Is My Therapist Talking About Me Behind My Back?

It’s natural to wonder about your therapist—the relationship between you and your therapist is inherently lopsided, with them knowing much more about you than you know about them. And it’s also natural to wonder whether your therapist ever talks about you with other people. They are only human, after all! Surely there’s some tea that even a therapist can’t help but spill?

The truth is, your therapist has probably talked about you with someone else at some point. But when is this ok, and when does it cross over into unethical behavior? Let’s find out.

The Anxiety of Therapy

You might be anxious about sharing so much of yourself with someone, especially if you’re new to therapy. It can feel weird to open up so completely to someone you don’t know much about. And knowing that it’s their job to keep your secrets can make you wonder about the toll that could take on a person. We all know that keeping secrets can be hard.

This is why it’s important to understand how a therapist can ethically reduce that toll. You shouldn’t ever feel guilty for confiding in your therapist or anxious about sharing anything with your therapist, because a good therapist has ways of coping with this responsibility while still respecting your confidentiality.

In Professional Situations

There are certain professional situations in which your therapist might find that talking about their clients is not only helpful, but necessary.

Supervision

Many therapists participate in “supervision”—they meet with a more experienced therapist, such as the head of their private practice or the senior clinician at their clinic, to discuss their caseload and any issues that may have arisen with their clients.

This doesn’t necessarily mean that you yourself are a “problem” or a “challenge,” though. Your therapist may just need to brainstorm with another mental health professional to make sure they are giving you the best possible care. Therapists are not omniscient, and in many cases, two heads are better than one.

So, think of it this way: If your therapist is talking about you in supervision, it means they are invested in your therapeutic relationship and want to help you to the best of their ability.

Case Conferences

Some mental healthcare practices or facilities require their clinicians to participate in case conferences—meetings where the team focuses on one or a handful of clients and really delves into things like those clients’ history, their current challenges, their potential diagnoses, and treatment approaches.

Therapists are ethically required to protect the confidentiality of their clients, including the clients of other therapists in the practice, so this kind of identifying information should never be shared outside of the case conference.

Case conferences can be very helpful if a therapist is struggling in their relationship with a client. It can bring to light new ideas and approaches to care that the one therapist may not have reached on their own. It can also introduce other therapists to certain symptoms, issues, or therapeutic situations that they have not encountered in their own practices, which can help prepare them for the future.

Therapy

Therapists should be in therapy themselves. How can you take care of someone else’s mental health if you’re not taking care of your own? This means that your therapist, in their own therapy sessions, might discuss their practice and their clients the same way you, in your therapy sessions, might discuss your own work.

But don’t worry—there is no reason for your therapist to provide their therapist with identifying information about you (you don’t tell your therapist your coworkers’ full names, do you? No, you say “Cathy said something annoying today” and “Roger is a pain in the butt” and “I don’t think I could survive this job without Amanda”).

In addition, just like your therapist is required to keep everything you say in your sessions confidential (with very few exceptions), your therapist’s therapist is held to the same rules. 

So, keep in mind that if your therapist talks about you in their own therapy, it’s because they are trying to take care of themselves so that they can provide you, in turn, with their best care.

In Personal Situations

I’m a trained therapist and I, naturally, have friends who are also therapists. Sometimes, we talk in very general terms about our work.

I don’t know the names of any of my friends’ clients, not even their first names. I don’t know what they look like or any information about them that could help me identify them. The only way I would ever encounter them is if I went to my friends’ offices and saw them there, and even then, I would not recognize anyone because the only things I know about them are—again, very generally—some of the things they’ve talked about with my friends during their therapy sessions. 

The only way your friends would ever encounter these people is if they purposefully showed up to your work and actively sought them out. They wouldn’t recognize them on the street, and might not even recognize them at your place of work if you haven’t shared their names, what they look like, or any other identifying characteristics. 

The same is true of your therapist—even if they have talked about you to their friends, they’ve provided no information that would ever make you identifiable to someone who doesn’t know you.

However, if this thought bothers you, talk to your therapist about it. Ultimately, you should be in charge of any information that is shared about you, and a good therapist will respect that.

When Should I Worry?

You might be concerned about stressing out your therapist—and this fear is valid. After all, you are sharing a lot of very personal information with them, often information that you yourself are having trouble dealing with. That is, essentially, the point of therapy. But should you worry about how your therapist will handle the responsibility of your thoughts and feelings?

The short answer is no. This is their job, and, as noted above, there are multiple ways in which your therapist can ethically work through any problems or challenges that have come up in the course of your time with them. It is their responsibility to help you carry the burdens you share with them in therapy and to figure out how best to do so.

Explaining Confidentiality

The situations I’ve outlined in which your therapist might share information about you are all in line with a therapist’s code of ethics.

Your personal information—also called personal health information, or PHI—should never be shared with anyone who is not a part of your care team. This includes your name, your demographics, and details about your mental health and your treatment, including any diagnoses.

They should not be sharing anything that could identify you to strangers with their friends or acquaintances. If they do talk about you in a professional setting outside of their practice, such as at a conference, they should protect your identity by not using your full name or your real name, and they should ask for your consent first.

A good therapist will respect these boundaries. If you find out that your therapist has broken this seal of confidentiality, you should find a new therapist immediately—and you might even consider legal action if this breach has negatively affected you (for instance, if you are fired or can’t find a job because private information about your mental health or disability status has been disclosed). 

Know your rights. The contract you and your therapist enter into when you start working together is one of confidentiality, and you should be able to trust that.

Final Thoughts

Is my therapist talking about me? The plain answer is, usually, yes. But in most cases, this is not a bad thing.

When your therapist talks about you in supervision, case conferences, or their own therapy, that means that they are invested in the care they are providing you. Whether they need a second opinion in order to figure out the best treatment for you or are discussing the feelings that come up in their sessions with you that might affect the way they interact with you, confiding in others—while still protecting your confidentiality—usually helps rather than hurts. 

It’s only when a therapist is sharing identifying information—including your personal health information—without your consent that you should worry. If this happens, at the very least, you should fire your therapist immediately and look for someone new.