22 Secrets Your Therapist Won’t Tell You

Whether or not you're part of the 25 percent of adults who've seen a therapist, these insider secrets will give you a dose of mental medicine.

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Sometimes, when we say, “That’s interesting,” it’s really not

Sometimes, when we say, “That’s interesting,” it’s really notiStock/shironosov
We say that when we get caught thinking about something else. (These are signs you might need therapy.)

Don’t take it personally if you see me outside the office and I ignore you

Don’t take it personally if you see me outside the office and I ignore youistock/Sasa Dinic
If I’m with someone, introducing you as my patient would violate patient confidentiality.

Do we talk about you at cocktail parties? Absolutely

Do we talk about you at cocktail parties? AbsolutelyiStock/Jacob Ammentorp Lund
The stranger your story, the better.

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Mental illness can damage the brain. You can’t just wait for it to go away

Mental illness can damage the brain. You can’t just wait for it to go awayiStock/KatarzynaBialasiewicz
The longer you wait to get treatment, the worse it will get and the greater the chances that prescription drugs won’t work. (These are depression symptoms you shouldn't ignore and these could be signs of an anxiety disorder.)

Anyone can call him- or herself a psychotherapist or a therapist.

Anyone can call him- or herself a psychotherapist or a therapist. iStock/shironosov
You want a psychologist, a psychiatrist, a clinical social worker, or a marriage, family, and child counselor. You have to be licensed to use those titles.

It never hurts to ask for a lower fee

It never hurts to ask for a lower feeiStock/Nikolodion
Some of us will say yes.

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Long-term therapy makes some patients much more self-absorbed

Long-term therapy makes some patients much more self-absorbediStock/Martin Dimitrov
Some start to believe that every thought and dream they have is important. (Here are surprising things your dreams can reveal about you.)

I might exaggerate a diagnosis to get an insurance firm to pay for more coverage

I might exaggerate a diagnosis to get an insurance firm to pay for more coverageiStock/Izabela Habur
I use a diagnosis I call adjustment disorder, which means you are having trouble adjusting to your life. That can apply to almost anybody.

Sexual fantasies about patients? Unfortunately, it happens

Sexual fantasies about patients? Unfortunately, it happensistock/Aldo Murillo
When it does, it’s very distracting and troubling.

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The people who pay for their therapy themselves seem to get better faster

The people who pay for their therapy themselves seem to get better fasteriStock/Yuri Arcurs
The patients who rely on insurance are typically not as motivated.

Sometimes I tell you to do the opposite of what I really want you to do

Sometimes I tell you to do the opposite of what I really want you to doiStock/KatarzynaBialasiewicz
For instance, I might tell you that this week I want you to be really depressed, to think about all the reasons you are depressed each day. It works for two reasons: First, nobody likes to be told what to do. And it helps you realize that you have a choice in how you feel.

Please don’t ask things like “Don’t you agree?”

Please don’t ask things like “Don’t you agree?”iStock/kupicoo
If you’re looking for approval, you’re not going to get it. A good counselor is not there to say yes to everything.

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No matter what you tell me, I’ve probably heard it before

No matter what you tell me, I’ve probably heard it beforeistock/sturti
You aren't going to shock me.

Unlike with cancer and heart disease, people with mental illness often think it’s their fault

Unlike with cancer and heart disease, people with mental illness often think it’s their faultiStock/FotografiaBasica
So when they get better, they’re proud of themselves for conquering adversity when, really, it was just the Prozac.

Get it straight: Psychiatrists are doctors who go to medical school; psychologists usually have a doctoral degree

Get it straight: Psychiatrists are doctors who go to medical school; psychologists usually have a doctoral degreeistock/megaflopp
Both of us can do therapy, but in most states, only psychiatrists can prescribe medication.

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If you feel isolated and alone in the world, I probably can’t cure you in psychotherapy

If you feel isolated and alone in the world, I probably can’t cure you in psychotherapyistock/Steve Debenport
That is the main issue for a lot of the patients I see. But the best thing you can do is go out in the world and help people.

Today I’m on this side of the couch, but tomorrow I could be on that side

Today I’m on this side of the couch, but tomorrow I could be on that sideiStock/Wavebreakmedia
A lot of us have our own issues.

In expensive cities like New York and Los Angeles, if you want a good psychiatrist, you’ve got to pay cash

In expensive cities like New York and Los Angeles, if you want a good psychiatrist, you’ve got to pay cashistock/FilippoBacci
The best psychiatrists don’t take insurance anymore, because they don’t pay us enough. If you go through your insurance, what you’ll get is a five-minute med check, not therapy.

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Yes, I may think you’re crazy

Yes, I may think you’re crazyiStock/dolgachov
But if you ask me, “Do you think I’m crazy?” I’m never going to tell you that.

Pharmaceutical companies love to give us free samples of the newest drugs

Pharmaceutical companies love to give us free samples of the newest drugsistock/Viperfzk
But a lot of the new drugs—at a much higher price—are very similar to drugs that have been around for a while. So if the first drug your doctor gives you is a new, expensive one, ask if you can try something generic first.

Most of what you say is confidential

Most of what you say is confidentialiStock/tomsickova
But if you admit to me that you committed child abuse or that you’re planning to physically harm yourself or someone else, I’m legally bound to report you.

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It makes me crazy when patients call me at all hours to have a chat

It makes me crazy when patients call me at all hours to have a chatiStock/Geber86
The fact that you can’t remember what it was I told you you’re supposed to do in a certain situation is not an emergency. Sources: Psychologists and psychiatrists in California, Washington, Pennsylvania, and Texas

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