’t ever told anyone, thinking they will be horrified."
"We have heard everything. Everything. I’m always compassionate and always understand why we do the things we do. I’ve yet to have anyone bring something I can’t 'get.'" —u/throwaway4u2021
28. "Your fantasies are normal. No matter what you fantasize about, you’re not the only one, and it’s probably way more common than you realize."
"Sex Therapist here: A huge part of my work is helping people normalize their sexuality and desires. Don’t be afraid to talk about it — I’ve heard it all." —u/Seeking_Starlight
29. "The number of people who are unaware of their own emotions and emotional process is astounding. So many people feel only 'angry' or 'happy' and worry something must be wrong with them otherwise. Normalizing feeling the whole gamut is just as important."
"Recognizing what we’re feeling as well as what it feels like in our body when we’re feeling is incredibly helpful for understanding how we process and feel. As a whole, how we treat emotions as a society is kinda fucked." —u/sredac
30. "Speaking to their departed loved ones. Thankfully, theories now support this and don't consider it to be a sign they're not 'moving on with their lives.'"
"I encourage my clients to explore the continuation of their relationships with the deceased." —u/Eachfartisunique
31. "Everything, dude. Everything. You name it, I've heard it. You regret having your child and wish you never became a mom? OK. You love your spouse, but their cancer came back again, and you don't know how you can go through this fight again? Yeah, I get that. Hard drugs? Shit, it's been a hard year. You wanna quit your well-paying job to sell carved soap figurines? OK, well, let's talk through what that might look like. You like to collect teddy bears because they give you a special lil' tingle in your nether regions? I don't kink-shame."
"Seriously. We've heard everything. EVERYTHING. Unless it's someone newish to the field (less than five years maybe), it's generally not going to shock us. And whatever it is, even if it does seem a bit of a unique circumstance, we'll get the underlying feeling behind it.
In the end, everyone wants the same overall things — to feel heard, to be loved, to take care of their loved ones, to manage stress, etc. Humans do the best they can, and therapists are there to help. But we can't provide guidance if you don't give us a chance, and that means opening up.
I know it's scary, and some therapists do suck. It's a lot like dating. If you don't click with the first one, move on until you find one you do click with." —u/incineratewhatsleft
If you need access to mental health resources, please see the following:
• The National Alliance on Mental Illness helps connect individuals to mental health resources. You can contact them through their NAMI HelpLine (call 1-800-950-NAMI (6264) or email at firstname.lastname@example.org).
• GoodTherapy helps you find therapists and counselors, rehab and residential treatment centers, and mental health resources near you.
• The Rape, Abuse & Incest National Network (RAINN) offers a National Sexual Assault Telephone Hotline (call 1-800-656-HOPE (4673) or chat online) to connect you with a trained staff member from a sexual assault service provider in your area.
• The National Suicide Prevention Lifeline is open 24/7 to provide free, confidential emotional support to people in suicidal crisis or emotional distress across the US. You can call their number (1-800-273-8255) or use their Lifeline Chat service via web chat.
• Befrienders Worldwide is a global network (available in 32 countries) that will connect you to a hotline in your area. They aim to provide a safe, open space for you to talk via telephone helplines, SMS messaging, face-to-face, internet chat, outreach, and local partnerships.
• The Trevor Project specializes in providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, queer & questioning (LGBTQ) young people under 25. They can be reached 24/7 by phone (1-866-488-7386), text (if you're in the US or Canada, text TALK to 741741 for free; if you're in the UK, text TALK to 85258; and if you're in Ireland, text TALK to 50808), or chat.
• The Substance Abuse and Mental Health Services Administration (SAMHSA) helps you find treatment if you're struggling with substance abuse (in which case, you can call their National Helpline at 1-800-662-HELP (4357)); experiencing stress, anxiety, and other depression-like symptoms (call their Disaster Distress Helpline at 1-800-985-5990); or are a veteran in crises (call their Veteran's Crisis Line at 1-800-273-TALK (8255)).
• The National Eating Disorders Association offers online screening tools, a database of treatment providers, and you can contact their helpline via phone call or text at 1-800-931-2237 or chat. For 24/7 crisis support, text NEDA to 741741.
Did these help normalize any feelings you may have or make therapy seem less daunting? As these therapists have attested to, you're not alone. Feel free to share your thoughts in the comments below, and if you're a therapist, let us know if there's anything not on the list that you'd add.
Note: Responses have been edited for length/clarity.