Why Do People in Relationships Keep Secrets From Each Other?

In a prior article, I discussed the difference between privacy and secrecy in a relationship (see my article: Privacy vs Secrecy in a Relationship).

What's the Difference Between Healthy and Unhealthy Secrets in a Relationship?

Aside from maintaining your own privacy in a healthy way, there can be other healthy reasons for maintaining certain secrets.

Discovering Secrets in a Relationship

Healthy Secrets

An example of a healthy secret would be a surprise. For instance, if one of the partners is planning to propose, they would probably want to surprise and delight their partner by taking them to their favorite restaurant and proposing with an engagement ring.

Similarly, one of the partners might want to surprise the other with a gift, a birthday party or a much desired vacation.

In both cases, these secrets were temporary and would add to the partner's pleasure.

Unhealthy Secrets

Unhealthy secrets include but are not limited to:

• Hiding Deceitful Behavior: Using a secret to hide deceit; manipulation; betrayal, lying, including lies of omission, often leads to mistrust and can ruin a relationship.  An example of this would be infidelity, including emotional infidelity.

• Hiding Serious Issues: Hiding serious issues, like serious medical problems; financial issues, including financial infidelity; an addiction, among other issues, can weaken or destroy a relationship. 

Why Do People in Relationships Keep Secrets From Their Partner?

There can be many reasons why people keep secrets from their partner, including:

• Maintaining Power and Control: The partner who is keeping a secret to maintain power and control over their partner is engaging in an unhealthy dynamic. Maintaining this dynamic can lead to a decrease in emotional intimacy, emotional distancing, resentment and the potential demise of the relationship.

• Feeling Shame and Guilt: Someone who feels ashamed or guilty about something they did will often keep it a secret because they fear their partner will reject or leave them.

• Feeling Fear of Criticism and Judgment: Even if a partner doesn't leave, they might be critical or judgmental about what their partner did, so the partner keeps it a secret so they don't have to deal with the criticism or judgment.

Keeping a Secret Due to Fear of Criticism

• Avoidance: Related to the above, someone might want to tell their partner about their secret, but they fear how their partner might react, so they procrastinate. The procrastination might be short term or it can be indefinite.

• Experiencing Lack of Trust in the Partner: When someone doesn't trust their partner, they might not want to be vulnerable by revealing what they did, so they keep it a secret.

• Having Poor Communication Skills: Someone who doesn't have good communication skills might not know how to reveal something negative to their partner, so they keep it a secret.

• Having Poor Interpersonal Skills: Someone who has poor interpersonal skills might not know how to approach their partner about something they did, so they keep it a secret.

• Having Poor Relationship Skills: Similar to poor interpersonal skills, someone who has poor relationship skills might not understand the importance of being open and honest with their partner. In many cases, they grew up in a household where good relationship skills weren't modeled for them, so they never developed these skills. There might also have been toxic family secrets.

• Not Wanting to Be Accountable to a Partner: Similar to poor relationship skills, someone might not want to be held accountable by their partner for their actions.

• Being Selfish/Self Centered: Someone who is self centered and selfish might only think of themself and not how their secret might affect their partner.

• Wanting Revenge Against Their Partner/Payback: If someone is angry about something their partner did, they might intentionally keep a secret as a way of getting back. This often happens with infidelity where one partner finds out the other partner cheated and the first partner cheats too as a form of revenge--even though they keep the infidelity a secret.

• Wanting to Be the Betraying Partner After Having Been the Betrayed Partner in a  Current or Prior Relationship: When someone was betrayed in a prior relationship, they might want to gain power in the next relationship by being the betraying partner.

How Can Secrets Ruin a Relationship?

• Secrets Are Stressful: Keeping a secret often involves a lot mental and emotional energy on the secret keeper's part, which creates stress.  The partner who is keeping the secret might also feel stressed because they fear their partner will find out their secret. If someone is keeping a secret from their partner, they might are not be open and honest about other issues in the relationship.  

Secrets Are Stressful

• Secrets Create Mistrust and Resentment: When someone finds out their partner is keeping a secret, they can feel mistrustful of their partner as well as hurt and resentful. 

• Secrets Hurt Both Partners: Keeping a secret hurts both people. The secret becomes burdensome for the secret keeper. Snt,ecrets also create emotional distance between the two partners, which can result in loneliness for both people (see my article: Are Toxic Secrets Ruining Your Relationship?).

Getting Help in Therapy

Whether you're the secret keeper or you're in a relationship where you have discovered your partner has been keeping a secret, you don't have to struggle alone. You could benefit from working with a licensed mental health professional (see my article: Coping With Secrets and Lies in Your Relationship).

Getting Help in Therapy

If you're the one who is keeping a secret, being able to let go of a burdensome secret can free you from guilt and shame.  You can also work with a skilled therapist to how you want to deal with the issue.

If you're the one who has discovered a secret, you might feel overwhelmed with emotions that a licensed mental health professional can help you to work through.

Couples therapy can help you to work through a betrayal and strengthen your relationship, if you choose to stay together, or end your relationship in an amicable way, if you choose to end the relationship, so you don't bring issues from the current relationship to the next relationship (see my article: What is Emotionally Focused Therapy For Couples?).

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up an appointment, call me at (917) 742-2624 during business hours or email me.

Privacy versus Secrecy in a Relationship

Knowing the difference between privacy and secrecy is essential, especially if you're in a relationship.

Privacy vs Secrecy in a Relationship

Although sharing the vulnerable parts of yourself is important for having a strong emotional connection in your relationship, everyone is entitled to privacy, so knowing the difference between privacy and secrecy is important.

What's the Difference Between Privacy and Secrecy in a Relationship?

Here are brief descriptions of privacy vs secrecy so you can compare the two lists to see the difference:

Privacy

Privacy in a relationship refers to having healthy personal boundaries including (but not limited to):

• Thoughts

• Fantasies, including sexual fantasies

• Dreams

• Opinions

• Having private time alone

• Experiences which are separate from your relationship--as long as it doesn't involve withholding information which would be harmful to your relationship (then, this would be secrecy and not privacy)

Secrecy

Secrecy in a relationship involves something unhealthy that you're intentionally hiding from your partner including (but not limited to):

• Cheating on your partner

• Financial infidelity: Hiding financial information or being dishonest about money that belongs to you and your partner

• Being dishonest or purposely misleading your partner/obfuscating

• Violating your partner's trust

• Other things that would be hurtful to your partner and disruptive to the relationship

Clinical Vignettes

The following vignettes, which are composites with all identifying information removed, illustrate how couples can get in trouble with regard to privacy vs secrecy:

• Julie and Tom - Issue: Privacy: Julie and Tom, who were both in their late 20s, had been in an exclusive relationship for six months. Both of them had only ever been in one prior committed relationship before their relationship together. Julie insisted she wanted to know if Tom had sexual fantasies about other women, but Tom felt Julie was crossing a personal boundary by asking him about his private thoughts. He assured her that he didn't want to be with anyone else and he would never cheat on her, but Julie continued to insist he tell her if he ever had sexual thoughts about other women. After numerous arguments, Tom broke up with Julie because he felt she was being too intrusive and controlling, and she wasn't respecting his personal boundaries.

Privacy vs Secrecy in a Relationship

• Bill and Ellen - Issue: Secrecy: After five years of marriage, Ellen discovered that Bill had withdrawn over $5,000 from their joint bank account without telling her. When Bill was confronted by Ellen, he told her that he used the money to pay off credit card debt on a card that was under his name before they got married. He said he didn't think he needed to tell her because he planned to put the money back in the account when he got paid later that week. But Ellen felt betrayed by Bill's secrecy and she told him she would find it difficult to trust him after this. She insisted they go to couples therapy to work through this betrayal. Although he didn't see what he did as a betrayal nor did he see the necessity of going to couples therapy, he agreed because he didn't want to lose his marriage. While in couples therapy, Bill learned the difference between privacy and secrecy, and Ellen and Bill worked to repair their relationship.

• Maggie and Pete - Issue: Secrecy: When Pete's best friend told him that he had seen Pete's wife, Maggie, holding hands while coming out of a hotel with an unknown man, Pete was crushed. At first, Maggie denied the affair, but after Pete asked to see her phone, she refused to show it to him. But she eventually admitted the next day that she had been having an affair for the last six months. She also admitted to two other sexual affairs starting four months after they got married. She apologized profusely and told Pete she never meant to hurt him, but Pete wasn't ready to accept her apology.  He moved out of their New York City apartment for three weeks to think over what he wanted to do. Although he didn't know if he could ever trust Maggie again, he agreed to attend couples therapy to try to repair their relationship.

Privacy vs Secrecy in a Relationship

• John and Bill - Issue: Privacy: Prior to moving in together, John and Bill had a long talk about their two year relationship. John told Bill that he needed some time to himself each day--even if it was just for an hour. Bill agreed, but after they moved in together, he got annoyed whenever John wanted to meditate in their bedroom for 30 minutes each morning. Even though they spent a lot of time together during the week and on the weekends, Bill felt ignored by John when John wanted this time to himself. When they were unable to work this out on their own, they attended couples therapy to learn to negotiate privacy versus secrecy. Bill discovered that since he was never allowed to have any privacy as a child, he didn't really understand privacy, but he was willing to work this out in therapy with John (see my article: Learning to Compromise About Spending Time Together).

In the next article, I'll discuss how to share a secret with your partner.

Getting Help in Couples Therapy

If you and your partner are having problems concerning issues related to privacy and secrecy, seek help in couples therapy.

Rather than struggling on your own, you can work with an objective couples therapist who can help you to work through these issues.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing, Emotionally Focused Therapy For Couples (EFT) Therapist and Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

   

What's the Difference Between Privacy and Secrecy in a Relationship?

There can be a thin line between privacy and secrecy in a relationship.

Since this is a topic that often comes up in couples therapy and sex therapy sessions, it's the focus of the current article.  

Privacy vs Secrecy in a Relationship

Where you draw the boundary between privacy and secrecy is a personal choice, but be aware that there can be serious consequences to keeping secrets, especially if you or your partner feel betrayed.

What's the Difference Between Privacy and Secrecy?

Let's start by defining the difference between privacy and secrecy and then looking at examples of each.

Privacy

Generally, privacy is consensual with both parties agreeing to the boundaries.

Privacy is also non-threatening to you and your partner because you have an agreement.

Privacy vs Secrecy in a Relationship

Secrecy

Secrecy is nonconsensual.  It hasn't been agreed to by you and your partner and there's no understanding about the boundaries. 

There are often selfish motives to secrecy that only protect the interests of the partner keeping the secret and would be potentially detrimental to the other partner.

Questions For Self Reflection

You and your partner might differ in how you each understand privacy and secrecy, which can create conflict and even jeopardize your relationship.

As a first step, it's important to do some personal introspection and consider the following questions for yourself:

• What are your true motives in keeping something hidden from my partner?

• Are you spending a lot of time and effort in trying to keep it hidden?

• Are you deluding yourself about the possible consequences by telling yourself, "What my partner doesn't know won't hurt them?"

• Are you hiding people, activities, plans or events in your life from your partner?

• Are you hiding financial matters from your partner, like credit card bills, hotel receipts and so on, when you have an agreement to share financial information (see my article: Financial Infidelity is a Major Issue in Many Relationships)

• Are you enlisting the help of friends or family members in keeping aspects of your life hidden from your partner?

• What are the underlying emotions involved with your behavior? Fear? Shame? Anxiety? Guilt? Sadness?

• Has your behavior created emotional and/or sexual distance between you and your partner due the hidden aspects of your life and your underlying emotions about it?

• Is your behavior potentially harmful to your partner if they find out or if others find out?

Answering "Yes" to the questions listed above point to keeping a secret rather than maintaining privacy. 

Lies include not only what you say but what you don't say, which are considered lies of omission (see my article: When Trust Breaks Down in a Relationship: Lies of Omission).

Also, consider these questions:

• As an empathetic person who cares about your partner, do you have a sense of peace about not revealing certain matters to your partner?  

• If so, what's behind your sense of peace?

• Does your decision coincide with an understanding and agreement you and your partner already have?

If you're being honest about your motives and you said "Yes" to the three questions immediately above, it appears that you're maintaining your privacy and not keeping secrets.

An Example of Maintaining Privacy

Angela and Sara are in a long term relationship. They each know that the other masturbates privately and they have agreed they don't need to talk about the details of their sexual fantasies when it involves other people--as long as they don't get involved with others in real life. Neither of them feels threatened by these fantasies.

Privacy vs Secrecy in a Relationship

An Example of Keeping a Secret

Jim and Betty have been together for two years, and they have an agreement to be monogamous. Jim values his relationship with Betty, but he can't stop thinking about his ex, Jane.  Occasionally, he meets Jane for coffee without telling Betty. He and Jane talk about the possibility of getting back together again, but Jim doesn't want to break up with Betty.  Jim justifies these get-togethers with Jane because he tells himself that nothing sexual has occurred between them. So, he believes he hasn't done anything wrong. He also feels that since Betty doesn't know that he meets with Jane, she won't be hurt by it. But one day Betty walked into the cafe where Jim and Betty go. She saw them sitting close together and talking softly, and she felt devastated and betrayed. Later that night, she confronted Jim, but he denied doing anything wrong. Soon after that Jim and Betty started couples therapy to try to work out their differences with regard to privacy and secrecy and Betty's feelings of betrayal.

Conclusion

There's a difference between privacy and secrecy in a relationship.

Each couple needs to have an understanding of what the boundaries are in their relationship and honor their agreement.

If you're confused about whether you're maintaining your privacy or keeping a secret, ask yourself the self reflective questions mentioned in this article.

If you are intentionally withholding information from your partner which leads your partner to believe things that are untrue (like you're monogamous when you're cheating), this is considered a lie of omission and your maintaining a secret.

Getting Help in Couples Therapy

If you're having problems in your relationship with secrets, get help in individual or couples therapy.

A skilled psychotherapist can help you to lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Ethical Issues With Using Managed Care For Psychotherapy

In a prior article, I discussed why it has become so difficult to find a psychotherapist in New York City on managed care panels.

This is a problem not just in New York City but all over the country.  In the current article, I'm expanding this discussion to include ethical issues involved with using managed care for psychotherapy.

Ethical Issues With Using Managed Care For Psychotherapy

The purpose of this article is to provide information to clients who are considering using their managed care benefit to attend psychotherapy so that clients can be informed consumers.

Ethical Issues About Using Managed Care For Psychotherapy
Managed care companies' main focus is saving money.  Although most managed care companies would deny it, their allegiance is to their shareholders--not to their subscribers.  When saving money is the main focus, this inevitably leads to certain ethical problems, including:

• Problems With Client's Privacy/Confidentiality:  When a psychotherapist enters into a contractual agreement with a managed care company, she will, most likely, have to share your confidential information with managed care representatives because it is demanded by the managed care company.  In effect, not only is the confidential information shared with the representative on the phone (or sometimes by mail or on the insurance company's website), but the information also becomes available to hundreds of other employees at the managed care company.  This is becoming even more of a problem than when I wrote the about this before because in the last few years there have been breaches in confidentiality when insurance companies sites were hacked.  This exposed thousands of insurance subscribers to having their personal information used illegally, possibly including information about their psychotherapy sessions.

• Problems With the Intrusive Nature of Managed Care: Managed care representatives often contact in network psychotherapists to find out why clients are still in therapy; to make "suggestions" about how psychotherapists should change clients' treatment plans, including referring clients for medication, even when clients have made it clear that they're not interested in medication; and, possibly reducing the frequency of sessions from weekly to every other week or less.  Often, the managed care representatives demand that psychotherapists justify their clients' treatment in writing in order for clients to be able to continue in therapy.  This often involves the representatives asking for detailed personal information about the clients' problems; what else the clients have attempted to do, aside from going to therapy (e.g., joining support groups, seeing a psychiatrist, etc) and so on. 

• Potential Conflicts of Interest For Psychotherapists on Managed Care Panels: To save money, managed care companies prefer short term treatment, even, at times, when clients are in crisis or very depressed and they need longer term treatment.  Many psychotherapists who are on managed care panels are aware that they are more likely to get referrals from managed care if they do brief therapy--even when clients need more intensive therapy.  This often leads to psychotherapists, who are on managed care panels, making decisions based on their financial needs rather than the needs of their clients.  In other words, if a psychotherapist is aware that a managed care company prefers psychotherapists who do brief treatment, he will be placed in an ethical dilemma because he knows that the managed care companies will look at their records to see which therapists only keep clients for a short period of time before terminating treatment so, in the long term, it is in his financial interest to keep clients for only a few sessions so he can get more referrals from the managed care company.  This often leads to poor treatment because the psychotherapist might only be focused on "shoring up" clients rather than helping the client to make meaningful change.  Clients might "feeling better" for a short time and then, after a while, they need to go back several other times to the prior therapist or to a new therapist because their problems were not resolved in short term therapy.  It also discourages clients from seeking help in therapy because, after going through several cycles of short term therapy with poor results, clients will often conclude that "therapy doesn't work" rather than that their therapist might have been pressured by managed care to provide suboptimal care.  This is not to say that all psychotherapists on managed care will choose less than optimal care because many will do what is best for the client, but it is a potential ethical dilemma.

Ethical Issues With Using Managed Care For Psychotherapy

• Potential Problems With Quality of Care:  As mentioned above, when psychotherapists on managed care panels are pressured by the insurance company to provide short term therapy, even when the client needs longer term therapy, the quality of care often suffers.  In order to justify longer treatment, psychotherapists often must go through a lengthy and time consuming process of providing increasingly more detailed information as to why clients need more therapy sessions.  Not only is this time consuming for the therapist, it also compromises confidentiality, as mentioned above.

• Pressure From Managed Care Regarding Medication:  As mentioned above, managed care companies often pressure psychotherapists to refer clients to psychiatrists for medication, even if the clients do not want to take medication and, in many cases, do not need medication.  Often, the representatives making these clinical "recommendations" are Bachelor's level employees, if that, and far less qualified to make these clinical decisions than the psychotherapist treating the client.  Once again, the focus is on saving money rather than  providing quality of care for clients.  

• Restricted Choice of Psychotherapists:  In order to save money, most managed care panels are narrow with a restricted number of psychotherapists listed by zip code.  This saves the managed care company money because there are fewer psychotherapists to choose from and the ones who are on the panel, who are often are other managed care panels, are forced to take many clients in their private practice in order to make financial ends meet due to low managed care reimbursement.  This usually meets that it is very hard to find a psychotherapist in your area who has openings because therapists are all booked up.  Also, many of the therapists (although not all) are new therapists who are starting their private practice and willing to take managed care until they can build their practice.  

• Diagnosis and Stigma: Managed care for psychotherapy is usually based on medical necessity, which means that a client must have a diagnosis that the managed care company deems necessary to cover this client.  As a result, psychotherapists must provide a diagnosis to the managed care company for each client that the managed care company will accept.  Once again, this brings up issues around confidentiality and privacy because these diagnoses are on the managed care computer system.  Also, as mentioned above, when a managed care company's website is hacked, the client's confidential information, including diagnosis, could be exposed (see my article: see my article: Psychotherapy: You Are Not Defined By Your Diagnosis).

What to Do to Avoid or Mitigate These Problems With Managed Care
Obviously, there are many clients who must use their managed care plan because they cannot afford to self pay for therapy.  If this is the case for you, you should, at least, enter into this process knowing what is at stake.  If this is the only way that you can access mental health treatment, it's better to use your managed care insurance than not to go to therapy at all.

Steps To Take to Be An Informed Consumer

• Find Out If Your Company Has a Health Savings Plan:  This is an alternative to using your managed care benefit that many people use.  Your human resources or health benefits representative should be able to tell you if your company has a health savings plan, if you are eligible for the plan, and how to use it.  If your company does not have health savings plan, you and other employees can advocate for this benefit.  Express your concerns to your concerns about these issues and find out what steps the company can take to remedy them.

• Find Out If Your Insurance Allows Out of Network Psychotherapy: When you go out of network, your benefit is not managed by the managed care company, although there might be some restrictions with regard to the deductible and how much the insurance will reimburse you depending upon the plan that your company negotiated with the insurance company.  If your company does not offer out of network benefits, you and other employees can advocate for it.

• Discuss Your Concerns With Your Psychotherapist: If your company does not have a health savings plan, out of network benefits or if you really need to use your managed care benefit, speak with your therapist about your concerns regarding diagnosis, confidential/privacy and quality of care.  You have a right to know the diagnosis that your psychotherapist is submitting to the managed care company.  You also have a right to know what information your therapist is providing to the managed care company if the insurance representative indicates to your therapist that they must do a review of your case.  You can stipulate what you want/do not want shared.  However, be aware that if your therapist does not share information that the managed care company considers necessary to approve additional sessions, you might not be able to continue in therapy.  This is another ethical dilemma.

Ethical Issues With Using Managed Care For Psychotherapy

• Consider Your Priorities:  Only you know your financial situation.  There are times when you might be forced to use your managed care health benefit to access therapy because you cannot afford to pay out of pocket.  This is understandable.  But it is often worthwhile to look at your priorities and assess how your spending your money and how you want to spend your money.  Take a look at your budget and make decisions based on what is important to you.  At certain times, it might be worth it to you to forgo certain expenses, like buying packs of cigarettes or buying expensive coffee in order to have quality mental health treatment.  

• Consider Sliding Fee Scale Mental Health:  There are certain mental health centers that offer sliding scale therapy based on household income.  Most of them will request proof of household income in order to assess your fee.  Many of the psychoanalytic institutes have referral services to their candidates in training where you can see a licensed psychotherapist in their training program for a reduced fee.  These students are usually supervised by senior clinicians.

Getting Help in Therapy
Many people need to use their managed care health benefit in order to access psychotherapy.  However, many of those same people are unaware of the issues involved with using managed care benefits for psychotherapy.

No one who needs mental health services should ever go without treatment regardless of whether you use your managed care benefits or not.   At the same time, it is important to be an informed consumer.

If you have problems that you have been unable to resolve on your own, you could benefit from seeing a skilled psychotherapist who can help you to overcome your problems (see my article: The Benefits of Psychotherapy).

A licensed psychotherapist can help you to overcome the problems that are keeping you from maximizing your potential (see my article: How to Choose a Psychotherapist).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

The Psychotherapy Session: A Unique Intersubjective Experience

Over time, people who are in therapy come to appreciate the uniquely private space of the therapy room.

The Therapy Session: A Unique Intersubjective Experience

Considering how busy most people are these days, other than their therapy sessions, many people don't take the time to reflect on what's going on in their lives and to get objective feedback.

For many people, the psychological insights that they have about themselves occurs in their therapy sessions.

The Privacy of the Therapy Session
In recent times, privacy has been eroded to such an extent that there are few (if any) other places where someone can come in and say whatever is on his or her mind in an accepting, objective, nonjudgmental private place.

Making Connections Between the Present and the Past in Therapy 
It's also a unique environment where an experienced therapist is trained to help clients to make possible connections between what is going on now and the past, and to begin to understand the many different aspects of themselves.

Most people don't feel immediately comfortable divulging a lot of private information about themselves at first.  It takes time to build a relationship with a therapist and to establish a rapport.

The Therapeutic "Holding Environment"
The attuned therapist creates a comfortable, secure environment for the client where the client feels heard and cared about (see my article:  The Attuned Therapist Creates a Therapeutic Holding Environment).

During the initial therapy sessions, it's important for the client and the therapist to each assess if they are a good "match" to continue to work together.  There aren't any specific steps for the client to determine this.  Mostly, I recommend that clients trust their intuition.

The Therapy Session: A Unique Intersubjective Experience

For the therapist, it's important that she work within the scope of her knowledge and skills.  So, if a client is looking for a therapist with a particular specialty, it's important for the therapist to reveal whether or not this is one of her specialties.

When it's a good match, over time, clients develop a comfort level where they feel they can talk about anything with their therapist.

Of course, there will be times when clients will feel ashamed to talk about certain topics, but it's important to remember that most experienced therapist have heard just about everything and, most likely, won't be shocked by what clients say.

Having a compassionate, skilled therapist and the time and place to talk about whatever is on a person's mind is a very freeing experience that is rare.

Many people, who are in therapy, look forward to attending their therapy sessions because it's such a unique experience where they have their therapists undivided attention and the time is dedicated to them.

Unconscious Communication:  The Intersubjective Space Between Therapist and Client
Clients and therapists often talk about getting into a particular intersubjective space that is unique to their particular therapeutic relationship (see my article:  The Psychotherapist's Empathic Attunement).

Within this intersubjective space, there is a form of unconscious communication between client and therapist that is particular to that client-therapist dyad.

As a result, there is more being communicated than the words that are being spoken.

There is also a latent communication that therapists, who are trained to work with unconscious communication, experience on a felt sense level.

Many clients will often talk about how they also sense this unconscious communication that is part of the intersubjective space between client and therapist.

Although there is always unconscious communication between people who are together, the unconscious communication between therapist and client is more focused than it would be between two other people and it usually develops over time.

When there is a good match between a therapist and client, it's not unusual for a therapist to intuitively sense what a client is about to say or for a client to sense what a therapist is about to say.

This is because this unconscious communication is "in the air" between them.

Choosing a Therapist
Thinking of the first session as a consultation is a good way to approach that first session.

Not only are you talking about your problems in a broad way, you're also getting a sense for whether you feel comfortable with the therapist.

You might not be able to tell in the first session, but after the a few sessions, you usually get a sense as to whether it's a good match.

For more information about how to choose a therapist, see my article:  How to Choose a Psychotherapist.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, see my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.