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.

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


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

istock/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

iStock/Jacob Ammentorp Lund

The stranger your story, the better.

Content continues below ad

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


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.


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


Some of us will say yes.

Content continues below ad

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

iStock/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

iStock/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

istock/Aldo Murillo

When it does, it’s very distracting and troubling.

Content continues below ad

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

iStock/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


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?”


If you’re looking for approval, you’re not going to get it. A good counselor is not there to say yes to everything.

Content continues below ad

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


You aren't going to shock me.

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


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


Both of us can do therapy, but in most states, only psychiatrists can prescribe medication.

Content continues below ad

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

istock/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


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


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.

Content continues below ad

Yes, I may think you’re crazy


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


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


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.

Content continues below ad

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


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

View as Slideshow

Want to stay smart and healthy?

Get our weekly Health Reads newsletter

how we use your e-mail
We will use your email address to send you this newsletter. For more information please read our privacy policy.