By A Hope419 Patient
Therapy is an adventure. Sometimes things work, sometimes they don’t. But after 8 years, and many, many discussions with people both in and out of a mental healthcare setting, there are some things that I wish I had known going in, and that I constantly find myself needing reminders of now. So, here are the top 10 things I needed to know to make therapy work for me. Hopefully, by reading this, you’ll be
able to skip some of the anxiety about starting therapy, or even going to an appointment with the therapist you’ve had forever. Your time is better spent elsewhere, I promise.
Therapy doesn’t work unless you do. You come to therapy because something isn’t working in your life, and you want help. That’s fantastic, and you should absolutely do that. But that’s only the first step. If you want the therapy to actually be helpful, you need to be prepared to work for it. You might be able to identify the problem right away, but if not, you’ll have to spend time digging into what it is that’s bothering you until you find exactly what it is you need to work on. Then, once you figure out what you need, your therapist will give you some skills to help you work on that thing, whatever it may be. Here’s the kicker, though: YOUR THERAPIST CAN’T DO THE WORK FOR YOU, no matter how much they might want to. If you’re struggling with setting boundaries, your therapist can teach you all the interpersonal effectiveness skills they have. but they aren’t the ones having the conversations with your family, so unless you actually do the work to learn the skills they give you, it’s not going to help. You have to do the work. You have to decide to take the skills they give you and actually put in the effort to use them. Some things they give you might not work for you, and that’s totally fine, but you’ll never know what does work for you until you give it an honest attempt. I’m 8 years in, and I’ve made a lot of progress in a lot of areas, but that progress has only happened in the times when I’m actively putting in the work to make it happen.
You and your therapist are only human. It’s really easy to come into therapy and expect to be given the answers right away. You always hear “if you’re struggling, get help,” but people forget to talk about what that help actually looks like. While some things might be relatively “simple” to figure out, other things take time and a lot of patience. As you’re going through the process, there will be times when you leave an appointment thinking “well… That was a waste of an hour.” There will be times when you don’t mention something because you don’t think it’s important, but that could be the one missing piece that allows you to figure out what to do next. There will be times when you get angry at your therapist because they are asking you to reflect on your own behaviors and they will call you out- that’s their job. There will be times when you don’t want to talk. There will be times when they just aren’t sure what to say that will actually be helpful. There will be times when things just don’t match up, and you’re not on the same wavelength, and you leave feeling a little weird about how your appointment went. Every single one of those things is okay and should be expected from time to time. You are both human. You are both fallible. Don’t forget to give both of you a little grace when those things happen. Take those situations, and learn what you can from them. The humanity is one of the best parts of therapy, so while it can be frustrating at times, it’s totally worth it.
You are allowed to say what you need, or even just what you want. This is something that I’ve just recently started doing, and boy, oh boy, has it changed the game. I’ve been with my therapist for almost 8 years now. I have been through a lot during that time, I have done a ton of work with her, and I’ve made a lot of progress. And honestly, it’s been rough at times. We’ve spent many an appointment spinning our wheels over what we should be focusing on, when all I had to give was “I’m having a hard time and I don’t know why.” I’ve left many appointments feeling like we were focused on something completely different than what I wanted or needed. The number of times I’ve heard “was this helpful?” at the end of an appointment, because we both knew it wasn’t hitting the mark is genuinely so frustrating to think about. I wish I had known, or been reminded sooner that I have the power to make therapy work for me, not just the other way around.
When in a discussion with some friends around therapy recently, one person was talking about how they wished they could talk to their therapist about something that they had talked about at one point, but had since moved on from, and somebody said “you know you’re allowed to ask for that, right? Like, you can say what you need. Your therapy is for you- you can ask them to work with you how you work.” This might seem obvious, but it was a revelation to me. I had never thought about it that way. I hadn’t realized that my feedback (or lack thereof) was holding my therapist back from being as efficient at her job as possible. It was holding me back at getting what I needed out of the hour I have with her. How in the world could she know that I found a loophole in the way she was opening up our appointments, so while I was being honest, I was also avoiding things I needed to be talking about? How could she possibly know I missed checking in with her in a certain way that we did a lot in the beginning, but hadn’t needed in quite a while? The answer: she couldn’t, until I decided to tell her.
And guys. It was awkward. I was terrified when I first tried it. I thought she’d be mad because I wasted both of our time. I was nervous that I’d ask for something and she’d say no, and I’d have to just deal with whatever it was that she wouldn’t or couldn’t do, and act like it was okay. I even briefly entertained the idea that by saying what I wanted to talk about, I was implying that I knew how to do her job better than she did. What actually happened was that she was excited to have something new to try to make things work better for me. She was able to start asking me questions in the way I needed to hear them, and we figured out a way for her to check in with me at the beginning of appointments that worked better for me. Once I had that one success, I did it again (without waiting so long this time), and you know what happened? We spent one appointment on something that wasn’t a priority, and when I said something at the beginning of the next appointment about is not being what I wanted to focus on, we shifted gears back to something that I felt was more important and spent our time there. It was that simple. I didn’t even have to defend why I thought it wasn’t as important. I just said it wasn’t, and that was enough. So, whether you’re just starting your therapy journey, or you’re in the midst of it, I encourage you to ask for what you need, or even just what you want. You might be surprised at how helpful it turns out to be. I know I was.
The Meme is true.
If you’re on the internet, chances are, you’ve seen some version of this meme. And if you’re like me, you’ve probably ignored it right when you needed to believe it most. But this is probably the truest meme you will ever find. Progress, healing, learning…. None of it is linear. You go in thinking “Ah, I’m going to do all of this work, and I will come out better for it. There’s nowhere to go but up, right?” Wrong. As you’re going through this process, it’s going to be messy. There will be days you feel on top of the world. Where you can look back and give yourself so much credit for all the work you’ve put in, and you can acknowledge that you’ve actually had some success. Then there will be days where you feel like a total failure. Where you will blame yourself for things not working, because you remember a time when they did, and you have already been taught the skills, and you think you’re failing at using them. No matter where you are along this crazy squiggly line, trust me when I say- if you keep fighting through it, things will get better eventually.
Healing is exhausting. It takes time and energy that sometimes, you just don’t have. It requires you to continually address parts of your life and your experience that are downright painful. Sometimes, it feels like you’re dangling from the side of a mountain, clinging on desperately, and feeling like you just don’t have it in you to keep fighting. You will get tired. You will want to give up. Hope will seem like the most pointless of emotions. But let me tell you the part I wish I’d known at the beginning: even if they don’t say it outright, your therapist is holding onto your hope for you. No matter how much you might want to give up on yourself, they aren’t going to give up on you. I’ve seen this in my own experience more times than I can count. I go in feeling like there’s no possible way that I’ll be able to handle some stressor or change my thinking about something, and that things will never change, and no matter how the appointment goes, I always find myself leaving with at least a tiny sliver of hope that eventually things will get better. You’re allowed to get tired, you’re allowed to be frustrated that things are taking so long and don’t seem to be working, you’re allowed to feel however it is you feel about your process. Your therapist will be there through it, holding that hope for you until you’re ready to hold it for yourself.
The skills you learn in therapy are not going to work every time. It’s remarkably easy to look at the skills you’re given, try them out and see that they’re successful once, and expect them to work every time. But much like if you’re trying to build some IKEA furniture- sometimes it’s just not the right tool for the job at that time. Sometimes you might reach for the screwdriver, because the last 6 steps have used that, when this time you need an Allen wrench. Sometimes, with therapy, you’ll reach for the skill you’ve been using for months, only to find that that’s not the one that works this time. And much like building IKEA furniture, it takes time to figure out what tools you need when. The fact that you didn’t pick the right tool this time doesn’t mean the right tool doesn’t exist, or you don’t have access to it. It just means you might need to look around to find the one you need before you can be successful.
Give it a fair chance. When you’re going through the process of therapy, it is really easy to “try” something without actually giving it a fair chance. If you’ve ever given a kid a food that they’re convinced they won’t like, you know what I mean. They “try” it by taking the smallest nibble they can get, and before it even makes it into their mouth, they’re making a face and gagging because of how gross it is. Sometimes, when we’re convinced that nothing will be able to help us, we do the same thing with therapy skills. We “try” it by barely giving it any thought or effort, but do just enough to say we tried, and we immediately dismiss it as useless when it doesn’t work, even though we never actually gave it a fair shot. As someone said to me recently “consider the possibility that this could actually work”… Maybe it won’t be successful, and you’ll have to try something else, but maybe…. It will. The only way to know is to make a genuine effort to make it work.
Talk about the little things. It can be easy to fall into the trap of thinking that things aren’t important enough to talk about in therapy. Say you had a disagreement with a friend, and they made a comment that sat with you wrong. You worked the disagreement out, but that comment is still sitting with you, even though the argument is “not a big deal” anymore because you worked it out… If you skip over all little things that you’re not bringing up because they don’t seem important enough, eventually it will build up and become overwhelming. If it’s worth time in your thoughts, it’s worth time in your therapy.
You have to be brave. In the words of Sara Bareilles: “I wonder what would happen if you say what you wanna say and let the words fall out? Honestly, I wanna see you be brave.” No matter how much you trust your therapist, there are going to be things that come up that are hard to share. Maybe they’re things that are hard to admit to yourself because they’re scary or you feel ashamed of them. Maybe they’re things you’ve been holding on to since you were young, and you’re not quite sure you’ve put the pieces together in the right way. Maybe you’ve been comparing yourself to someone else and have convinced yourself that what you’re going through is “not that bad” and you feel embarrassed about asking for help on something that should be easy. Maybe it’s something else entirely. But if there’s anything I’ve learned over my time in therapy, it’s that usually the thing I’m most nervous about sharing is the thing I need to talk about the most. When I stop sharing those things (intentionally or otherwise), I stop making progress and things start to feel hopeless. But as soon as I decide to be brave and bring up the things I’ve been avoiding, no matter how I feel about them otherwise, the weight lifts and I start feeling hopeful that progress is possible again. Be brave. You are worth it.
Life is hard. I know, that bit probably sounds obvious, but this is something that I am constantly having to remind myself. No matter how many tools you have in your toolbox, it’s always going to take effort to get the work done, and some things will be harder than others. There isn’t always going to be a solution to whatever the problem is. Sometimes, the only “fix” is to tolerate it until the time comes that you can change it. Life is going to be hard. You’re going to face things that challenge you, scare you, and threaten to break you. You may have heard the cliché statement of “you’ve had 100% success at survival so far,” and while that’s true, it forgets to acknowledge that sometimes, that path absolutely sucks. That’s just how it is. Therapy isn’t going to make life not suck from time to time. But it is going to teach you how to handle those phases of life, and give you the support you need until things start looking up again.
No matter where you are in your therapy journey: just starting out or hanging in for the long haul, I hope something here will help you find success. You have quite an adventure ahead, so get yourself ready to work hard, be brave, and fight hard right alongside your therapist. They’re there when you need them, and you are worth every effort on their part and yours. You’ve got this.