This research considers how mental dialogues (or imagined interactions [IIs]) about personal secrets predict the maintenance of secrecy and associated levels of mental and physical well-being. Participants described secrets they were keeping and completed questionnaires assessing IIs about the secret. After 2 months, participants reported whether they had revealed the secret and reported on moods and physical health. Results indicated that IIs predicted future revelation, negative moods, and physical illness. Five types of secret keepers (untroubled, anticipatory, defensive, repressive, and private) were identified that reflect distinct cognitive responses to secrecy. One view of secrecy suggests that keeping secrets leads to preoccupation and anxiety that ultimately affects mental and physical health. This research confirms that a pattern of rumination and ill health represents one response to secrecy; however, people may process secrecy in different ways with different potential consequences for well-being.