On Starting Therapy
By Eliza Jade Brown
What to expect from your therapist
Meeting with a therapist reminds me of standing in front of a compassionate mirror that shows you your blind spots but does so in a thoughtful, and compassionate way. Another way to perceive a therapist is the therapist aims to be both an objective voice, but one that is attuned to the unique and individual needs of their client. So think of a well-meaning, highly trained person you just met that truly listens to you and remembers the details about you so when you meet with them again, they have a better understanding of what is right for you rather than focusing on what works for everyone else. I have also heard from author and fellow therapist Lori Gottlieb that a therapist resembles an editor. The client is the author of their own story, but the editor after considering the narrative makes suggestions for tweaks and changes in previous chapters and this in turn helps the author to write their next chapter.
Tips for how to talk with your therapist
It helps to:
Show up as your authentic self, the one that takes their shoes off at the end of the day and sits down on the couch unconcerned with being “on”.
Be right in there in the process of understanding yourself and your challenges in the session, rather than presenting to your therapist or waiting for them to tell you how it is.
Anticipate that the therapist is solely there to help and focus on you, not to meet their own agenda. You do not need to worry about appeasing your therapist or take care of their feelings.
Understand that the therapist is not a mindreader, and miscommunication happens. There is some effort involved in helping your therapist understand what you are sharing and letting them know if you think they are missing the mark.
Have patience in the process. It is challenging to encapsulate all of who you are and what you do moving at the pace of typically one hour once a week. Prioritizing can help at the start, but there may be some stumbling in the dark to start really getting at deeper issues needed for change.
How to find the right therapist or counselor
This takes a bit of self-awareness and potentially trial and error.
It helps to understand which type of person you find easy or comfortable to open up with unless perhaps you are working on challenging yourself to connect better with a certain type of person, and this is actually the reason you are seeking therapy. This is uncommon and may be easier as an assignment outside of therapy sessions. It is hard enough to open up with someone you just met, moreso if they already remind you of someone you do not get along with. For example, If you have struggles opening up with someone that looks or sounds a certain way because they remind you of someone you have problems with, choosing someone who reminds you of this person will probably complicate the first few sessions and potentially create a shaky foundation for the therapeutic relationship. The therapeutic relationship is similar to other relationships that at the start, first impression matters to help establish a general positive feeling towards the other person, your therapist.
Another important factor is specialty. Most therapists have a number of issues and challenges they have professional experience in due to their extensive training, but usually only have a few that they are truly passionate about and this tends to be their specialty. So yes, you can go to a therapist that specializes in depression but not ADHD for ADHD symptoms and benefit from it, but you may find your sessions tending more towards targeting depression and only touching on ADHD every so often. That being said, you can change therapists if you find they may not be who you need to talk with after all. It is also possible to find out in the process that your therapist meets most of your needs that you may not want to switch to another therapist in pursuit of a certain specialty. In this case, it may be best practice for your current therapist to put in the work to learn more about the issue that is not being met. As mentioned earlier, let your therapist know if you think they are missing the mark. This way, you can discuss solutions together.
Why do I need help - what should I expect from my first session?
You tell me! Only kidding. Part of the first session may be to explore this together. However, it does help the process to do a bit of self exploration prior to the first session. Two ways you can do this is to perhaps approach the in-take form thoughtfully or journal about what you would like to see change or have help with. The first session can be about exploring and defining those problems that you are most aware of, and potentially uncovering problems you may not be as aware of. From here, you and your therapist may set tentative goals of what the first few sessions will look like. I have found some clients benefit from more structured goals while others feel restricted by it, and prefer more of a loose guideline starting out. I suppose we can consider it as someone starting out with the details and prefer to work their way out to the big picture versus someone starting out with the big picture and then moving towards working out the details.
Do I need group or couples therapy with individual therapy?
In my opinion, if the problem or issue you are seeking therapy for has a significant impact on you, starting with individual therapy is a safe bet. Your individual therapist can then make a recommendation for group or couples therapy as needed. Group therapy is beneficial for learning and practicing skills similar to attending a class, and for hearing differing personal perspectives and receiving support from other clients seeking help for similar issues. Couples therapy is beneficial if you are ready to take the step of working through relationship issues and challenges in therapy with your partner or even family member or friend. This is not to be confused with times when a partner or support person is invited into an individual therapy session to learn more about your challenges and how to better support you. True couples therapy requires a separate and neutral therapist. The couples therapist tends to focus on the couple’s and the relationship’s needs over the individual needs of either person. So if you notice you have individual needs outside of the relationship that needs to be addressed and worked through, it may be best to explore them in individual therapy rather than couples therapy.
More questions before starting
Many practices, including the Austin Mindfulness Center, offer a free 20-minute consultation or in-take call prior to the first session. Offering this only helps both you and your therapist since it increases the chances that you are able to find the right fit. This call can also give you a feel for the type of therapeutic relationship you would have with your therapist. As with starting a new commitment or new habit, starting therapy can feel daunting. I hope the information here helps remove some of the unknowns and ambivalence of starting therapy.