“I’ve got this thing on my mind” - Can I share this in therapy?

Have you ever had this recurring thought, which you were glad nobody knew of?

If you did, you are not alone. If that particular recurring thought was causing you distress in some shape or form, you may have even considered whether therapy could help you. If you did, you would be relieved to know that making what therapists call a ‘disclosure’ can lead to easing of the symptoms, and there are studies to prove it.

Whether a client can pluck up the courage to voice what is bothering them in the therapy room can also depend on the impression that they have of their therapist. If these difficult (and often shameful) thoughts are disclosed in the presence of a compassionate therapist, they can lose their power, making them less distressing.

Why the thought is distressing

It could be that clients of therapy are more afraid of the social judgement for having problematic thoughts rather than actually being distressed by the thought they are having in itself. This could particularly be the case with sexual kinks or fetishes. In this case, even if the kink or fetish is legal, it may be deemed unusual by society, meaning that the activity relating to the thought is not practised by the general population. Secrecy could be a way of containing any risk of shame arising from being found out.

However, suppressing a thought is shown to have a greater chance of making it more persistent, known as the White Bear Phenomenon. In therapy, there is the possibility to examine rather than suppress.

Client confidentiality

As client confidentiality is paramount in a therapeutic relationship, an ethical therapist has a duty to protect what their client shares within a therapy space. This means that unless there are serious concerns, you can be sure that what is disclosed stays confidential.

Counsellors and therapists who are part of professional bodies abide by codes of ethics and practice which are meant to ensure that no client issues are shared with external parties other than supervisors or confidential supervision groups, and even in those cases, no specific identifying information related to the client is shared.

Of course, safeguarding means that within the UK, not all topics are equal. As a general principle, if there is a risk of serious harm to the client or others, therapists may need to act. However, for the vast majority of cases, there is no need to break confidentiality. Therefore, talking through any distressing thoughts can be the starting point to addressing them, even if it may feel safer to hide these through suppression.

If you do have concerns about whether the topic that is bothering you is something that a therapist can handle, being able to disclose a broader description of what you are facing when you get in touch with the therapist first could be is way in which you could check before establishing the therapeutic relationship.

What is ‘normal’, anyway?

While we go about our day-to-day activities, we often assume that there is consensus on what is abnormal. Things we have societally achieved a wide consensus on often dictate what is considered ‘normal’.

A therapist helping people with distressing thoughts will approach the topic with curiosity, and will need to hold their own judgement, if it does arise. So, it is not surprising that some users of therapy are reluctant to speak about what they consider their deeply personal and shameful thoughts until they have established trust with their therapist. Once shared, good therapy can help people gain the level of clarity and support needed to address the problematic, recurring thoughts in a way that suits them best.