An insidious and common kind of speech pathology is having more in your imagination than you are allowed to say.
What prevents you from speaking may be cultural. Or it may be a lack of skill, which in this case is almost certainly due to being in a culture that does not train its members to do this.
I would hypothesize that a person’s degree of emotional/psychological suffering scales very closely to the degree that they are not able to speak about what is in their imagination.
Some people kill their imaginations to save themselves the trouble of feeling bad. This is what alcohol addiction, and some other drugs, can accomplish. This is also what is accomplished by becoming subservient to the conventions of a culture that proscribes or inhibits speech that might free its members from the suffering described above.
As far as I can tell, there is no large or major culture anywhere in the world that allows its members speech to match their imaginations.
Imaginative speech in art is mostly OK in most cultures. But interpersonal imaginings are not.
If you imagine anyone in any way, especially in a way that is painful to you, but you cannot speak about it to them, you have this speech pathology, or your culture does. If the person you are imagining is just an acquaintance or conventional friend, this does not matter too much, though it is not an ideal situation.
If the person you are imagining is your primary interlocutor, you have a serious speech pathology.