Ten years ago, I was diagnosed with breast cancer. I had an active therapy practice and initially chose to keep this news from my clients. It took me months of tests to get an accurate diagnosis before it was time for my surgeries and chemotherapy, and I frankly thought they wouldn’t notice.

But I was also protecting myself. These were vulnerable days, and I didn’t want to have to worry about how to talk about my experience of this frightening new reality with them. I struggled with whether it was fair to burden my clients with knowledge that could interfere with their ability to speak freely about their own less-than-life-threatening issues, or make them feel even more distraught about the uncertainty of life.

Eventually, my client Beth, who had a history of traumatic attachment injuries and had begun therapy weeks after her husband had died of melanoma, noticed that something seemed off with me. When I’d first mentioned I was having minor surgery and would be gone for a few days, she’d nodded and wished me well. I had no plans to explain further, so Beth caught me off guard when she plopped down on the couch for our next session and immediately asked, “How did it go?”

My lengthy pause instantly flooded her with panic and tears. In that moment, it felt utterly clear that being truthful was the only right choice: for her, for me, for the therapy. “I have early-stage breast cancer and…