What Can I Not Tell My Therapist? Honest Boundaries in Therapy

• 15 Jun, 2025
• Rohan Talvani
• 0 Comments

Ever leave a therapy session replaying what you said and wonder, "Wait, should I have kept that to myself?" The worry is normal, but therapy is supposed to be your safe space. Still, it’s tough to know if there are rules about what you can or can’t bring up—especially if you’re thinking about admitting something out of the ordinary.

Here's the straight shot—a therapist will not freak out if you tell them you hate your neighbor or you’re struggling with dark thoughts. Their job is to help you make sense of your mind, not to judge. But, there are a few limits. For example, if you talk about plans to seriously hurt someone or yourself, or if there’s child or elder abuse, your therapist sometimes has to report that to protect you or others. It’s called "mandatory reporting."

Outside those exceptions, your secrets usually stay put. And yes, you can talk about adult things, past mistakes, even illegal stuff from long ago—as long as there’s no threat right now. Therapy isn’t a confessional with the police hiding in the next room. The big thing? If you’re not ready to talk about something, you don’t have to. Therapy moves at your pace, and being honest helps, but nobody expects you to spill every secret on day one.

• How Therapy Confidentiality Really Works
• What Therapists Must Report
• Is Anything Actually 'Off-Limits'?
• Tricky Topics: Shame, Crime, and Trauma
• Tips for Talking Openly—and Setting Your Boundaries

How Therapy Confidentiality Really Works

Here’s the deal with confidentiality in therapy—it means stuff you say usually stays between you and your therapist. This trust thing isn’t just a nice gesture; it’s actually a legal and ethical rule for therapists. So, when you walk into that office (or log into a video call), you can let your guard down, because your private business isn’t getting shared with the world.

For most people, the idea of having someone who legally can’t spill your secrets feels like a superpower. But you should know how this shield actually works. In the United States, laws like HIPAA (the Health Insurance Portability and Accountability Act) protect your mental health information. Therapists can’t even say you’re their client unless you give them permission. Even if someone calls and asks, "Hey, does Pat see you?" the answer is a hard no without your go-ahead.

There are some exceptions, and therapists have to spell these out at the start—usually in a written form called "informed consent." Pay attention to that paperwork, because it lists when the confidentiality bubble can pop. Outside the rare cases (like immediate danger), your info is locked down tight.

• Insurance companies might get basics, like session dates—not details—if you use insurance.
• Therapists sometimes talk to other professionals (like their supervisor or consulting team), but your identifying info is kept anonymous.
• Your files are locked up (physically or digitally) and protected by law; therapists face huge penalties if they break this trust.

Wondering about teens in therapy? For kids under 18, parents have some rights, but therapists often still keep most details private if there’s no risk of harm. The goal is trust—without that, therapy just doesn’t work. Bottom line: the therapy boundaries are set up to protect you, not to trap you.

What Therapists Must Report

So, here’s the deal: therapists keep almost everything you say private, but there are some legal rules that force them to break that promise. It isn’t about them wanting to get you in trouble—it’s about safety.

Every therapist learns about "mandatory reporting" early in their training. When you sit down and talk, they should let you know upfront about these exceptions.

• Threats of Serious Harm: If you tell your therapist you have a real, specific plan to hurt someone else or yourself, and you sound like you might go through with it, that’s a red flag. They are required by law to take action—sometimes even talking to police or a hospital just to keep everyone safe. This covers suicide plans and threats to others.
• Child or Elder Abuse: If you share something that either shows someone is abusing a child or a vulnerable adult, or if you’re the one doing it, your therapist must report it. This isn’t just tradition—it’s written into every state’s laws.
• Dependent Adult Abuse: Some states include people with disabilities in mandatory reporting rules, too. Same logic here: it’s about protecting those who can’t protect themselves.

If you’re curious about the hard numbers, check out this simple breakdown:

Beyond those issues, therapists don’t go running to anyone with your secrets—even if you talk about illegal stuff from your past, unless someone is still in real danger. Bottom line: the therapy boundaries exist mostly to keep people safe, not to trap you.

Is Anything Actually 'Off-Limits'?

This is probably the question most people get stuck on before opening up in therapy. You hear all the talk about 'safe space' and confidentiality, but is there really anything you shouldn’t say out loud? The honest answer: almost nothing is truly forbidden in therapy, but a few things can change the convo fast.

Your therapist is ready for pretty much any topic—anger, guilt, weird dreams, embarrassing habits, even thoughts you think no one else has. The only true "off-limits" things are the ones your therapy boundaries or the law create. For you, personal boundaries matter. You might not want to touch dark memories on the first day, and that’s totally fair.

From the legal side, therapists do have to report if you say:

• You plan to hurt yourself or someone else, with real intent.
• You’ve harmed a child or vulnerable adult, or know it’s happening now.
• You’re at serious risk due to abuse, neglect, or domestic violence—some states require reporting even here.

Outside of these, even things like past drug use, stealing as a teen, or cheating on a test years ago aren’t 'off-limits.' Therapists aren’t cops. In fact, a 2024 survey by the American Psychological Association showed 89% of people admitted something pretty raw in therapy that they had never told anyone else. No one got arrested or kicked out of therapy for it.

Confused about what your therapist is required to report? Here’s a quick look at typical reporting rules in the U.S.:

So can you talk about anything? Pretty much, as long as you (and others) aren’t at risk right now. If you feel like you just can’t bring something up, try asking your therapist if it’s even something they’d have to report. Most are happy to explain their boundaries, no judgment. It helps both of you feel more comfortable—and that’s how the real work gets done.

Tricky Topics: Shame, Crime, and Trauma

Some stuff feels too raw or risky to talk about, even in therapy. You might wonder if it’s weird to feel ashamed, or worry you’ll get in trouble for sharing secrets about past mistakes or even crimes. Here’s the deal: most therapists hear wild and messy stories all the time. You’re probably not the first person to ask, “Can I say this?”

Let’s break down what folks get nervous about sharing:

• Therapy boundaries get real when people talk about crime. Telling your therapist about a crime you committed years ago—like shoplifting as a teen or experimenting with drugs—doesn’t mean they’re going to call the police. Unless the crime was super recent or there’s an ongoing danger to someone, therapists are usually not required to report it. But if you talk about child abuse, elder abuse, or a plan to hurt someone (including yourself), that changes things. The law says therapists must step in.
• Shame is a big wall for a lot of people. Maybe you feel “broken” for having certain thoughts or emotions. The truth is, most therapists have heard it all: cheating, lying, regretful sex, addiction—none of it shocks them. Talking about shame is often how you start to heal it. If you feel like you need to test the waters, you can say, "There's something hard for me to talk about, and I'm nervous you'll judge me." Most therapists will give you space and reassurance.
• Trauma is huge and scary. Opening up about abuse, violence, or loss can feel like jumping off a cliff, but it’s also where the biggest relief can happen. Research from the National Institute of Mental Health found that about 70% of adults experience at least one traumatic event in their lives, and lots find relief in trauma-focused therapy like EMDR or CBT. You don’t have to tell the whole story at once. Take breaks. Let the therapist know what works for you.

Wondering what therapists actually deal with most? Here’s a quick look at some numbers:

So if you think your problems are too much, you’re not alone. Most people are carrying their own secret stuff. Therapists expect that. If it helps, you can ask ahead of time, "Have you worked with people who have gone through something like this before?" Usually, they’ll say yes.

Tips for Talking Openly—and Setting Your Boundaries

Getting the most out of therapy doesn’t mean you’ve got to put every thought and memory on the table right away. Honestly, there’s no grade for how much you reveal. You run the show, not your therapist.

Here’s the thing—studies show people who talk openly in therapy are more likely to see improvement within six sessions. Still, honesty doesn’t mean you have to talk about everything before you’re ready. One national survey found that 30% of people hold something back in sessions, especially in the beginning. That’s normal.

If you’re worried about bringing up something tough, say that directly. A lot of folks start with, “This is hard to talk about,” and a good therapist gets the message. You can even tell them you’re not ready for certain topics. Real talk: therapy moves at your pace.

• Jot down anything you want to discuss before your session. Having a few notes can break the ice.
• If you want to skip a topic, just say, “I don’t feel comfortable talking about that right now.” It’s simple and it works.
• Ask your therapist how they handle confidentiality. A little reminder goes a long way for peace of mind.
• Set limits—if a question makes you cringe, let them know. You can say, “Can we slow down on this subject?” or “I don’t want to go there yet.”
• If a topic feels super sensitive, start by describing your feelings about talking about it, not the subject itself.

You’re allowed to revisit your boundaries in therapy any time. As you build trust, you might feel safer digging a little deeper. Or you might always keep certain things off-limits, and that’s okay too.

Remember, therapy boundaries are your right. The goal isn’t spilling every secret, but finding relief and support at a speed that feels right for you. Shadow, my dog, has boundaries too—he’s all in for belly rubs, but don’t even try touching his paws. It’s the same idea: know your comfort zone, and stick with it until you decide otherwise.