What Your Therapist is Really Writing About You

You’re walking into the therapy office. You can hear zen music playing throughout the waiting room as the smell of lavender wafts to your nose. You sit on a plush couch decked out with throw pillows and plush blankets. There’s a box of Kleenex strategically placed within arms reach. But, before you can say anything, your therapist picks up their pen and notepad. What are they writing exactly?

Because most therapists don’t actually share what they’re writing, it causes people to wonder. Maybe you wonder if they’re even paying attention, or if they’re writing something judgemental about you. Whatever the reason, people get paranoid and curious about what’s being written about them. For that reason, I wanted to write the truth about what therapists are writing.

It’s weird to have someone write “private” notes about you as you watch. What’s even weirder is most therapists never mention what they’re writing or why. This may bring up feelings of deception, paranoia, and defensiveness.

With that said, here’s what therapists are really writing:

1. Why you came to therapy:

In the first therapy session, your therapist will ask you questions about why you’re seeking therapy, how you’ve been functioning, and about your history.

2. What they observe:

How a person behaves can reveal a lot about their mental health. For example, if you’re in a therapy session and you’ve been crying for the past 60 minutes, that could provide a lot of insight into just how badly you’ve been feeling. This is especially important if this behavior is unlike you.

3. Important names:

If the person is important to you in some way, it helps to write certain names or places down to remember them.

4. Symptoms:

Everyone experiences mental health concerns differently. Two people with depression can appear totally different. It’s important to tailor treatment to you, specifically.

5. Big things that have changed:

Maybe you’ve gone through a breakup, the death of a loved one, a new job, etc. These are situations that can greatly impact you and treatment trajectory.

6. New symptoms (like sleeping more):

Maybe you mention something that’s never come up before. This can include eating more than usual, panic attacks, increased stress, etc.

7. Jotting down something so they don’t forget:

Imagine intensely listening to someone when something pops into your head to mention. This can include a new revelation, noticing a new pattern in your life, etc. Instead of interrupting you and your thought process, sometimes it’s better to make a note and mention it to you later in the session.

8. Your goals for treatment:

Everyone goes to therapy for one reason or another. Over time, your goals may change. In the beginning, maybe your goal was to feel less stressed. But over time, you realized that your job is a terrible fit for you and that you’re burned out. Your new goal may be to figure out what fulfills you and to consider what career path you should take.

9. Notes about how you’re doing:

There are some therapies where it’s helpful to track progress over time. For example, if you have social anxiety, a therapist may assess your anxiety level in different scenarios. Based on your ratings, they can see how it changes from week to week.

10. Diagrams:

Therapists have different training backgrounds on research-based treatments. Within those treatments, are many ways to understand how your experiences are connected. Diagrams can be used to “map out” your experiences, including important things that happen in your past and present. Doing this helps your therapist understand how you view the world based on your experiences, as well as how to steer treatment.

Key Takeaway:

I understand what it’s like to be on both sides of the “couch.” I often ask permission to take notes out of common courtesy. If you’re really curious about what your therapist is writing, you can ask! Odds are, they’ll be open to sharing.

By asking, you may stir up a conversation about your therapist’s thought process on treatment, or how you think treatment is going.

Until next time,

Dr. Brittney Jones, Licensed Clinical Psychologist

Founder of Today’s Psychologist, LLC