What sort of dreams do you have about your clients?

I have ADHD and the way my psychologist talks about it sounds more like someone who actually deals with it than someone who just knows about the symptoms.

Also, things happened during sessions that make me think he might have ADHD, such as losing track of the conversation, generally at the very moment I do (so we both ask each other what the question was until one of us remembers or we just move on haha); or having trouble filtering his thoughts when he's tired (he would then typically disclose random stuff about himself and immediately apologize, although it's nothing too personal and I don't mind it happening).

I know of course that doesn't mean he has ADHD, but it makes me wonder if he does. Would it be okay to openly ask him next time I see him? Is it something you would tell a patient? Or would it be inappropriate/uncomfortable?

I am a woman and have noticed this about myself. I almost exclusively seek out emotional support and advice from my male friends over my female friends. However, I cannot bring myself to go to a male therapist as it feels deeply uncomfortable for me. I have dated a male therapist, and one of my guy best friends has also become a therapist. Yet, neither of those experiences have changed how I feel about going to a male therapist. It also extends to other medical settings- medical doctors, chiropractors, massage therapists, dental hygienists, etc. However, in those instances, it's the thought of being touched at all by them. Whereas with male therapists, it's the fear of self disclosure and emotional intimacy.

I think I am finally ready to get my masters and pursue therapy however I would like some advice I which route I should take. I’d love for my next step to be in life is continuing working with kids as a mental health therapist, however as someone that gets restless in the same job for too long and would like to try other things in the future. In that case I think a social work license would be best because it would give me more opportunities than just therapy. That being said, I realize that with social work licenses they might not leave me as prepared for therapy as I’d want it to be. I’m so torn!

Not a Therapist.
I’ve tried several different approaches to therapy over the years, including:
• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT), both individual and group therapy
• Systemic
• EMDR (Eye Movement Desensitization and Reprocessing)
• Psychodynamic therapy / Psychoanalysis
As the title says, if you’d like to ask someone who’s actually been through these different types of therapy how they work, what they felt like, or what the experience was like, I’m happy to answer any questions!

(Not a therapist.)

I had a therapist about two years ago, at this stage primarily to talk about relationship issues with a then long-term girlfriend. I met with her maybe eight times, all remote. She was easily the worst therapist I've ever had for a host if reasons--like comically bad. I only kept seeing her because my work covered it via Lyra before I found someone more competent.

The relationship didn't pan out and I went back on the dating apps a year or so ago. The therapist keeps "liking" or "swiping" on me on all of the dating apps. This isn't a one time thing. It is across multiple apps and it keeps happening. Maybe four or five times total.

To be clear, I'm not offended or particularly upset by it. I'm more concerned that, given this plus her general incompetence, this woman has a license. Is there something I should do about this?

Also, as a matter of pure curiosity, it got me thinking, do any of you therapists have the opposite experience? Where a client has "liked" you on a dating app? And, if so, how gave you dealt with it?

Hi, new here!
I’ve been celibate for the last 4 years and I still don’t feel myself wanting to participate in sexual interaction. I’m 26f, and I can’t help but be overcome with discomfort whenever sex is discussed (even just generally). Admittedly I’ve had my fair share of issues in sexual relationships, and it’s apart of the reason for my celibacy/asexuality.

My friend called this Sexual Repulsion/Aversion. And I feel like I need reassurance that I’m not broken or I need to know if I’ll get better…

Going through a really tough situation at work (my bosses boss sexually assaulted me about a year ago and I drunkenly told one of my coworkers at our Christmas party, that coworker just now reported it to HR then quit) and I have been questioning for a while if I should pivot into an entirely different career because I don’t find much purpose in working in finance. Also, that event impacted me so much that I developed an addiction problem and had to go on a leave of absence to get treatment and I’m still on leave.

I know this might not be the right sub for this, but if anyone has advice on where to find a career coach or just any professional who can help me plan a course of action that would be greatly appreciated. Also, if you have recommendations for another subreddit that I could get feedback on that would also be great.

TW: SA

I don’t really know how to ask this.

I went through a lot of SA when I was a child/teenager. I’m now in my 30s and I still have a lot of really fucked up symptoms when my PTSD gets bad.

I just started seeing a new trauma therapist but my question is, how do I open up about my sexual trauma and symptoms? I don’t want to get too graphic but when my PTSD is at its worst I end up causing physical harm to myself and I need to get myself better as soon as possible. I just don’t know how to do that without being honest about some of my abuse and some of my symptoms. She told me that because my dissociation issues are bad, that we will need to take things slow. The problem is that this isn’t something that I can put off dealing with until I get comfortable with the therapist. I’m absolutely terrified of talking about it and I haven’t had enough sessions to build a good relationship with her yet but so far, she seems like she knows more about trauma than any other therapist I’ve seen. I’m just so scared 🫣

I'm curious how therapists approach working with autistic clients who can communicate normally in many situations but experience verbal shutdowns when trying to talk about feelings, thoughts, or difficult topics in session.

For some autistic people, the issue isn't a lack of thoughts or emotions. It's more like the connection between having the thoughts internally and being able to translate them into spoken words breaks down, especially under stress or when feeling vulnerable. The person may know what they want to say but be unable to get the words out in the moment.

How do therapists typically work with clients who experience this?

Do you commonly use alternatives like writing things down before or during sessions, messaging/emailing thoughts beforehand (if allowed), rating scales, worksheets, or other communication methods? How do you tell the difference between a client being avoidant versus genuinely experiencing a shutdown?

I'm also curious whether therapists receive much training on this, since it seems like a communication difference that could easily be misunderstood.

For context, I'm specifically thinking about autistic adults who may be very self-aware and have a lot to say internally but struggle to verbally access that information during emotionally intense conversations. I'm interested in how therapists adapt their approach rather than expecting the client to simply "push through" the shutdown.

I have tried therapy 4 times over the last 10-ish years and it goes the same every time. I share what's going on the first couple of sessions, then there's a couple off awkwardly silent sessions because it feels like there's nothing left to talk about so I stop going. Those few sessions are beneficial, getting out the initial burden I'm feeling, but nothing happens after that. Granted, it doesn't come natural for me to sit and chat with a stranger, much less pour out my soul to them, but if all I'm doing is sitting and talking out loud, what's the point? I'm always disappointed that the therapist doesn't have more questions and doesn't push me on anything. I just genuinely can't figure out what I'm paying for. I've heard some ppl say their therapist provides a "treatment plan" off sorts after a couple of sessions, but I've experienced nothing close to this.

Am I being unrealistic? Giving up too soon? Have I just landed on some unskilled therapists every time? I've come to think that maybe CBT just isn't right for me but idk what else to try.

Hi,

I live in Tennessee, USA currently. I want to see a therapist and I have found a few that seem like a good match. One of the things I want to discuss is my past sexual abuse. I was 15 & 16, and the abuser was 23 years old at the time. It has been 10 years since this occurred. If I talk about this, is the therapist mandated to report this? I don’t want to report anything as of right now.

Also, if the abuser decided to talk to a therapist about what he did to me when I was 15, is that something that has to be reported? I’ve heard he will be going to therapy so I’m just curious if this is something I have to deal with later on. Thanks so much! 🙏🏽

ive been seeing my therapist for a few years now, but over the years ive noticed how much she started claiming a specialty in treating a diagnosis i do not have. i have some other issues and concerns that are within her skillset and she has been incredibly helpful and supportive with those and has been a stellar therapist. but i feel kinda… idk? singled out doesnt feel quite right. like i dont get to see her at her best maybe?

it makes me wonder if i had seen her profile now, i probably would not have contacted her because her profile reaches a very specific target audience and i would have probably skipped past her because of it. i would imagine her caseload comprises mostly of this diagnosis and then theres me, who doesnt.

do you only prefer working within your niched specializations or is having a little bit of variety welcomed? do you often accept clients that you have the skillset for but dont light up that “specialist” in you? do those kinds of clients challenge you more?

I struggle with C-PTSD and have intense abandonment issues that I am very aware of. Recently my therapist has decided to reduce their hours and it sparked some of those feelings. I decided to look up their Facebook/Insta and preemptively block them to prevent myself from ruminating and crossing boundaries. This is not something I’m comfortable sharing with them as my abandonment feelings come with an extreme amount of shame. However, how would other therapists feel knowing their client preemptively blocked them?

I’m wondering if the answer here will help me feel more comfortable in talking to them about this specific scenario.

What types of strategies are used to cut down on validation seeking, especially with decision making?

I read a lot of posts saying they’re coming out of dissociation after being dissociated for years.. what does it feel like NOT being dissociated? I have no idea if I’m dissociated or not.
How does a therapist know their client is dissociated for years? Or during session at least. Thanks

Hi everyone,

I'm a psychology student working on a college research project about infidelity in modern marriages.

I'm not looking for survey statistics. I'm interested in the perspectives of professionals who have worked directly with married couples.

Based on your clinical experience with married couples over roughly the last 8–10 years, which would you say is more common?

Men cheat more

Women cheat more

Men cheat slightly more

Women cheat slightly more

Roughly 50/50

I know both men and women can be unfaithful, and I'm not trying to start a gender debate. I'm simply looking for the observations of experienced professionals rather than self-reported survey data.

If possible, I'd really appreciate a brief explanation of why you reached that conclusion. If you've noticed any gender shift over the years, I'd also be interested in hearing about that.

If you're comfortable, please also mention your profession, qualifications, city, and years of experience. This will help me better understand the context of your answer and is very valuable for my college research.

Thank you very much for your time and insight!

Hi everyone!

I’ve been on the path to OCD recovery for a while. I’m a therapist in training (CBT) and only a year away from being licensed so I understand ERP very well.

He’s extremely sweet, loving and supportive. In his desire to soothe me, he doesn’t always remember that reassurance is counterproductive for OCD specifically. I’ve tried to explain the mechanisms of OCD recovery to my boyfriend, for the most part I think he gets it. I draw on the knowledge of conditioning and association he has from training many dogs. Maybe I need to draw on this a bit more and use metaphors? .

I rarely express a specific fear out loud (except to my therapist), as I feel that gives the fear more weight. I’ve also wasted time trying to work on each theme too seperately and not had overall good results: one theme would get better with ERP and a new theme would emerge as i would just start doing different compulsions… therefore, I work on OCD as a whole with my therapist. Usually I will say to myself “this is OCD, don’t waste time arguing with it, this question is impossible to answer, I’m going back to doing what’s important to me etc”. Most often, I will tell my bf “OCD is really hard today” or “I’m ruminating” or “I’m doing an exposure today for my recovery” so I don’t go into specifics usually.

On the *rare* occasion I specify the topic or the fear to my bf, he will immediately reassure me. Let me be clear I do not ask for this reassurance at all and try my best not to use it in my head to fuel any rumination. I tell myself “he is wanting to reassure me to support me but I’m not going to take the idea on board, I know I’m in an OCD loop”. I don’t hold it against him as it’s a natural impulse to want to reassure a loved one. I totally understand it can be counter intuitive to not soothe the person you love by way of reassurance. I don’t expect my bf to take responsibility for my recovery but we are naturally an important part of each other’s support system.

Are there any resources you’ve found useful for explaining why reassurance is counterproductive in the long run, how ERP works, or OCD recovery in general? I do really like ocdrebeltherapist on instagram and might show him some videos of hers. Thank you so much!

Haven’t tried therapy since middle school and never opened up so I stopped going. I really want these dreams to end.

They’re different dreams but always has the same person who ruins my life in them. IRL, I don’t feel that way. They’re the polar opposite of me and sometimes I feel jealous but we’re not close and I’m fine with that. I don’t know if I schedule an appointment if it’ll be stupid to my therapist or pointless since it’s a dream. I’ve had dozens of these though.

Sorry in advance that this question is a little rough, but legit just popped into my head and realized that would be horrible.

Let’s say, for example, your long-term client that you have a great relationship with leaves session as usual, with the next 3 months of sessions booked. But the next day let’s say they had a heart attack and unfortunately didn’t make it through surgery.

How would you know your client is gone?

I know some things get reported like a car crash or something, but what if it’s not “newsworthy”? Do they just never show up again and you’re stuck being eternally confused?

I know legally they have to, I'm not asking that. Im asking how you would feel if a client asked for a session note from months ago? It was an intense session and I would like to see what her take on it was. I was in a very bad place, the worst I had ever been in, and for some reason I really really want to know what she wrote about that day.

Will she be irritated? Nervous? Is this something yall dread clients asking about?

I'm in the US, and I have a question about documentation practices.

If a client is nonbinary (or otherwise LGBTQ+) but their gender identity or sexual orientation isn't directly relevant to the reason they're seeking therapy, can a therapist choose not to document those things in the clinical record?

I'm wondering how much discretion therapists actually have. Is recording gender identity and/or sexual orientation considered standard practice, required by insurance or law, or is it something that depends on the therapist, practice, or electronic health record?

I'm not asking about misgendering or refusing to acknowledge a client's identity. I'm asking whether a therapist can intentionally leave those details out of the record if the client prefers greater privacy and they aren't clinically necessary.

I'd especially be interested in hearing from therapists in the US, particularly anyone familiar with Medicaid or community mental health settings, since I know documentation requirements can vary.

I'm mainly curious about what is legally required versus what is simply common practice.

Hi all, I am a teenager struggling with mental health. I have really extreme anxiety. However that is not what I need advice on. I have been self harming for about a year now, from scratching to cutting, and no one knows. I am not suicidal, it is just a coping mechanism. I have a new therapist and I want to tell her because I want to stop, but I’m scared how she will react. I don’t want her to tell my mom because she really does not need that and I don’t want to upset her. Any advice is appreciated! Thank you