Common Issues When Starting Therapy

What to expect when starting therapy

In the Ireland of my experience the phrase “the less said the better” with regard to problems, and the tendency to sweep them under the carpet, was the order of the day.  The notion of airing your ‘dirty laundry’ in public was considered deeply suspicious, as was the idea of engaging the services of that very ‘American phenomenon’…. the therapist.  The attitude was to put your head down and get on with things, no matter how much pain you were going through. Thankfully these attitudes are changing and an understanding and awareness of mental and emotional health and well-being is dawning.

The first step towards therapy

Taking the first step to see a therapist is a difficult one and a new experience for us.  It is a step we take when we are already feeling vulnerable and often when we are unable to think clearly.  We sometimes ask ourselves is it the right thing to do – should I talk to a therapist?  Old beliefs and cultural habits die hard and we wonder are we not making a mountain out of a molehill; just being self-indulgent, navel-gazing, whinging, complaining…… If something is bothering you enough for you to consider talking to someone other than friends or family then chances are, you are taking the right step.

• Is it ‘self-indulgent’ to want to resolve feelings or patterns that affect you negatively and impact the way you interact with others?
• Is it ‘making a mountain out of a molehill’ to want to live your life to your full potential?
• If a direct result of learning to understand and be compassionate towards yourself was to be more understanding towards others, would it still look like ‘navel-gazing?

Personally, I think not.

Starting therapy

Starting therapy is a brave and hopeful step. When you meet your therapist, no matter which therapeutic approach or way of working they are trained in, they will give you the space in the first sessions to tell them your story, in your own words and at your own pace.  There is no right place or wrong place to begin, and you may find that you say more than you expected, or that it is difficult to say all you had planned to.

The environment is confidential and the therapist will listen to you without judgement.  They will understand that it may be the first time that you are talking about certain things and that it might be difficult for you to articulate what you want to say.  The therapist may ask about your family, lifestyle, support network, medical history, doctor and current medication.  They will establish what your hopes, expectations or goals for attending therapy are; and work with you to define these more clearly if they seem vague.

The therapist should assess in this first and second meeting if they are the right person, with the correct training and skills, to assist you.  If they are not, they will explain why, and help you find the service or the person who is better able to help you.  The therapist you meet will tell you how long the session is, usually 50 minutes, and work with you to find a mutually convenient time, weekly in most cases, and where possible, the same day and time each week.

The therapeutic relationship

There is considerable evidence that the relationship or bond between client and therapist is an essential element in all successful therapies.  The tentative beginnings of this bond should be established early in your work, so you should feel safe enough to know you want to work with the therapist by about the 3rd or 4th session, and trust them enough to want to continue working with them. For many of us trusting others can be very difficult, so trust is something that will be established slowly over time.

If this is not the case, and you feel that you don’t want to continue or cannot work with your therapist for a particular reason, that something is not right for you, try to tell them.  Difficult as this may seem, remember they are trained and will not take this personally.  You have come this far, and rather than not returning and having an unsatisfying experience, telling your therapist may clarify what would be more useful for you.  They will work with you to make the right move.  Sometimes communicating the difficulties you are experiencing to someone who will not take it personally, and who will help you to change your experience, can be therapeutic in itself.

The highs and lows of therapy

In therapy there can be difficult and painful moments.  You might feel elated and a sense of relief that you finally have a space that is all your own where you can explore your personal challenges, or, you might feel drained and emotional; whatever the feeling, it is important to remember that initial sessions can be tiring.  You are embarking on a rewarding and fulfilling journey that can ultimately be life-changing.

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