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How Do I Express Thoughts of Sadism or Violence to a Psychologist?

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Hello, I’m currently seeing a psychologist and psychiatrist after an emergency stay in a closed psychiatric ward. I’ve been mostly honest with the problems I’m facing, though I find that I really struggle to bring up an issue unless directly asked about. Currently, they are treating me for psychotic symptoms, though I haven’t been taking my antipsychotics, as well as several other issues related to sexual abuse and lack of empathy. One issue I believe is likely of concern however, though I haven’t really spoken about much other than mentioning ‘violent thoughts,’ is sadistic urges and very frequent thoughts of harming or killing others. I have no idea how to broach this subject, I don’t want to face judgment or get myself sent to a ward again. So far they only know that I’ve had violent thoughts, but I’ve never gone into detail as to what they are, and they don’t know of my history of harming animals when I was younger. It feels like addressing this is likely my best bet in getting treated for what is actually important, I just have no idea how to approach this. (From Sweden)

How Do I Express Thoughts of Sadism or Violence to a Psychologist?

Answered by on -


You’ve already done a good job here. You were clear and direct about your concern, expressed the fear of judgment for having these thoughts, and showed an understanding that the early childhood experience of hurting an animal is often connected to these thoughts. What you are struggling with takes courage, and you seem to be displaying a great deal of it. It was a very brave thing for you to write these feelings down and send it to us here. Now it is time to take it to the next level and bring these issues to the people who can help you at a time when you are in a safe place and are struggling with these concerns.

If it is too difficult for you to speak of these symptoms directly show the psychologist this blog and ask him or her for an opinion about what the person writing the blog could expect. The purpose of doing this would be to allow you to communicate these symptoms through the blog and then use it as a vehicle for discussing your need for treatment.

You are right that finding a way to express this while you are there is essential because it is, as you’ve said, the best bet for treating what’s important.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

How Do I Express Thoughts of Sadism or Violence to a Psychologist?

Therapists live, online right now, from BetterHelp:

Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Dan Tomasulo Ph.D., TEP, MFA, MAPP teaches Positive Psychology in the graduate program of Counseling and Clinical Psychology at Columbia University, Teachers College and works with Martin Seligman, the Father of Positive Psychology in the Masters of Applied Positive Psychology (MAPP) program at the University of Pennsylvania. He is Director of the New York Certification in Positive Psychology for the Open Center in New York City and on faculty at New Jersey City University. Sharecare has honored him as one of the top 10 online influencers on the topic of depression. For more information go to: He also writes for Psych Central's Ask the Therapist column and the Proof Positive blog.

APA Reference
Tomasulo, D. (2020). How Do I Express Thoughts of Sadism or Violence to a Psychologist?. Psych Central. Retrieved on December 5, 2020, from
Scientifically Reviewed
Last updated: 23 Jul 2020 (Originally: 26 Jul 2020)
Last reviewed: By a member of our scientific advisory board on 23 Jul 2020
Published on Psych All rights reserved.