It’s normal to be unsure of what to expect in therapy if you’ve never been or when starting with a new counselor. You may imagine a stuffy professional with bifocals and a note pad asking about your relationship with your mother and saying “how does that make you feel?” The unknowns can be intimidating and you might be worried about being judged. You may even have had negative experiences with counselors in the past. It’s understandable that you may be hesitant. It’s a vulnerable thing to sit in an unfamiliar room with a stranger and talk about your concerns, however, it can be a wonderful, freeing, self-growth process that can lead to so much light, happiness, and healing. You deserve that.
I don’t want to be judged….
One common fear is that your therapist is judging you. People are usually in counseling because something is not going well and it’s scary to admit your less-than-good habits, acknowledge mistakes, to talk about times you were not your best self. Counselors are trained in a practice that’s known as unconditional positive regard, and if a counselor can’t practice it then they probably aren’t cut out for the job. Judgement by a counselor ruins the healing process. Instead counselors remain objective and if you disclose something you’re concerned about, a counselor will be gentle, nonjudgmental, accepting, and curious about what’s driving the behavior in order to better understand it. We understand that people make choices or act in certain during times of distress, because of a lack of skills, or a missing information. I tell my clients that the behaviors and patterns you’ve had were because you needed them in some way and they served you even if they had some negative consequences. We will focus on how these things helped you. I am not here to judge. Counseling should help you identify patterns to see if you want to change them and to help you make informed decisions in your life.
People worry about counselors talking about you or sharing your personal details. Not only are we legally bound to confidentiality but ethically, counselors hold the privacy of their clients as a vital part of the process. I am always honored that my clients share their personal lives and I will protect that in every way possible. When I start with a new client, I explain that the only time confidentiality is not kept is in the event of a major life threatening safety issue or if abuse of someone who is not able to defend themselves, such as a child or elder adult, is reported. In our small city of Portland, I even address what happens if we bump into each other around town.
Getting vulnerable with a total stranger….
Getting to know each other takes time. Therapy is about the relationship with your counselor. It works best when you feel comfortable and safe and that trust can take a couple sessions to develop. If you aren’t feeling it after a few sessions, your therapist may not be the right fit for you, you may not be ready, or another barrier might be lurking. It’s appropriate to voice concerns or hesitation to your counselor. Our job is to help you sort these out and make a referral to another therapist if the fit or style isn’t right. If counseling feels intimidating remember that we are humans too. We are flawed, have problematic personality traits, have overcome hardships and challenges, and deal with our own challenges and issues. Many therapist training programs recommend that therapists in training do their own counseling, not just to be their healthiest selves but to know what their asking of their own clients. In many ways we have been in your shoes. I tell clients that they are the expert on themselves. I have specialized training and will share information I’ve learned that I think could help, I’ll point out observations I see along the way, and teach skills I think might be useful, but it’s your life and you ultimately know what’s best for you.
So how does it all work?
Counseling doesn’t fix you. You don’t need to be fixed. Counseling helps you see things differently and make changes if you want to. It will take you to the edge of your comfort zone but not beyond. Like in physical therapy, the concerns are explored, contributing factors are identified, you are given education about how your body works, suggestions for taking care of it, and skills to try. Therapy explores what’s going on, how the problem or concern came to be. It starts with information gathering and getting to know each other. As more about a person or their situation is understood, information relevant to concerns is shared. That could be education about emotions, social interactions, relationships, information about depression or anxiety, how the brain works, stress and what it does to us, and more. Evidence-based practices that have shown effectiveness are used. For example, I use Cognitive Behavioral Therapy to explore how beliefs and thought patterns affect feelings and behavior. I also explore how the body is affected. Emotions often live in the body and sometimes headaches, stomachaches, or other physical concerns can be tied to an emotional issue. The real work is in between sessions. It’s what you do with the new information that really counts.
Are you going to ask me about my mother?
Part of therapy is exploring where concerns or issues are coming from. This could mean exploring family relationships or things that have happened in the past. It’s important to know that you don’t have to talk about anything you don’t want to. In fact, therapists know that getting into a painful topic before you are ready can do more damage than help and we are trained to recognize what might be too vulnerable to address. Part of therapy can be developing good self-care, self-esteem, and coping skills until you’re ready to explore more sensitive topics. I let my clients know that it’s appropriate to tell me if you are not ready to talk about something. This is especially true if you’ve experienced any kind of trauma or abuse. It’s ok to not be ready to address these things. I’m going to write more about healing from trauma in another post soon. For now, it’s important to know that you should set the pace of therapy. It’s like a motorcycle with a sidecar. You are driving, I’m along for the ride and will point our what I see as we go and offer suggestions but ultimately you are driving.
What about the time and money? Is it worth it?
Insurance should cover the cost of counseling. You may have a copay depending on your insurance. Health Savings Accounts or Flex Spending Accounts are other smart options to minimize health care costs. If you don't have insurance and are unable to pay sliding scale fees may be available or a counselor can help you get connected to a community agency that may have other options available. The length of time spent in counseling depends on your personal needs. Some concerns are able to be addressed in as little as 5 to 10 sessions, other times, ongoing support is required. Long term counseling is usually appropriate when there are more serious mental health concerns like a significant anxiety disorder or clinical depression, or when significant things in your past history are affecting you now. And yes, it's totally worth it! The long-term benefits of going to counseling can be wonderful! To better understand yourself and why you do what you do, to know why some situations bother you so much, to have improved relationships, to feel better with yourself, or to be happier are all possible benefits. Clients see less stress, better moods, improved self-esteem, less worry, less intense emotional concerns, and more. You are absolutely worth that!