Things I Wish Someone Had Told Me Before Starting Therapy… Part One.
Written by Lisa Torquato, LSW, Primary Therapist and Marketing Director at Tree of Life Counseling Center.
What’s the point?! Is therapy really going to help? Why bother talking about my feelings? How long do I have to keep coming here? Do I have to lie down on that couch? Is my therapist going to judge me? How can I be honest with a total stranger? This is a waste of time and money. Nobody cares, especially someone who’s being paid to talk to me. I’ve had bad therapy experiences in the past. My family isn’t okay with me being here. I swear I’m not crazy. I can handle it on my own. I don’t want people to know I’m in therapy. I’m just not sure I want to do this…
As a mental health therapist, I’ve heard them all - the questions, concerns, uncertainties, and worries about starting therapy. And honestly? I get it.
What goes on in those tiny therapy rooms is largely a mystery to a lot of people. Well, as I always say to my clients, knowledge is power! Let’s start dispelling some common therapy myths together right here and right now.
Yes, there will probably be a couch. No, you don’t have to lie down on it.
Assuming we’re talking in-person sessions and not virtual, yes there will most likely be a couch, maybe some chairs, and probably a strategically placed tissue box (no, you do not have to cry - but you’re certainly allowed to).
The whole “therapy couch” cliche is one that largely comes from the work of Sigmund Freud, an Austrian neurologist and the father of psychoanalysis - a specific approach to therapy. Freud believed clients did their best therapeutic work lying on a couch, looking away from the therapist, because it allowed the client to be more open and vulnerable. Psychoanalysis is still practiced by some therapists, but it is no longer the clinical “norm.” It’s one of many clinical approaches. If a therapist forces you to do just about anything outside of your will - including lying on a couch - it might be time to look for a new therapist.
If I’m your therapist, you know I always tell my clients that you are more than welcome to lay down and get cozy on the couch… But only if you want! I’ve sat on the floor with clients, I’ve let them sit in my seat, I’ve gone on walks with them… It really is whatever you’re comfortable with.
Your relationship with your therapist is going to take time to develop… Just like any other relationship.
When you step into my office for that first intake appointment, we are total strangers. I’m not going to pretend otherwise. I’m also not going to pretend I understand you, your life, or the challenges you’re facing after we spend only 50 minutes together. People are complicated. I get that. I’m about to ask you some personal questions, and that might be uncomfortable. I get that too.
While I can’t promise you’re going to feel comfortable right away, I can tell you I’m going to work to support you as best as I can for the time that we work together. I’m really not judging you. I just want to help however I can. I can handle your feelings, even the big ones. It might take time for us to get to know each other and for the trust to build, but during those 50 minutes we spend together each week… You are my complete focus. I might not personally relate to your situation that much, or I might relate to it a TON. It varies. But, most of the time, it doesn’t really matter to me. I’ve received a lot of schooling and training, done internships, passed licensing tests, received supervision, and just spent a lot of time and money to sit in this chair. Now I don’t say that to be prideful, I say it to assure you that I am well equipped to support you in a way that’s different from your best friend, your mom, your partner, or your boss. Try to be patient in the process. Give our relationship time to mature.
There’s generally no “It’s Not Your Fault” Moment.
Remember that famous scene in Robin Williams and Matt Damon’s 1997 blockbuster hit Good Will Hunting? Therapist (Williams) hugs client (Damon), telling him over and over again, “it’s not your fault, it’s not your fault.” Matt Damon breaksdown, starts crying, and seemingly cures all the issues that brought him to therapy!!
Look, I love the drama as much as the next girl… It’s a great movie and a great scene… Unfortunately, this isn’t how therapy typically goes. Normally it’s slow and progress is gradual. Sure, there might be small moments of realization or catharsis, but behaviors and beliefs generally take a long time, and a lot of hard work, to deconstruct and really change. Some weeks the hour might feel like a waste of time and you might get frustrated. I promise it’s not a waste, but it happens. Commit to the process and change does come. Please be patient with yourself and be patient with me. We’re on the same team.
I don’t want to (and can’t legally) prescribe you medication.
I’ve had new clients who are worried that all therapists are basically just pill pushers. Nope! Therapists have wildly different and varying views on medication and psychotherapeutics, such as antidepressants or antipsychotics. Feel free to ask your therapist their opinions! Only doctors, psychiatrists (doctors that focus on mental health), and certain types of nurses can prescribe you with medication. I definitely communicate with these kinds of people sometimes to provide you with a more holistic program of care, and I might refer you to someone if I think there is a chance medication could help, but I don’t receive any sort of compensation or kickback for those referrals. At the end of the day, it’s always your decision whether or not to accept any referrals I provide.
I am here if you’re curious to learn more about the role medication can play in your overall mental healthcare, or if you need help processing various decisions about medication so you can come to a solution you feel confident in. Meds are just one tool available in the mental health toolbelt. Some of my clients take lots of different medications, and some take none at all. There’s no “right” answer.
So what do you think? Have we successfully dispelled a few myths about therapy? I hope so! Stay tuned for more from this series and, remember, if you ever have a question about what to expect in therapy… Don’t hesitate. Go ahead and ask!
NOTICE TO USERS The Tree of Life Blog is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on this blog.