My first experience with therapy was after a particularly angsty teenage summer, after which my parents and I both agreed I could use a little extra support. I was open to the idea of talking to someone and thought it might be a good place to air out the web of thoughts locked up in my mind. And so began my 5pm Monday appointments with Susan. What I thought would be such a straightforward process (I talk, she listens) turned out to be much deeper and more complex. There were times of levity and humor, moments when I would laugh and my world felt less burdened. There were also moments of challenge and strain, sessions when I did not want to attend and Susan made me feel angry. She challenged me to look at myself, the webs behind the webs and to begin to dust them off, examine them, and to see who I was on the other side. One-year-later, I ended therapy and what was left was a remarkably different life. I could not point to one moment in the process, one aha revelation, or one self-care strategy that magically transformed everything. But the slow process of weekly challenge, connection, and growth led me somewhere in which I felt lighter, my relationships were more fulfilling, and I looked forward to my future. Well over a decade later, I sincerely thank my first therapist for that experience.
Looking back, I have a few takeaways on the process. I should also mention that somewhere between now and then I got my own doctorate degree in clinical psychology and began seeing clients myself. I have valued both experiences (as a client and as a therapist) and I want to explore some thoughts or concerns that you may have. If you are new to therapy, or if you are a returning client, Welcome! Are you ready?
Am I ready? Do I need therapy? What is wrong? The process of starting therapy can be a daunting one because it often comes at a time of need. Many people feel that something is off or something is wrong but they do not necessarily know what it is. Some people feel as if they don’t have the language to put a voice behind what is going on. They just know that something does not feel right and it is not the common cold. When I hear these concerns in my practice, I like to assure my clients that even when they feel as if they are not making sense I can often piece together the larger picture and distill it down in a way where they feel seen and understood. Being seen in those moments of pain, confusion, or challenge is often the first step in starting therapy. It will give you hope that your therapist is in alignment with you and may even have insights that you felt were clouded.
Therapeutic Alliance. So, let’s say that you start therapy and you experience that moment of connection where your therapist gets you and even gets more than what you originally shared. That is the beginning of a therapeutic alliance and it is crucial! You must, must, must like your therapist and want to work with them. If you find yourself dragging your feet, not liking your clinician, or not feeling comfortable to share, then it is okay to stop working with them and move on to someone new. And please do not worry about hurting our feelings. We are not hurt by you finding a better fit and we likely suspected that that change was coming. In order for therapy to work, the therapeutic alliance is critical.
Your therapist is not your friend. But you said I need to like my therapist? Yes, you need to like your therapist, but your therapy sessions should not feel like catching up with a friend over coffee. Remember Susan, my therapist from when I was a teenager? I told you there were moments of challenge and when she made me feel angry. Susan understood that her role as a professional was to push at times when I was ready. She understood that uncomfortable feelings can lead to growth. Her ability to tolerate my discomfort is part of what made her a great therapist. And this is where the therapeutic alliance is crucial. The times when your therapist pushes you into a place of discomfort is your opportunity to pick up that piece, examine it, and to tell your therapist exactly how that made you feel. The growth that can come from these moments will follow you outside of therapy and into your world for the rest of your life.
I don’t believe that my therapist actually cares about me. I hear you on this one and this fear snuck up on me quite a bit when I was starting therapy. The idea that I was supposed to share my deepest thoughts to an essential stranger was not alluring, to say the least. How did I know she was not just counting down the minutes? For this concern, I can certainly validate the thought from my own experience as a client, but I hope to reassure you from my experiences as a therapist. First, I do not take on clients that I do not like or that I do not care about. The pathway of those that I have worked with is a special one. I worked at a residential treatment facility when I was 22-years-old and I still remember those that I treated from that time and I think of them fondly. I remember my first client as a doctoral student. In fact, I remember my whole caseload. Still to this day, the clients that I have now are a big part of my professional life; I learn from them as much as I hope they do from me. Remember, the therapeutic relationship is reciprocal and you are seen and valued in our work together.
How do I know therapy is working? Many therapists will use standardized outcome measures. These will measure the symptoms and concerns that you present with and will give a concrete number that you can base progress on. These are wonderful tools but not the only way to measure growth. Recall my experience with Susan and how therapy was slow and I did not have a singular transformative moment. Through therapy, you may notice positive changes not measured on a questionnaire. You may feel more attuned with yourself, more open with your feelings, confident in your worth, and comfortable in your relationships and in your world.
Am I ready? If you want to take this first step, I would be honored to be a part of your journey. I hope these questions helped address any concerns you may have about the process and I am happy to answer any more that arise. If you’re ready to take the first step, schedule a free 15-minute consult at Coastal Collective Counseling where you will be seen, heard and valued.
