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So I Started Therapy, Now What?
by MindJournal – 7 min read
Deciding to go to your first therapy session is huge, but it's a lot like eating well or exercising. You start out strong, maybe too strong, and try to get all the work done in the first three weeks because you want to see change. But when results don't immediately happen, you get frustrated. The novelty wears off, and so does your resolve. Before you know it, you've thrown in the towel and you're back to pretending that nothing needs to be worked on.
The issue is that there's an image of professional help, spurred on by movies and TV, that it requires little to no effort. You simply need to show up, and once you're there, you'll hear a couple of wise words and all your problems will dissolve.
It's a nice idea. The only snag is that it doesn't exactly work that way.
In reality, the big cinematic breakthroughs are rare. The ultimate motivation for many people in therapy is to try and re-wire unhelpful or unhealthy ways of thinking, feeling or behaving. That takes work, and it takes time.
"You won't walk out with a solution after one session," says Jill A. Stoddard, the author of Be Mighty. Put another way, "If problems were easy, you wouldn't come here," adds clinical psychologist Mitch Abrams.
Of course, you don't have to be unwell or in a state of crisis to do therapy. It can also be a way of actively engaging with your wellness – like a regular massage, but for your mind. Regardless of the destination, to get there starts with, well, a good start. Luckily, keeping the following in mind can help.
Being Patient as a Patient
As any guy who has ever experienced an awkward date knows, rapport doesn't form instantly. You might walk out of your first session unsure if you've found the right therapist, but try not to put too much pressure on it. As long as it wasn't completely terrible, give it two or three tries before you decide whether to carry on with this person.
Asking questions early on can help and give you a sense of what's to come. "What's your approach?", "What will the sessions be like?", "How can I be most effective?", "How will we know that things are getting better?"
All of these will get the therapist to talk. You should hear clear answers about the process and goal-setting, says psychologist Robyn Landow. But there's no set formula for making your decision. Ultimately, it's a gut feeling, and you're allowed to shop around.
"It's like hiring a personal trainer and thinking that's enough to make you the next Mr Universe."
Say Words, Out Loud
It should go without saying, but you have to talk. Usually, the first two therapy sessions are less about problem-solving and more about establishing what brought you in, with the occasional delve into your past. In clinical terms, it's called the intake.
The talking part is crucial because, let's face it, even the best therapist can't simply look at you and know how you're feeling or determine your goals. You don't have to know the extent or the whys. You just have to, as best you can, give it some kind of name because "we're not mind readers," Stoddard says, "we only know what you tell us."
If you're wondering whether or not to share something, the advice is usually to share it. The thought is already in your head, after all. It's perfectly fine to bring something up and follow it with "but I don't want to talk about it right now," Landow says. The therapist can file it away, but since you're there through your own choice, you're not required to explore anything.
No One Way to Feel
You can leave a session feeling any number of ways: happy, exhausted, relieved, calm, motivated – heck, even a bit unsure. The only thing you shouldn't feel is nothing. "If you walk out feeling indifferent, you might have the wrong therapist," says Abrams.
There may even be times your therapist will annoy you, most likely because they tapped into something you don't quite understand yet or got you to reflect on less-than-flattering things about yourself.
It's fair to push back. Just do it with self-awareness, such as, "I didn't like what you just said, I felt angry/sad/misunderstood." That approach furthers understanding and builds trust between the two of you. "It's a mature confrontation," he says. "I can disagree without hating you."
Do You Tell People?
There's power in matter-of-factly mentioning that you're in therapy. It opens you up to messages of encouragement, allows others to say what they've done, and lets people know that you're trying, all of which can further bolster your efforts.
Ultimately, it's up to you what to say to your confidants. Abrams suggests that if you do decide to share your discoveries, talk about broad themes rather than specific details, and let the response of those around you guide whether you choose to reveal more.
Journaling can also help. Done before a session, it can clear away any nerves and help you decide what you want to say. Post-therapy, journaling gives you a chance to recap lessons or things to remember. Just realise that when you write, unexpected connections can happen, like your ex popping up while you're sitting near your current partner. It doesn't necessarily have a larger meaning, but the key is not to hold back, so do it somewhere you feel safe and comfortable.
Put In the In-Between Time
You can show up, give your all in a session, and not do anything until the next one. It's a possible approach, but it's like hiring a personal trainer and thinking that's enough to make you the next Mr Universe.
As the saying goes, there are 168 hours in the week, and you spend less than one with your therapist. How you use the remaining time increases or decreases the return on your investment. If you haven't been told before you leave, Stoddard suggests asking, "What should I work on?"
There's no one answer, but there should be some form of homework to build on what was discussed and help focus your time and thoughts. "If you're ruminating about the session all the time, that's a problem," Abrams says. "If you're not thinking about it at all, that's a problem. Where you want to be is in the middle. We want to get you mindful."
