What to (Actually) Expect From Going to Therapy

More and more people want to pursue therapy as a career path than ever before.

Graduate programs in counseling are booming. Since the onset of the pandemic therapists have seen a major uptick in clientele, and “you should go to therapy” is a suggestion that has become (mostly) as culturally acceptable as telling a friend to take a vacation. In fact the idea of going to therapy has taken on a new meaning. Synonymous with self-care, it has become something to indulge in; despite therapy not being easy at all, or even enjoyable. It’s mostly hard and uncomfortable.

I opened my private practice last year after years of working with mandated clients. Clients who, if it was up to them, would rather being doing any number of things than talking to me. I eventually became exhausted and burnt out from the hours, climbing caseloads, and low pay. Though I had experience working in private practice, building my own came with its own set of surprises.

When I think about my work as a therapist I find people, mandated or not, want (generally) 3 things: relief, to feel less alone, and to be told what to do. Ironically the adage “therapists don’t give advice” is mostly true, though we all have. There are several reasons why, but perhaps most practically, any advice we give you’ve probably already heard from someone anyway. We’re more likely to ask you want you want (many many times since desire is so elusive) than to tell you what you should do.

In the beginning therapy feels both relieving and uncomfortable. It feels invigorating to talk with no expectation of pausing, to talk freely to someone who you don’t know. Talking to someone you don’t know about yourself is also jarring. Sometimes clients don’t come back after noticing this particular intimacy that only exists in a relationship that promises privilege (patient/therapist, parishioner/priest, client/lawyer).

No one person’s experience in therapy mirrors another but humans are more similar than dissimilar and the process of therapy often includes over-arching themes, ebbs and flows that ripple beyond singular therapy experiences. Insight is one of the first mechanisms of change. Once you become aware of your patterns, and often these are patterns you’ve decided you don’t want to continue engaging in, the hard “work” begins.

At this point you will start to begin exploring the process within therapy rather than just the content of what you’re saying. You will start to talk about why you engage in the same patterns and you will begin to identify when you engage in those same patterns in therapy. The therapist becomes a representation of someone in your life, simply because you will always know less about them than they know about you. Your therapist will become a blank canvas for projections of your fantasies, wishes, and feelings. For example, if you fear your therapist leaving you—retiring, for example, suddenly, which many people do—undoubtedly the question will be raised: what is this fear connected to? Maybe a period of your life that is hard to let go of, or a person in your life who disappointed you who you still resent. Once you discover insight, you will trudge ahead with your therapist tackling the difficult task that is making a decision after learning something new. Often this decision includes doing nothing at all since self-acceptance is one of the most powerful tools for change there is.

Therapy isn’t self-care because the process itself is the opposite of escapist, which many ‘self-care’ activities are. Therapy is not passive. Talking about your anxiety will make you more anxious until you discover why you are anxious.

Expect your therapist to make mistakes and expect to feel understood and simultaneously misunderstood. Expect to be asked a question more than once. Expect your relationship with your therapist to surprise you, and to form an attachment to your therapist that is unlike any other in your life. Initially expect to feel uncomfortable and hopefully, with time, you will feel a sense of omnipotent relief and active acceptance of all that you are, without feeling the need to reciprocate emotionally. This will not come easily at first to many of you, especially those who have made a habit out of taking care of others. Expect to learn how to ask for what you need and expect to learn that some people in your life will not, or cannot, attend to your needs in the ways you wish for. Expect to learn how to practice acceptance of the former and other truths that are painful, but that tend to vanish from our worries when we accept them as reality.

Don’t expect to like the first therapist you meet with. Finding a therapist you feel comfortable with and have confidence in takes time and sometimes multiple tries. Don’t expect a magic bullet, or for angst to disappear, or for things to get better right away. Expect to question yourself including your thoughts and feelings—a lot—until the day comes that you don’t as much. Expect then, to begin to understand what you desire, independent of any persuasions, societal, social, or familial. That moment is certainly worth the work.