Ask a Psychologist: How Much Do I Get to Know About My Partner’s Therapy Sessions?

How much should I know of what's behind closed doors?

Q: Dear APW,

I’ve been married for two and a half years (but we’ve been together a decade) and recently my husband and I have been going through some tough times. We’re in the process of trying to find a couples therapist and after a particularly bad fight my husband decided he should start seeing one individually. This is actually where my question comes in because we have a pretty open relationship and now it feels like my husband is talking to someone else about things he might not be talking to me about. Also, might he be talking about me? We’ve been together for a while and my husband never seemed to have a lot of issues, but now I’m wondering if things that seemed small may actually be huge but he doesn’t want me to know about them (a few strange phobias, a somewhat repressed sexual identity he said wasn’t an issue, divorced parents).

So, my question: how much of what he talks about in therapy do I get to know? I really want to ask for a play-by-play (or a tape-recording?) of the session, but I understand that this is probably off limits. Can I ask about general topics? Can I ask about things (his sexuality) that might affect me? Should I be worried that my issue-free man apparently has lots of issues? I’m not against people seeing a therapist, and have considered it myself, but I am concerned about the specifics of his visits. Thanks.

A: Dear APW Reader,

The core of your question is about trust. You have been in a relationship with your partner for many years, and you have strengths as a couple. But recently, you’ve been going through a difficult time. And now, you’re wondering whether you can trust your partner, and whether he trusts you. Understandably, this is anxiety-provoking, and whatever feelings you’re having are totally valid. But just as you deserve validation of your feelings, your husband deserves validation of his. So far, his therapy has likely provided that.

Even when couples have been together for a long time, there can still be topics that are tough to talk about, or new topics that have come up over the years. And no one is issue-free. That fact may be upsetting, but it’s realistic, and being aware of one’s issues is much healthier than not being aware of them. In other words, it’s a good thing that your husband is exploring his concerns in therapy.

It’s normal to worry about partners and relationships, and it’s also normal for anyone who has a partner to talk about that person in therapy. But your husband also needs to understand that you’re feeling concerned, excluded, and worried about him and your relationship. You should talk to him directly, and compassionately, about these concerns. Your idea to begin couples therapy is also great. With your husband’s permission, you can also talk to his therapist, with him or without him. But his therapist also has to set boundaries to ensure that his sessions feel safe to him. I’ll talk more about options for how to talk about this, including in couples and individual therapy. First, I want to address the important issue of a patient’s privacy and confidentiality in therapy, which therapists take very seriously.

Patient Privacy and Confidentiality

To give a short answer to your question, it’s up to your husband how much you can know. In therapists’ practices, patients’ confidentiality is critically important. You have probably heard of HIPAA (the Health Insurance Portability and Accountability Act of 1996), the federal law that sets rules about how private health information can be shared in health and health-related contexts. HIPAA ensures that patients have rights over their health information and how it’s shared. This includes sharing information with anyone—with other providers, family, partners, or close friends. HIPAA states that if private health information is to be shared, patients must give explicit permission, usually written, to indicate what information can be shared, and with whom.

Otherwise, the default is that therapists keep information private. It’s become harder than ever to find true privacy, and therapy can serve as a unique and sacred space to talk about important things. There are, of course, circumstances in which providers can make exceptions to these rules without patients’ permission. In the practice of psychology, according to the Ethical Principles of Psychologists and Code of Conduct, these limits to confidentiality include when a patient is considered a danger to self or others (e.g., if someone is suicidal or homicidal), if a patient is believed to be engaged in child or elder abuse, or is a victim of abuse or neglect, or if there are legal requests, such as a subpoena, involving the patient.

How Therapists Can Talk To Partners

Many therapists do talk to patients’ partners with patients’ permission. Some therapists talk with a patient’s partner over the phone, or invite them to a session to collaboratively discuss general issues. Often, this is to facilitate a broader conversation that can continue with a couples therapist. Some therapists may alternate seeing a patient individually as well as with a partner, but most therapists and patients find it most helpful to have a separate couples therapist who can work more objectively (and, therefore, more effectively) with interpersonal dynamics, and whom each partner can equally trust.

Because a trusting therapeutic relationship and a patient’s privacy are so important, it is not common for an individual therapist to give a patient’s partner a play-by-play report of a session. Most therapists, unless they’re in training or are engaged in certain styles of therapy, do not even record sessions or write them down verbatim. If they do, the tapes or transcripts are typically used for the therapist’s private review, or for review with a clinical supervisor, so that the therapist can reflect on and understand how to best help the patient. Your wish to know exactly what’s going on in the sessions is understandable, but it is unlikely that your husband and his therapist would agree to this.

Trust… And Boundaries

In a healthy relationship, partners need to be able to talk openly about a variety of topics. This is what’s bothering you the most: so far, your husband has felt unable to openly discuss important issues with you. It’s normal to feel worried, hurt, or angry about this situation. It may be a sign that something is wrong. But it’s also healthy for partners not to talk about every concern or issue they have. Boundaries are necessary, to a certain extent, to ensure that people do not get hurt.  Some things should be kept private, or can be kept relatively private, while they’re being worked through. But you can also do your own work as a couple to process your feelings about this, and to work on communicating more effectively, which should facilitate more open communication and deeper trust in the future.

It’s really important for couples to have people with whom they can safely explore concerns about their relationship, as well as their own issues, which may be affecting the relationship. So, while your idea to start couples therapy is wise, I’d also encourage you to see your own therapist. There may be parts of your own history or psychology that are making these circumstances harder to deal with, and an individual therapist can provide support around those issues. It’s been a tough time for you, and you should make sure that you’re taking care of yourself and getting support. In addition to working on your marriage, this means finding ways to reduce your anxiety, spending time with supportive people, and making sure that you have private space for yourself and what’s important to you, too.

The information provided in Ask a Psychologist is intended by Dr. Brofman and APW to serve as general advice and guidance for all readers. The advice herein does not constitute a clinical recommendation or relationship, and Dr. Brofman and quoted mental health professionals do not take clinical responsibility for this information. Ask a Psychologist does not take the place of a confidential clinical consultation with a trained mental health professional.

Featured Sponsored Content

  • Lian

    What a compassionate response :-)

  • Ella

    This is so timely. Thank you for this post.

  • SimilarBoat

    I think what can be hard for partners who aren’t in the therapy session is the fact that the therapist works for the partner, not for them. So while a couples counselor is going to help find solutions to a shared problem that work for both people (after hearing about the problem from both people, not just one person), a therapist just working with the husband only has the husband’s goals in mind, and only hears the husband’s perceptions of different situations. So the other partner can feel misrepresented and cut out of important conversations. Do you have any advice for dealing with that?

    • Whitney S.

      Sounds like the husband has assembled a Team Him and now the partner need to assemble a Team Partner. That can be family, friends, or their own therapist. If the couple themselves are having issues it wouldn’t hurt to get a couples therapist on the issues with both parties together.

      When it come down to it, the way people talk about you or perceive you is uncontrollable in all contexts. Everyone sees and reports things through their own lens. Good news is a trained therapist is aware of this, and having the most objective data is not always necessary to making some positive progress.

  • Teresa

    It is worth asking your partner if it is okay if you ask about therapy–when my husband started going (issues not really about us that were then manifesting themselves into our relationship), I felt similarly. I wanted to know what they were talking about because I really wanted to know that they were addressing the issues that were really affecting our partnership. But, I know that what is said in therapy is private. Finally, I just asked my husband if it was okay if I asked him about his appointments. He said it was absolutely fine and that he’d tell me as much as he could. Once I knew I could ask, I actually needed to ask less because I felt that he would tell me anything that really impacted me. That may be better than asking his therapist because he might feel that you don’t trust him (and, maybe you are feeling unsure of your trust for him right now?) if you go around him? It’s a hard line to walk between privacy and wanting to be involved in the things that are impacting your relationship.

    • La’Marisa-Andrea

      I like this. This seems the most workable and practical solution in my book.

      • Kayla

        I like this too, but I would add that discussing timing might be a helpful addition. Is husband comfortable with her asking immediately following a session what was discussed in that session? Is he comfortable having a dinner later in the week, after he’s had some time to process, where he gives her a summary of what he and therapist talked about? Is he willing to give her a summary of what issues he’s been working on six months from now, but not yet?

  • anon

    “But it’s also healthy for partners not to talk about every concern or issue they have. Boundaries are necessary, to a certain extent, to ensure that people do not get hurt.  Some things should be kept private, or can be kept relatively private, while they’re being worked through.”
    I would just like to second this point. A few years ago my partner had about 6 months of therapy to deal with a lot of complicated issues, which including a history of family violence. Before he started the therapy, I was one of only two people he’d ever spoken to about it. And while I wanted to help him and to understand, there are limits to my ability to do so without training etc. Furthermore, given the nature of what he experienced it was actually just difficult for me to process that information without some sort of impact on my own mental health. So while it was hard to have my partner going to therapy week after week without knowing what they were talking about, it was definitely better for the both of us that he wasn’t sharing it with me.
    I don’t wish to suggest that the OP’s husband has experienced anything like what my partner has. But I do hope this is useful to illustrate the importance of boundaries.

  • A

    When I was in a similar situation with my partner, what helped was letting her know that I understood that she didn’t want to share the play-by-play of her appointments, but that it made me anxious about our relationship if I didn’t know anything, particularly if stuff was coming up that might affect our me/us. My request, which was easy-ish since I trusted her and her therapist, was that she add “how/what to discuss with my partner” to their list of stuff to work through and that I’d be patient while she figured that out. It worked for her to set a date where she and I would talk (alone) about the stuff that she thought I needed to know, and the following week I went with her to her therapist session to discuss how it went/how I was doing.

    • MC

      I can’t upvote this because I’m not logged into Disqus but I think this is a great suggestion!

  • I’ve been on the other side of this. I sought individual therapy about a year ago, and while I cannot share any insight into what your husband is going through, I can offer some insight into why it would have been uncomfortable for me to talk directly to my husband about certain issues. I was struggling with my own depression, part of which manifested as intense feelings of shame and guilt – and I felt I could be more honest with someone neutral, instead of confessing my “shameful weakness” in front of someone I love intensely (it isn’t, of course, shameful OR weak, but it sure felt that way at the time). In addition, I was struggling to adapt to marriage, which felt both wonderful and cozy, and like my emotions were consistently scraped raw. I had no desire to leave my marriage, but I DID need to speak to someone honestly about what was going on in my head and have them be able to help me work through it, without them worrying, “what if you secretly ARE wanting to leave?” A year later, I’m feeling immeasurably better, and when the last wave of depression crept up on me, I felt able to be much more open with my husband about what was going on in my head. But sometimes when things knock us sideways, we (all of us!) just need to talk about the tangle of emotions without fearing we’ll say the wrong thing and hurt someone we love.
    In short, as Dr. Brofman said wonderfully, “some things should be kept private, or can be kept relatively private, while they’re being worked through.” It doesn’t mean that your spouse doesn’t still love you to pieces! There are just things, for whatever reason, that they can’t discuss with you right now. Good luck to you both as you navigate this!

    • “but I DID need to speak to someone honestly about what was going on in my head and have them be able to help me work through it, without them worrying, “what if you secretly ARE wanting to leave?” A year later, I’m feeling immeasurably better, and when the last wave of depression crept up on me, I felt able to be much more open with my husband about what was going on in my head. But sometimes when things knock us sideways, we (all of us!) just need to talk about the tangle of emotions without fearing we’ll say the wrong thing and hurt someone we love. ” -YES to this. When we aren’t even sure what’s going on ourselves, we need to be able to talk to a professional that can help us go deeper instead of seeing the thoughts/feelings at face value and making it about the relationship when it’s rarely about the relationship and instead about something going on inside of us (projection).

      • Sarah

        I can’t upvote but just want to second this. It takes time to work through this stuff, and sometimes how you feel in the beginning of therapy is quite different to how you feel in the middle and at the end. Which in my experience can be pretty confusing when explained to other people (other than the therapist).

  • honeycomehome

    That photo is stunning, Vivian Chen!

  • Alexandra

    When I was younger I had this wrong-headed idea that my partner was supposed to be the one to heal me of all my baggage. So I would tell serious boyfriends absolutely everything about my past, hoping for insight, comfort, healing, etc. This was a standard part of any serious relationship I had–I’d unload everything at about month four and wait for the healing to begin.

    Problem was, it never did. Partners aren’t therapists. Thankfully, by the time I met my husband, I had recognized I had issues that no layperson should be expected to help me with–that these issues were ruining my relationships, instead of my relationships healing the issues. I quit dating for two years and did a lot of hard work with an actual therapist. I got better.

    And then I met my husband, who coincidentally IS a licensed social worker (a therapist). I don’t share the intimate details of my baggage with him. It’s just too much. It would burden him, there isn’t much for him to do with that stuff, and most importantly–I got help with it and don’t need to go into it with him. He knows the generalities but not the specifics. As a result of getting help, I don’t relive the specifics anymore, anyway.

    All this to say–a partnership is made of two individuals with problems. You can support your partner, but we all have to shoulder our own burdens in order to move forward. There are things it’s ok to keep to oneself–things that it doesn’t bless the other person to know, things that are private (not secret, which implies that there is some sort of shame). To make an earthy analogy–it’s ok to close the door to the bathroom when you poop.

  • anony-mouse

    I am SHRIEKING inside at the thought of my husband asking my therapist to listen to a (non-existent) recording of our time together. Therapy is private, even within a marriage. While I share some of what happens in there with him, asking to hear a recording or even a play-by-play would not be okay.

    • La’Marisa-Andrea


  • La’Marisa-Andrea

    This question and the desire to breach one’s privacy in such a way really makes me uncomfortable. I think if anything, if the LW is concerned about what is going on in her husband’s therapy sessions, she should ask him about it. Ask him if he’s ok discussing the sessions with her and the topics discussed. The LW might be able to get a sense of whether he would also be open at some point to allowing the therapist to talk to her. Of course, this might be completely off the table. But I would not go around the husband on this.

    I feel there are some things that are intensely personal, even in a marriage, and that people need healthy and safe spaces where they can work through things…even things that may affect their partner. It can hurt to be excluded (especially if the issue is the two or you or you just wanting to be supportive to your partner), but not everything is about us all of the time. We are not all trained therapist and have the tools in our arsenal to help our partners in ways they may need it.

    Finally, sometimes I work want to work through my feelings and thoughts on an issue without my husband before I discuss it with him. There are some spaces my husband is absolutely not allowed to breach for my own emotional well being. Therapy sessions and reading my journal is right up there. I welcome questions and wouldn’t be offended by him asking, but I personally wouldn’t want my husband approaching my therapist without having gotten the ok from me.

  • Clare

    I mean this is in a very gentle way, but whatever your husband is discussing in his personal therapy session is none of your business. I don’t think the letter writer realizes how incredibly invasive and controlling her desire to have a transcript or play by play is. I don’t think it is ill intent! I just don’t think they necessarily understand that the confidential nature of therapy is often part of what makes therapy so effective.

    That being said, how being in therapy impacts her husband is very much her business and although the letter writer should check in with her husband first, I would imagine asking him basic, open ended questions about his therapy sessions such as ‘how was your session’ would be completely acceptable.

    I think getting a therapist of her own, as well as a couple’s therapist would probably help the letter writer be more comfortable with her husband’s individual counselling. It would also deepen her understanding of how counselling works. I wonder if part of the reason for the letter writers anxiety around counselling is the sense of the unknown, especially since media depictions of therapy are often very dramatic and inaccurate depictions.

  • Laura Holway

    I’m pretty sure that my therapist would label meddling with the other partner’s own therapy as pretty codependent behavior. If your spouse is acting in a way that makes you uncomfortable or sporting behavior that directly affects you, it’s your job to discuss this DIRECTLY with him or seek therapy together. If you aren’t feeling like you can trust him, talk to him about it. But, going to his therapist or asking him to unpack those very intimate details doesn’t seem quite right to me. Talk directly to him and only about things that involve the two of you.

    • Lolly

      I interpreted this question as the LW asking for permission to get info from the husband, not the therapist. Maybe I’m wrong? But there’s a lot of shaming going on when this isn’t clear.

  • macrain

    The LW should not be shamed for having a desire to listen in on her husband’s therapy session. It would be invasive and controlling if she demanded to have a recording of every session, but… she isn’t doing that. She acknowledges that this is not appropriate and is asking what is. That she is asking the question shows that she wants to approach all of this in a way that is respectful and supportive. It’s totally normal to have some anxiety over all of this. It is also normal to have feelings and desires and to wonder what you should do about them. Shaming does not help.

    • Sarah

      Agreed! While it may not be appropriate, I think it’s totally understandable that she would feel this way. If you’ve been with someone for ten years and you’re used to being each other’s main confidant, then knowing that they are now sharing this information with someone else instead of you could be pretty confronting imho.

    • La’Marisa-Andrea

      Well, I personally think a desire to listen in on one’s therapy session, the desire to want to invade someone’s privacy to that degree is pretty gross, even if one knows that such a desire is completely out of bounds. I don’t think she’s being shamed for it on here as much as people are just pointing out, whoa, that’s pretty invasive and here are other ways you can go about getting some info to help address your concerns. With that being said though, I also think there’s a huge difference between wanting specifics as to what goes on in therapy and more generally, wanting to know what’s going on with your spouse when they suddenly start going to therapy. I just feel like one is more respectful of the sacred and safe space that is therapy. So I guess my short answer to the question of “how much do I get to know” would be whatever he’s willing to share. I totally get how nerve wrecking that might be and how anxious that would make the other party. I don’t think LW’s anxiety about all of this is a problem — I think her desire to want to know specifics about what goes on in her husband’s therapy crosses a fine line with me personally. I would never be comfortable with someone, I don’t care who it is, asking me about the specifics of my therapy sessions.

      • macrain

        When you label someone’s desires as “pretty gross”- that is shaming.

        • La’Marisa-Andrea

          I absolutely disagree. Stating I personally find some desires gross is not shaming. If I said she was a horrible person for it, that would be. Which I didn’t say.

          • macrain

            You are right- you didn’t call her a bad person and I know that’s not what you meant. I think your comment could have been kinder and more sensitive towards the LW, is what I was getting at.

  • K

    I go to therapy (my partner does not) and I talk about my partner in therapy, among other things. But I talk about my partner in the context of making our relationship better and making me happier in our relationship. My therapist and I both recognize that she only hears one side of the story, but the purpose of me telling her about some dishes that didn’t get done that dissolved into a huge fight is 1. to understand my own feelings (why did that upset me so much?) and 2. to help me break the cycle from dishes to huge fight. A few years ago, my ex-husband decided he didn’t want to be married anymore and left me out of the blue and I go to therapy because I want this relationship to be strong and positive and nothing like my last one.

    Letter writer, try not to feel threatened by the therapist and your partner trying to work some things out. It sounds to me like you’re concerned that your partner is possibly keeping some big things from you e.g. issues about their sexuality, and that you’re going to be blindsided. First, you can get blindsided even without a therapist (see my ex above) and I would argue your partner is doing the right thing and second, ask your partner for what you need. You can say: “I feel like I can’t ask for this, but knowing that you might be discussing things with your therapist that matter greatly to me and our relationship is difficult for me” and see what your partner says. From my experience, saying things like that is really really hard for me but my partner’s response is reassuring and sometimes wonderful.

  • Shauna

    While I think this was a great post, I find it fascinating that no one has yet to comment on the financial reality of this advice. Even with good health coverage, with therapy sessions costing anywhere from $40 – $200 per hour, going through individual therapy for each partner AND couples therapy means you are looking at a minimum of $240 / month, which is not an insignificant amount of money.

    • Kayla

      Totally true. But also, sometimes not true.

      I found a nonprofit with sliding-scale therapy rates when I was in college, had shitty insurance, and made almost no money. And I’m so glad I did.

      It’s a lot of extra work to track down affordable therapy, and it might not always be possible, but I wouldn’t rule out getting therapy because of financial concerns without looking for low-cost options first.

    • Ryf

      I don’t think the country of the poster is mentioned, is it? There’s lots of countries where therapy is included in health insurance (like mine).

  • Amy March

    I think sometimes the antidote to insecurity is trusting yourself. Deep down, I think you know that of course he is talking about you, you’re a huge part of his life. What do you think he’s saying about you and your marriage and his sexuality? I’m not sure it matters so much what he actually says as it does that you trust what you believe about your marriage, and if you think he’s saying things you find problematic, think about why those things seem likely to you and why they concern you.

    And then you don’t talk to him about wanting a play by play of therapy. You talk to him about your thoughts and feelings and concerns.

    • La’Marisa-Andrea

      I agree. I don’t think what he’s actually saying really matters either. This really isn’t about what he’s saying in therapy. The concerns LW has are there and I suspect they wouldn’t go away if her husband were to say he wasn’t discussing her and his sexuality…they’ve got other things they need to talk about and maybe down the road, some couples therapy would be in order.

  • Carolyn Wanatee

    Your husband is an individual. (!!!)

    And if your relationship is as open as you say it is, I’m sure he will be discussing these things with you, but he may need time (and a professional) to sort it out before talking with you about it. Let him know you are there if he wants to talk about it and continue to seek couples counseling.