Full Disclosure

 

Dear Dr Darcy,

I have been in therapy for approx 12 months for social anxiety and depression.  I have a wonderful psychologist who I trust, yet I am still unable to disclose my sexual orientation.

I know I should have probably told her from the start, but fear of rejection etc. I was embarrassed and ashamed enough having to admit to social anxiety.

The thought of telling her now fills me with absolute dread and fear and sends my anxiety level through the roof.   I guess my question being, is it important that she knows and will it hinder progress if I don't tell her?

ANSWER

I will never understand why most therapists fail to conduct a thorough assessment at the beginning of the therapeutic relationship during which the therapist asks enough questions which would lead to the disclosure of information such as this.  Is it laziness?  Thoughtlessness?

Fundamentalists would claim that the client should take full responsibility for disclosing important information to the therapist; anything short of which results in the therapist enabling the client to remain passive in the relationship.  I hear that concern, to which I say, bullshit.

In general, people have a hard time disclosing personal information to strangers, which is who a new therapist is in the client’s life.  And as the professional, I think the onus lies on our shoulders to ask every conceivable question at the beginning of the therapeutic relationship so that we know what the hell we should be focusing our work on.  It’s the equivalent of a physician conducting a complete blood count (CBC) during a physical exam – it’s basic.  And the failure to do it is inexcusable, in my humble opinion.

Do I think it’s important that your therapist know that you’re a lesbian?  YES.  Am I surprised that  your failure to disclose this information is exacerbating your anxiety?  No.  I’m sure most things exacerbate your anxiety, which is why you sought out a shrink in the first place.

You’ve been seeing your therapist for about a year now, right?  Great.  Think of this as your therapeutic mid term exam.  You need to either push through the discomfort of disclosing your sexual orientation to her, or I’d say that it’s a good time to begin questioning the efficacy of your work together.

Let me underscore:  This is NOT your fault.  Yes, it would have been ideal if you’d walked into her office on day one and had itemized for her every emotional ache and pain you had, but most people don’t even know what hurts when they walk through my door for the first time, which is why my first appointment with a client is 2+ hours.  By the time they walk out the door, I know every important aspect of their history and I know how to prioritize my work with them.

Listen, it’s conceivable that you can do this, particularly after a year of therapy.  I’m not saying that it will be easy, but here’s the thing about anxiety:  We can’t rely on it to tell us when to avoid a situation, because anxiety isn’t based on real threats – it’s based on our fear of a real threat.  So the fact that you become filled with dread over the thought of telling your therapist that you’re gay does not mean you shouldn’t disclose it.  If it turns out that you can’t push through the discomfort, email me and I’ll give you some names of new therapists.