Skip to main content

Verified by Psychology Today

12 Things Your Therapist* Wants You To Know

Scary, negative, intrusive thoughts are so hard to talk about

*DISCLAIMER: These points refer to therapists who have been trained to treat perinatal depression and anxiety. If you do not feel like you are in the presence of a therapist you can trust or if you find yourself questioning his or her level of expertise in this area, please find yourself another therapist. We can help you do that.

If you are experiencing postpartum anxiety, postpartum panic, postpartum OCD and are afraid to tell anyone about the thoughts you are having that scare you, please find yourself a safe, professional place to talk so you can start to feel better. In addition, please be informed about the nature of anxiety. While anxiety can feel paralyzing, it responds to proper treatment. Scary thoughts are a treatable symptom, often relieved with talk therapy, CBT, and/or medication.

Here are some points your therapist might want you to know.

1) I know it is hard to talk about the crazy-feeling anxiety racing through your mind right now. I know it is difficult to distinguish between what is problematic and what is normal. I can help you figure that out.

2) If your thoughts are about suicide, you need to tell me that. If your thoughts are about harm coming to your baby, this is extremely common and if you feel too anxious to talk about it now, you might feel better talking about it at a later time.

3) It might surprise you to discover that you actually feel better after you tell me what is worrying you, even the specifics of the scary thoughts you are having.

4) Did you know that 91 percent of all new mothers report having negative, intrusive, unwanted thoughts about harm coming to their babies? (Abramowitz, 2006)

5) Negative thoughts and images that worry you, will not worry me.

6) No matter how scary, how intrusive, how overwhelming your thoughts are, I have heard worse and nothing you say will alarm me.

7) Scary thoughts that are really scary are not diagnostically more serious than any other scary thought. The only thing bad about scary thoughts that are anxiety-driven is that they feel so awful.

8) I know it can feel like you are going mad. Your high level of distress is an important indicator that what you are experiencing is anxiety, not psychosis.

9) Do not let feelings of shame, embarrassment or guilt interfere with what you want to tell me. It will be okay.

10) Scary thoughts do not lead to actions.

11) Nothing bad will happen if you tell me what you are thinking.

12) You will not be judged here.

Take a deep breath. Decide what is best for you. Try to put words to your resistance and fear. Believe that I can help you with this so you can start to get some relief.

Karen Kleiman, MSW, LCSW

citation: Abramowitz, J. S., Khandker, M., Nelson, C. A., Deacon, B. J., & Rygwall, R. (2006). The role of cognitive factors in the pathogenesis of obsessions and compulsions: A prospective study. Behaviour Research and Therapy, 44, 1361-1374