5 Things to never say to a psychiatrist

In this blog we will discuss some of the things you should never say to a psychiatrist.

We will also discuss whether one should keep some information private from our psychiatrists or not. 

 Things to never say to a psychiatrist

Here are a few things you should never say to a psychiatrist:

Lies

It is important that you bring yourself to therapy with complete honesty and to avoid lies as much as possible- this includes white lies. 

Lying in sessions do more harm to you than to the psychiatrist- in fact, you lying to them is not going to cause any harm to them but rather it will hurt your journey in therapy extensively. 

So, even if you are afraid to disclose the truth for fear of rejection or have a sense of embarrassment over some details of your life, you should be truthly in sessions. 

Being dishonest or lying to your psychiatrist, you won’t be able to get to the root of whatever is causing you to be in therapy in the first place. 

Don’t say that you want to be friends

It is important that you are aware of the boundaries between you and your psychiatrist- your psychiatrist is not your friend nor are they someone you are casually seeing. 

The relationship between you and your psychiatrist is a professional one and psychiatrists must maintain professional boundaries with their clients. 

It is likely that you are likely to develop a close relationship with your psychiatrist, because of the intimate information you are sharing with them, you have to understand that they cannot be your friend- it is unethical.

Do not suggest meeting up

Because you and your psychiatrist share a professional relationship, do not discuss meeting up for coffee or developing a relationship outside of your therapy session.

Your psychiatrist shares a professional relationship with you and suggesting going out for coffee or some casual meet up will just create a difficult situation for your psychiatrist not to mention a total rejection from them. 

Don’t tell them you just want a prescription

Your doctor might prescribe you medication for your condition after they have determined a diagnosis. While medications can be beneficial, and even necessary, for people with mental health conditions like depression or anxiety, medications are often used alongside therapy. 

This means that if you are diagnosed, your doctor will suggest that you seek therapy however if you tell them you just one a prescription they might be weary as to your commitment for progress 

Avoid telling your psychiatrist that you want to be fixed

You have to understand that your doctor cannot fix you, they will help you deal with the problem and suggest ways in which you can get the help you need such as therapy and other lifestyle changes. 

Don’t waste time on small talk

It is normal for one to feel awkward about being in therapy and as a result of which you might be engaging in small talk to deal with the anxiety however, try not to avoid diving deeper into more pressing matters. 

You have one hour with them, if you waste that time on talking about surface level things it is unlikely that you will be getting the help you need. 

Don’t lie about serious symptoms

It is crucial that you do not lie about threatening symptoms such as suicidal ideation, eating disorder symptoms, or hallucianations etc. 

These symptoms could be a manifestation of serious and life threatening disorders and in order to get the help you need, you have to be honest and truthful with them.

Don’t ask about the other clients

There is no real point in trying to ask information about your psychiatrist’s other clients because it is very unlikely that they will disclose any information about their other clients. 

The same confidentiality that protects you also applies to your psychiatrist’s other clients. This means that you cannot ask them for information about other clients they’re seeing.

Don’t apologise for talking about yourself

Some clients tend to apoligise for taking up space and time in sessions as well as in the outside world. 

You must remember that the entire purpose of therapy is to discuss you, so you should never feel the need to apologise for talking too much about yourself. 

Things to never say to a psychiatrist: Issues related to legalities

You can tell your therapist illegal things- they are bound to listen to you, be empathetic as they help you process these confessions and help you through the process of coming to terms to what is being shared. 

The response of your therapist differs according to State laws as well as the regulations set by the licensing board that your therapist is bound to. 

Confidentiality is sacred in the profession and anything and everything you say in therapy is protected by law, and a court order is required to allow the therapist to break that confidentiality.

Even when the therapist is bound by court order to break confidentiality, most judges are very reluctant to issue such an order.

However, a therapist is bound by some form of “mandatory reporter” law where if a client makes the therapist aware of a crime that they are involved in, the therapist is more or less required to report this to the authorities. 

Some of the crimes that could land you in trouble with the law includes:

• Ongoing or impending abuse or neglect of a minor or a vulnerable adult- with disabilities. In such a case, the therapist will be required to report the crime to the authorities.
• A therapist may be required to notify authorities and/or potential victims if clients threaten physical harm to themselves or others- this include suicidal ideation.
• Fraud such as pretending to have a certain disorder inorder to access controlled pharmacological medication etc for illegal drug use. 
• In most cases, therapists are not legally required to report drug use. Crimes that you might report to them such as drug use (illegal drug use) remains strictly confidential and it is unlikely that you will be reported to the authorities when you tell them about your drug use. 

Confidentiality is an important aspect of therapeutic care considering that trust is necessary for clients since most of what is shared is often something they would like to conceal from others or at times, the problem tends to be the parents themselves. 

While a therapist must keep things confidential and it is part of their ethics to maintain confidentiality, there are limits to this confidentiality since therapists are bound by the ethical guidelines of their state licence.

For your own safety, there are some exceptions to the rule when it comes to confidentiality in therapy. Generally, these rules have to do with the well-being of the patient or people in the patient’s life.

For example, therapists are required to report if a patient is a threat to themselves or others. This may mean the patient has threatened suicide, is repeatedly harming themselves, or has threatened to harm another person. In this case, a therapist may recommend hospitalisation so the patient can be monitored. 

Once the patient is deemed stable, the therapist may then work with close friends or family members to develop a support plan for the patient in order to maintain that sense of stability.

Additionally, therapists are also required to report cases of ongoing child abuse or neglect. In these cases, a variety of public servants may be brought into the fold, including law enforcement or child protective services. Again, this is a measure created to ensure the safety of a patient and it should not deter you from being open and honest about your situation with your therapist.

Finally, if a minor is seeking therapy and is engaging in risky behaviour, their parents or guardian may be informed. Different states have different laws regarding minors in therapy, so it can be a good idea for the parent, therapist, and patient to sit down in an early session and establish ground rules.

What this means is that your therapist, if you are a minor, is mandated to disclose information if you are in danger or in harm’s way or if your behaviour is harming others, depending upon the laws of their state.

Your therapist will not tell parents about various situations that you present in sessions unless you are in threat of harm according to ethics and state law. However, you have to understand that all of this is for your own well-being and safety and otherwise they would not normally do this since they want to provide you a safe space to talk as well as they take your privacy very seriously.

There are some Laws that are also in place to protect your privacy such as The Health Insurance Portability and Accountability Act (HIPAA) which contains a privacy rule that ensures that an individuals’ medical records and personal health information are protected which also includes information about therapy. 

At your first visit with your therapist, they should give you enough information about confidentiality and limits of confidentiality as well as information explaining privacy policies and how your personal information will be handled. 

When it comes to discussing confidentiality and privacy with younger children, the therapist along with the child and parents will discuss confidentiality together and also discuss ground rules so that both parties know what type of information will be shared with parents and what will be kept private. 

Conclusion

In this blog we have discussed some of the things you should never say to a psychiatrist.

We have also discussed whether one should keep some information private from our psychiatrists or not. 

FAQ related to Things to never say to a psychiatrist

What are the qualities of a good psychiatrist?

Some signs that your psychiatrist is a good one and a keeper includes:

• Empathetic 
• Active and Engaged
• Learning
• Updated
• Open and conscientious

What type of interest does a psychiatrist have?

Based on Holland’s theory of career interests, Psychiatrists tend to be predominantly investigative individuals- inquisitive and curious. Often they could also be artistic and have social interests geared towards helping others. 

Do psychiatrists get burnt out?

Yes, psychiatrists as well as other mental health professionals do get burnt out because of the demands of their profession such as working 50 hours every week, with about 60 percent of work hours devoted to care etc.

REFERENCES

7 Things I ‘Shouldn’t’ Have Said to My Therapist — but Am Glad I Did. healthline. https://www.healthline.com/health/mental-health/7-things-i-shouldnt-have-said-to-my-psychiatrist-but-am-glad-i-did

What Not to Say to Your Therapist. Verywellmind. https://www.verywellmind.com/what-not-to-say-to-your-psychiatrist-5186539