Online therapy has opened up a world of possibilities: you can connect with your therapist from anywhere, save yourself the commute, and feel comfortable in your own space. However, this convenience also comes at a price: the screen acts as a barrier that blurs some extraverbal cues that are evident in in-person therapy. Small gestures and body postures carry a lot of weight in the therapeutic process, but it’s easy to miss some of those nuances when communication is limited to a digital plane.
The therapist can’t capture the trembling of a restless leg, the biting of a lip if the camera doesn’t show it, or sweaty palms. This means that what you say—and how you say it—becomes the primary means of understanding on an online psychiatrist platform. Words are essential for therapy to progress, but it’s not always easy to express what you’ve been suppressing for a long time or what you haven’t confessed to anyone.
When the “Problem” Isn’t the Real Problem: 5 Obstacles That Hold You Back
In psychological therapy, the problem people carry around is rarely the real cause of their discomfort. You may arrive thinking your problem is work anxiety, fear of relationships, or a creative block, but when you start digging deeper, you may discover that this is just one manifestation of a much more complex situation.
The therapist helps you connect the dots, but you must give yourself permission to let out what you’re carrying inside. It’s important to open up without filters. Unfortunately, it’s not always easy to do so. Research conducted at the Universities of Oslo and Bergen discovered the main internal obstacles that prevent people from opening up in therapy:
1. Fear of being judged, criticized, or misunderstood
When you reveal such a vulnerable side of yourself, it’s understandable that you fear being judged. You may be scared that the therapist might misinterpret what you say or form a negative image of you. Even if you rationally know that the psychologist or psychiatrist is there to help you and not to criticize you, the feeling of exposure can be simply overwhelming. This could cause you to put up a wall, shutting out the very thing that worries you most.
2. Thinking It’s Irrelevant
Sometimes, the filter you activate in your mind acts like an overly demanding gatekeeper: “Why would I tell him that if it’s surely not important?” This thought can cause you to dismiss emotions or experiences that are actually key to understanding what you’re going through. The curious thing is that, often, those small details that you consider insignificant can be the thread you pull on to unravel much deeper emotional conflicts.
3. Shame
Talking about certain topics can stir up feelings of shame so intense that you may feel better off swallowing them and pretending they don’t exist. Shame acts like a cloak that envelops your emotions and makes them more difficult to manage. Perhaps you fear the therapist’s reaction or don’t even dare to express what you feel because it seems unacceptable. However, remember that therapy is the best place to express everything that keeps you up at night.
4. Fear of Negative Emotions
Sometimes what stops you isn’t so much what others think, but the fear of what you’ll feel if you talk about it. You may fear breaking into a thousand pieces or that the emotion will be so overwhelming that you don’t know how to put yourself back together. However, the fact that something scares you so much is a sign of how important it is. The therapist is not only there to listen but also to help you manage those feelings.
5. Not wanting to involve other people
Talking about people close to you in therapy can generate a deep internal conflict. Perhaps you fear betraying their trust, feeling disloyal, or even feeling guilty for exposing intimacies you hold sacred. This is a common obstacle when dealing with family members or partners, because you feel like you’re violating their privacy by talking about your relationship with them. However, the goal of therapy isn’t to judge those around you, but to help you understand how those relationships affect you.
As a result of this repression, therapy slows down. In fact, a study conducted at the University of Maryland revealed that 65% of clients leave something unsaid in therapy, primarily out of avoidance. Of these, 46% were keeping secrets, primarily out of shame or insecurity. And since psychologists and psychiatrists don’t have the power to read minds, only 27% can uncover what their clients aren’t sharing.
The therapeutic process requires this uncomfortable honesty, because only then can the psychologist or psychiatrist understand what’s going on and help you. How can you achieve it?
The 5-Second Rule for Opening Up in Therapy
Mel Robbins, one of the most leading motivational experts, realized that the longer she waited to act, the more excuses, doubts, or fears came to mind for not doing so, and the harder it was to get out of her comfort zone.
This is a perfectly understandable human tendency, as change often requires us to do new and uncertain things. Our brains, on the other hand, are obsessive about order and generally prefer the familiar to the unknown.
The mere exposure effect reveals that, as a rule, we gravitate toward what we already know. As a result, and to protect ourselves from uncertainty, our brains manage to crush those flashes of inspiration and motivation with insecurity and fear.
To counteract this tendency, Robbins developed the 5-second rule, a simple rule that can have enormous transformative power. It simply consists of following those small motivational impulses to take action.
By counting down those 5 seconds, we interrupt the negative thought patterns that lead us to procrastinate or repress certain content. Therefore, we don’t give our brain time to hit the emergency brake and kill the idea or blur the motivation.
Obviously, it’s not about deciding to take action every time we face a dilemma. Sometimes we also need to take time and perspective. However, once we’ve decided on something, like going to the psychologist, it’s best to avoid procrastination.
And once you’re in the office, if something crosses your mind, don’t block it. Don’t let your brain hit the emergency brake and censor you before you speak. Don’t allow doubts to flood you and silence you. Simply count down: 5, 4, 3, 2, 1… and let it out.
Sometimes seemingly insignificant details, unspoken fears, repressed impulses, or uncomfortable experiences are the missing piece to make sense of the puzzle and move forward in therapy.
References:
Kleiven, G. S. et. Al. (2020) Opening Up: Clients’ Inner Struggles in the Initial Phase of Therapy. Front Psychol;11:591146.
Bohart A. C., Wade A. G. (2013). “The client in psychotherapy,” in Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change, 6th Edn, ed. Lambert M. J. (Hoboken, NJ: John Wiley & Sons): 219–257.
Hill, C. E., et. Al. (1993) Beneath the surface of long-term therapy: Therapist and client report of their own and each other’s covert processes. Journal of Counseling Psychology;40(3): 278–287.
Zajonc, R. B. (1968). Attitudinal effects of mere exposure. Journal of Personality and Social Psychology; 9(2): 1–27.
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