Many people enter therapy with the wrong expectations, the wrong attitude and even the wrong therapist—any of which can result in an unproductive, frustrating or disappointing experience. But you can make it a positive experience if you approach it the right way. Think of it as enrolling in a course where you are the subject matter—if you’re curious, teachable and motivated, it can be one of the most rewarding classes you ever take.
Take inventory of your symptoms. Is anxiety keeping you up at night? Are you fighting with your partner? Maybe you’ve experienced a trauma that you can’t seem to put behind you? If you’ve got a specific issue, look for a therapist who specializes in it—whether it’s weight loss or post-traumatic stress disorder. Search for names at PsychologyToday.com or GoodTherapy.org. Note: Think about gender preferences. If your issue is not gender-related, such as fear of flying, it won’t matter. But if your issue is a controlling mother, then you might prefer a male therapist. Review bios, specialties and treatment approaches, then set up calls with a few therapists—most will offer a free initial phone consultation. Helpful: Explain what you’re dealing with, and ask the therapist how he/she might treat it. After interviewing a few therapists, trust your gut and select one to see for three or four sessions. If you feel like it’s not working, move on to someone else. The type of therapist you choose—psychologist, counselor or social worker—doesn’t matter as much as your relationship with that person.
Take ownership of your session. You’re there to talk, so take some time beforehand to think about what you want to say. Helpful: Arrive not just on time, but early. Give yourself 10 minutes in the waiting room to reflect on where you left off last time, what’s happened since then and what your priority is today. If you wait for the therapist to steer the conversation, he may never get to what you want to talk about because he doesn’t know. In between sessions, keep a therapy journal. How that helps: You can use it to jot down a few notes after each session, as well as relevant thoughts, experiences and even dreams you’ve had. When journaling, ask yourself, What do I want? and How do I feel? Refer to your journal before each appointment so that you can bring up the issues that are important to you.
What not to do: Don’t rehash everything that happened since you last saw your therapist. Some clients do this because they don’t want to deal with deeper issues, which is missing the whole point of therapy. A little conversation about an outside event is OK if something big happened that directly applies to the issue you’re working on, but you need to spend more time on the thoughts and feelings that resulted from it. Otherwise, you won’t make progress.
Don’t expect answers. Should you break up with your partner, quit your job, ground your teenager? A therapist probably is not going to answer that for you. His job is to give you the tools to answer those questions yourself. If a therapist gives you the answer, you won’t be any closer to understanding yourself, and you won’t be empowered to handle another situation on your own. Instead, a good therapist will help you understand what’s going on inside your head and help you develop the tools and emotional strength to address challenges. He might ask, for instance, “Why do you think you feel suspicious about your partner’s phone texts?” or “Why are you having trouble completing that job application?”
Tell your therapist if you have concerns about the sessions. Speak up if you don’t like something your therapist says, does or even the cologne he wears. If you bottle up concerns, a rift will build and you won’t make progress. Better: Address any frustrations at the beginning of the session so that you can clear the air and move on. Maybe you’re upset because your therapist was late or didn’t seem to get your point or his aftershave smells like the one your father wore. By telling your therapist how you feel, you’re helping him understand you better. Confrontation is hard, of course, but practicing it on your therapist will help you handle it better in life, too. Start with, “I’m a little uncomfortable bringing this up…” Talking about your feelings builds trust between you and your therapist. Don’t worry about hurting his feelings. Most therapists know how to handle confrontation without getting defensive. If yours doesn’t, consider choosing a different therapist.
It’s all worth mentioning. When you’re in therapy, buried or forgotten feelings get dredged up. Example: If something about your son crosses your mind while you’re discussing your childhood, tell the therapist about it. Does your sister’s face pop into your head while you’re describing a coworker? Say so, no matter how random or insignificant it seems. There probably is a connection to what you’re talking about—it’s like a gift from the psyche—that can help you and the therapist understand deeper parts of you.
Pick a good time for your session. What is the best time of day for a therapy session? Maybe you’re a morning person and will be more talkative then…or maybe you come to life when the sun is going down. But timing also can depend on where you have to be after the appointment. It can be tricky to go back to the office after an intense session or to meet your mother-in-law for dinner (after you were just griping about her). If you can’t avoid a schedule conflict, then tell your therapist what is on your agenda, so that he can stop the more intense conversation five or 10 minutes before the session is over. The therapist can use that time to help you make an action plan and “cool down,” just as you would after a workout. You also can plan your own cooldown period after the session. It helps to go for a walk or write in your journal before heading to your next appointment. This process is called “containment,” and it helps you to more easily reenter the rest of the world. It’s like putting your feelings on a shelf until it’s time to examine them again. The idea is to let yourself regroup and collect your feelings so that you can get back to your normal routine. Also: Take care of any housekeeping business—scheduling, payments, insurance—at the beginning of your session, not the end. It’s hard to switch gears from raw emotion to a discussion of whether your therapist will take your new insurance.
Ask about your progress. From the beginning, talk about the end. Ideally, that will be when all therapy goals have been met. That may be achieved in 12 sessions—or it may take six months or more than a year. If you’d like to keep to a specific time frame, let your therapist know that up front. Along the way, you need to know you’re making progress. There are two clues that things are going well. The first is when you begin to “internalize” your therapist. That means when you are on your own, you start to ask yourself the same questions your therapist would. That shows you’re incorporating what you’ve learned in therapy into daily life. The other clue is when you find yourself saying, “I’ve never told anyone this before.” Your therapist is hearing, This is a safe place, and this client really trusts me. Whether it’s something bad or just too embarrassing to talk about, opening up is a sign that you’re healing. Talking about your progress along the way means that you will be better prepared for when therapy ends—a difficult time for some clients. It helps you tie up the loose ends, clarify takeaway points and go back out on your own with closure.
