Unpacking "Doorknob Confessions": An Avoidance Tactic Our Brains Employ in Therapy

Clients, we are cauldrons of emotions. We’re the less-than-predictable counterpoint to the composed professional seated nearby. As our session is nearing the end, we reveal something to our therapist that makes their head turn on its axis. The thought process behind doorknob confessions, goes something like this: “If I strategically wait until I’m walking out the door to tell my therapist this big thing, I won’t be forced to go into it right now,” explains Kristin Krivickas, MSW, LCSW, mental health clinician at Eden Health. Doorknob confessions can also occur just as a client is logging off from a virtual therapy session.

As demonstrated in TikTok videos made by therapists, doorknob confessions may be connected to longstanding issues or recent events. Consider them therapy’s version of a Ross-and-Rachel Season 4 cliff-hanger. Clients might bring up the death of a loved one, a breakup, childhood abuse, suicidal ideation, self-injury, addiction relapse, or a change in their living situation.

The first time it happened to me, I was working as a therapist-in-training when my client disclosed that she was being sexually harassed at work. After a few shallow breaths, I thanked her for telling me and assured her that we could continue this conversation in our next session. Her disclosure had struck a nerve since another client of mine had been pressuring me to continue a relationship outside of therapy. He had a history of stalking and harassing women. As the door closed behind her, I felt helpless, gripping the manila folder that held innermost thoughts.

What’s Behind These Confessions

"Many times there is a shroud of shame or guilt that accompanies these confessions,” explains Daryl Appleton, Ed.D., M.Ed., psychotherapist, and work/life balance expert. “We are hardwired as humans to avoid pain, including emotional hurt that can come from judgment, guilt, and shame.” Clients might be concerned that the disclosure will change the relationship or prompt a referral to another therapist.

Aside from a fear of rejection, doorknob confessions may signal “an attempt to control the situation,” notes Laurie Singer, M.S., LMFT, licensed psychotherapist, and board-certified behavior analyst. In some cases, the potential for legal ramifications or other negative consequences may heighten a client’s ambivalence about making a disclosure.

If clients feel like they aren’t getting enough time to share or believe their relationship with their therapist entitles them to extra time, they may use the doorknob confession to prolong the appointment. Krivickas adds that some clients “have difficulty accepting the finality of the session, especially if the session was emotionally heavy.” Clients with an insecure attachment style or limited social support, for instance, might feel anxious or abandoned when leaving the relative safety of the therapy office.

How Your Therapist Will React

"There is always a bit of whiplash when you hear a doorknob confession as a therapist because most times, the information comes out of nowhere, and it rarely has any connection to what you were talking about in the previous 40 minutes or so,” says Appleton. Therapists might initially feel anxious, confused, or frustrated. These reactions are normal and, in most cases, short-lived. Therapists recognize the vulnerability it takes to share something impactful and will respond to their clients with empathy and compassion. “As therapists, I promise we won’t judge you,” says Appleton. “We most likely won’t even be shocked by what you are about to tell us, and if we are, we likely have great ideas around solutions and resources for you."

Following a doorknob confession, your therapist will make an assessment and determine if the issue warrants immediate attention like incidents involving self-injury or suicidal ideation. “If clients have informed me of an abuse that took place with them or someone else, we need to discuss it right away,” says Singer. “I want to make sure they and others are safe.” The therapist may also be required to report the incident to law enforcement or child welfare organizations.

Aside from situations involving an imminent threat, extending the session may not be possible. Appointments are often scheduled back-to-back, and some insurance policies don’t cover longer sessions, explains Krivickas. In these instances, the therapist will encourage the client to book a follow-up appointment and assess the client’s readiness to explore the issue.

What Helps Clients Feel More Comfortable

If it’s coming up to the end of the session, clients can consult with their therapist about how to broach a sensitive topic. Singer suggests starting the conversation with something like, “This is difficult for me to talk about, but I need to tell you.” Therapists can provide tools and reflection exercises than can help clients sort through complex emotions and foster personal growth.

Doorknob confessions are more likely to occur when clients haven’t built up enough trust with their therapist. If these confessions become more frequent, the therapist will share their observations with the client and seek their input about how to improve communication.

"The therapeutic space—whether in-person or virtual—needs to be safe, private, uninterrupted, and secure,” says Krivickas. “You are entering into a relationship with a complete stranger, with hopes that this person will help you navigate through whatever challenges you are facing.” Her advice is to bring in a list of topics, goals, or questions to guide the session.

Choosing the Right Therapist

Signs of a good relationship include mutual trust and agreement on therapy goals, interventions, and treatment options. “The therapist should make you feel welcome and comfortable,” says Singer. She suggests having a phone conversation with the therapist before the first session.

Likewise, Krivickas encourages clients to ask about the cost of therapy, length and frequency of appointments, and expectations for homework assignments between sessions. Along with conveying realistic expectations, therapists need to have sufficient training, experience, and cultural competence to support their clients’ needs. Ultimately, the client “is the one who  decides to move forward with a particular therapist or not,” says Krivickas. “If it doesn’t feel right, shop around until you find the right therapist for you."

Keep in mind that therapists have different styles and approaches to helping people. Appleton suggests reflecting on what you’re seeking from therapy, the core problems you wish to address, and personality styles and techniques that work well for you. “Check in with your head, heart, and gut,” adds Appleton. “Your therapist is potentially going to push you into uncomfortable places as a part of the therapeutic journey, but they will be with you every step of the way. Mutual respect; general liking; and feeling seen, heard, and understood can go a long way in a therapeutic relationship."

Final Thoughts

My client’s disclosure of sexual harassment was the first of several experiences with doorknob confessions. Looking back, it made me think of the immense privilege bestowed on therapists when they hear something that clients have been struggling to say out loud. Therapists, too, are a cauldron of emotions, and the difference between therapists and clients is humbling at times. Still, therapy holds the promise of being accepted and trusting someone—just like the sacred pacts we once made over pinky swears and friendship bracelets.