Should I Tell My Therapist Everything? Will It Get Me in Trouble?

There really isn’t much you shouldn’t tell your therapist. But it’s a good idea to try not to tell them everything all at once.

Research shows that about 20 percent of clients leave therapy early and that most of the people who drop out of therapy quit after only two sessions.

There are many reasons people quit therapy so soon after they begin, and one of them is that they feel overwhelmed by how much they shared in their first session. They feel so nervous about having to go back and follow up about it that they just don’t go back.

A relationship with a therapist is like any relationship in that it flows better and is much more rewarding if you open up and share about yourself slowly, over time, as you get to know and trust one another better. If you go into full confession mode right away, you may worry you’ll be rejected for it.

Chances are extremely low your therapist would reject you for anything you tell them, but you may feel rejected even if your therapist is warm and caring toward you. Your self-loathing might kick in and make it feel too difficult to ever face that same therapist again who now knows that thing about you.

So, our advice is to take it slow. You can start by telling your therapist your therapy goals, your reasons for coming to therapy, and the basic stuff that doesn’t feel too terribly personal: for example, whether you’re having symptoms of anxiety or depression, thinking about changing your career, or wanting to improve your relationships.

It’s probably best to wait before sharing the thing you’re most afraid of someone else knowing about you or your worst childhood memories. Again, it’s not bad to share these things early in therapy, and your therapist can handle it if you do. But chances are good it will make you feel bad, because it’s nerve-wracking to share your carefully guarded secrets with anyone—even a therapist.

Your therapist will ask a lot of really personal questions in the beginning. Answer them as honestly as you can, but keep in mind you don’t have to share any more details than you feel ready to share. It’s perfectly legitimate to tell your therapist, “I’m not comfortable talking about that yet.”

And while we don’t recommend lying to your therapist (read on for more about what happens when you do), it’s not the end of the world if you do, especially in the beginning. Sometimes, telling little white lies or lying by omission early on in therapy is the only thing that makes you feel safe enough to keep going until you feel ready to tell your therapist the truth.

Maybe the thought of lying in therapy seems strange to you, or maybe you’ve already done it.

Either way, it’s not unusual—in fact, researchers have found that more than 90 percent of therapy clients lie to their therapists.

One of the most common lies people tell their therapists is that they’re enjoying or getting a lot out of therapy when they’re not.

It’s totally counterproductive to do this, but also totally understandable—most of us don’t like to bluntly tell others that we don’t like them or that we don’t think they’re doing a good job. And most people go into therapy wanting their therapist to like and think well of them—not resent them for telling them they think they suck.

Therapy clients also lie about how severe their symptoms are, what they’re insecure about, and how bad they’re feeling. It’s also common to lie about having suicidal thoughts.

The downside of telling any of these lies (or others) is that it limits how helpful your therapist can be. If a therapist doesn’t know how bad it really is for you, or that the way they’re working with you isn’t helping, you’re probably going to end up feeling pretty dissatisfied with therapy. You may even quit early without having been helped much by it.

Therapy is many things, and one of the most important is that it’s a quest for the truth. The truer a picture your therapist has of you, the more they’re going to be able to help you.

That said, some truths are hard to tell. Therapists know this, too. Telling your therapist a lie, especially early on, is not going to doom you or prevent you from being helped by therapy. It’s just going to limit how helpful therapy is for you—until you’re ready to tell the truth.

You might worry about sharing something even if you know your therapist can’t break confidentiality or report it—you might simply worry that your therapist will judge you for it.

If so, you’re not alone. It’s normal in nearly every social situation to be conscious of how you come across and to avoid saying or doing things that might cause someone else to dislike or reject you. These instincts don’t go away just because you intellectually know therapy is supposed to be different.

And it doesn’t help when you hear horror stories from people whose bad therapists acted unethically or unprofessionally and left them feeling rejected, worse about themselves, or looked down upon.

We’re not going to lie—those bad therapists are out there, but good therapists don’t do that.

A good therapist doesn’t stop where most people stop when you tell them something weird about you (if it’s actually weird—it probably isn’t nearly as weird as you think). They don’t just go, “Wow, that’s weird.” First, they know we’re all “weird” when no one else is looking, because “normal” is just an act we put on when we’re in public.

Second, and even more importantly, they care. They’re curious, maybe even fascinated by what you’re telling them, and they want to help you figure out why you do that weird thing you do. And nearly always, the reason is something that makes a therapist feel compassion or respect for you, not ridicule.

Even if the way you cope is quirky, what’s driving your behavior is probably something a lot of people can relate to and understand—including your therapist.

One of the scariest things to tell a therapist is that you’re having suicidal thoughts. It’s scary just to have them. Thinking about suicide can make you feel defective, broken, or like you have a dark secret you have to hide at all costs. It’s hard to tell anyone out of fear of how they might judge you—even a therapist.

Then there’s the fact that one of the few times a therapist can break confidentiality is when you’re a danger to yourself or others. You might worry that the second you tell your therapist that you’ve ever thought about killing yourself, they’ll immediately want to call an emergency hotline, transfer you to a higher level of care, or even try to get you hospitalized.

Fortunately, though, there’s more nuance to it than that. Simply telling your therapist you’ve ever had suicidal thoughts does not mean they will immediately try to escalate the situation or refer you out.

Therapists are familiar with the topic of suicidality, trained to talk about it and treat it with nuance, and are aware of how common suicidal thoughts actually are.

While there’s a chance an inexperienced therapist might get anxious if you tell them you’re thinking about suicide, veteran therapists will calmly explore this with you and gather information to determine if what you’re experiencing actually indicates you need a higher level of care.

You may well be in an advanced state of crisis that requires more than weekly therapy to address. Or working with a therapist may be all you need to deal with your suicidal thoughts. Your therapist will help you figure that out.

Ultimately, no matter what kind of suicidal thoughts you’re having, or what your risk level is, you should tell your therapist.

Therapists are not the thought police, and their response to you is not punishment for having the wrong kind of thoughts. The plan of action a good therapist comes up with will be tailored to your specific situation so that you get the care you need to stay safe and get through a crisis.

A good therapist will not push you into a higher level of care if it isn’t what you need. They will not judge you. Instead, they will meet you where you are and do all they can to help you.

Is your therapist cool or are they a narc? What will they do if you tell them you use alcohol, marijuana, or other legal drugs?

What will they do if you tell them you use illegal drugs? And what will they do if you tell them you’re using a lot of drugs, injecting drugs, or engaging in other high-risk behavior related to drug use?

Nothing. Your therapist will do nothing.

Well, not exactly. They’ll want to talk about it. They’ll want to explore what you’re doing, and why, and whether it’s causing problems in your life. They’ll want to know if it’s affecting your physical or mental health.

But they won’t turn you in to the cops. The only way drug use is ever an exception to confidentiality is if you tell a therapist you have an active plan to end your life (or someone else’s) by causing an intentional overdose.

Yes, substance use can cause you harm or put you at risk of harm. But that’s also true of a lot of other dangerous things you can do that a therapist can’t break confidentiality about or report you for.

For example, if you tell your therapist you like to drive way faster than the speed limit, or engage in risky sexual behavior, or pick fights at bars with people twice your size, they’ll want to explore that with you, and help you stop if you want to stop. But they won’t call and tell your spouse, your employer, or the cops.

In fact, they can’t. They risk losing their license if they do. And no good therapist would want to do that anyway. Their whole job is to provide a safe, judgment-free zone where you can talk about, and perhaps address, any behavior you want to change—or simply understand.

The reason there are exceptions to confidentiality when you are actively suicidal or homicidal is that the risk is so extreme and specific. (It’s also because awful events have spurred states to enact laws allowing or requiring therapists to disclose in those specific circumstances.)

For the most part, it’s a therapist’s job to help you navigate the gray areas and dark places in your life and help you find your way to where you want to be—not judge you and turn you in.

Guilt over harm you caused in the past or fear of consequences of a crime you committed are good reasons to go to therapy. But can you trust a therapist with the details of what you did?

It depends. The simple rule of thumb in therapy is that if you did it a long time ago, a therapist probably can’t or won’t report it. But if you’re doing it now, or are planning on doing it in the future, a therapist may be allowed, or even required, to report it.

There are exceptions, however, to this general rule of thumb. Read the tips box below for more details.

You might wonder about more than just what your therapist is able or required to report, though. You might wonder if they’ll judge you, or even have to stop seeing you as a client if what you tell them is too disturbing.

First, consider what you have to confess in context of everything else a therapist might hear. Therapists hear a lot of things. People confess their darkest secrets to them. Depending on what they’ve heard, and their views, what you might think of as an awful confession might barely register to a therapist as bad.

For example, your therapist might have worked with someone who murdered multiple people or someone who devastated dozens of people financially. If so, that one time you punched someone, or that time you hit another car in a parking lot and peeled out without telling anyone, might seem pretty tame to them in comparison.

Also consider why you’d be telling them. The vast majority of therapists do what they do because they believe everyone has the capacity to heal and change and because they respect and enjoy working with people who want to change. They might not respect what you did, but they’ll respect that you’re trying to address it.

But yes, there is a chance you might tell your therapist something that would shock them. In rare cases, your therapist might have been victimized in a similar way or have another reason that they wouldn’t be able to work with you anymore (in which case, they would simply refer you to another therapist).

In extremely rare cases—such as if you confessed to a string of unsolved serial murders—they might decide it’s worth risking or giving up their license (and their entire career) to break professional laws and report it. But that level of drama is usually reserved for the movies.

For the most part, your therapist respects your desire to deal with what you did and embraces their role—which is not to get you in trouble, but to help you heal.

In the last section, we briefly went over the general categories of what a therapist has to report. But it’s a little more complicated than that.

First, to review: as mandated reporters, therapists are required to report any information they receive about child, elder, or vulnerable adult abuse. Depending on the state, they are either allowed or required to break confidentiality if a client presents an active and immediate threat of harm to themselves or others.

Therapists are also required to release records or testify in court if they receive a court order. This means that if a judge tells them they have to do it, they have no choice unless they want to be held in contempt of court, which can result in fines or jail time. (But they don’t have to share your information just because a lawyer tries to get them to—the ultimate say comes from the judge.)

There are a few other exceptions you might want to consider. First, if you are going to therapy because someone compelled you to—such as child protective services, a judge, or a parent (if you’re under 18)—your therapist may be allowed or required to disclose information to the person or organization that’s making you go to prove that you’re meeting the requirements of your mandated therapy.

However, if this is the case, your therapist will explain it to you from the beginning. And the ethical rules they follow limit what they can disclose to the smallest amount of information necessary. In some cases, this may mean simply confirming that you attended your required sessions.

While we think it’s important to know and consider all of the exceptions to confidentiality, we encourage you to think about your therapist as a person, too.

Most therapists don’t want to report clients. Most therapists don’t want to escalate a situation when you tell them something in confidence and are asking for their help.

Therapists want to honor your privacy and your trust in them. They take many steps to limit how much information other people can get from them, including writing minimalistic session notes, pushing back against legal requests that are anything less than a court order, and taking a case-by-case approach to dealing with client crises.

So, while it’s important to be informed and to understand the exceptions to confidentiality, it’s equally important to remember why therapists do what they do—and what brings you to therapy. You’re there to get help, not get reported or get in trouble, and to the extent they can, your therapist wants to honor that.

There’s so much you want to tell your therapist. But can you trust them?

For the most part, you can. Therapists take confidentiality seriously. Any therapist who doesn’t is at risk of losing their license, because every single type of therapist is bound by professional rules that require them to maintain it.

And it’s more than just a requirement.

If you can’t trust a therapist not to tell other people the deeply personal information you share with them, therapy won’t work. You’ll hold back, lie, or avoid the topic you most need to talk about, and your therapy will stay on the surface of your life, not touching or changing it much.

While confidentiality is a central principle of therapy, there are a few exceptions to it. These have been introduced over time, as lawmakers and the public have decided there are some situations where public safety takes precedence over therapeutic principles.

So, while there is no perfect guarantee that your secrets are safe with your therapist, you can walk into your therapist’s office with confidence that they are (especially if you know what the exceptions to confidentiality are and whether they apply to what you want to talk to your therapist about).

And the rewards of opening up to a therapist are immense. Talking about secrets takes away their power. When you explore things you feel ashamed, uncertain, or self-conscious about with a therapist, you can make peace with them, let them go, or realize you never had a reason to be ashamed in the first place. So please, give it a chance—good therapy can change your life.