*(The examples provided below are composite cases, synthesizing disguised information and not any patient in particular)*
There are many good reasons to start therapy: personal growth, self-empowerment, learning new skills. But when it comes to making the first appointment, it is not uncommon to second guess your decision.
I’m curious about therapy – but is that a good enough reason to start?
I’m not happy, but it could be worse… isn’t therapy for people who are struggling more than I am?
How can therapy help if I don’t know what is wrong with me?
It’s okay to start without fully knowing what you’re getting into, or what is the one problem that needs your attention. The whole goal of therapy is better self-knowledge and what you care about. Your interest in personal growth and commitment to yourself is all you need! If this sounds like you, here are some tips to help you prepare for your first appointment.
Tip #1: Identify a goal.
Therapeutic goals are a useful way to ensure you and your therapist are addressing what matters to you. Goals do not need to be too specific or ambitious; you can think of them as a trail marker pointing you in the right general direction, rather than strict directions to one particular destination. It’s okay if you don’t know exactly what you want to come from therapy. Taking some time to reflect on where you are in life and where you want to be can help you identify where you’d like to see a change.
Lorraine was one client who sought out therapy with only an inkling of what she wanted to gain from it. She knew one problem clearly: that she felt fulfilled and confident in her career, but devalued and “like a pushover” in other areas of her life. Why she felt this way was a mystery, but she was determined to get to the bottom of it. We used this to craft Lorraine’s first goal: to understand what was getting in the way of asserting her needs in her personal life.
Tip #2: Come in with an open mind.
In therapy, it helps to be open to possibilities. Some of what you’ll discuss with your therapist will be clearly related to your stated problem. Other topics might seem less relevant on the surface, but anything you discuss with your therapist helps paint a more accurate picture of you. Therapists are trained to listen carefully and can bring new perspectives to your experiences that might not have crossed your mind before. With an openness to discuss different parts of your life, you can gain a deeper understanding of your experiences.
Like many people starting therapy for the first time, Lorraine was surprised I didn’t have more answers for her after our first few sessions. She was a solutions-focused woman who found security in having answers – so it was no wonder why she felt unsettled having a mysteriously passive side in her personal life. I was not surprised to hear Lorraine excelled professionally: meeting on her lunch break, she had to mute her notifications because she was so often a resource for others with questions. She looked the part of a leader with her colorful blazers and bright smile. Lorraine spoke easily about her career and aspirations, but when I asked about her upbringing, she had less to say. She remembered feeling like “just another kid” in her family: one of six children, there was often competition for her parents’ attention.
Lorraine struggled to understand why she could not prioritize her needs more in her personal life. It took much exploration of her day-to-day experiences to understand the decisions she was making (sometimes without realizing it) that led to her feeling like a pushover. As her curiosity and openness grew in our sessions, Lorraine and I began drawing connections between her life experiences, upbringing, and her professional strengths. As a leader, she was committed to making everyone on her team feel known and cared for – something she missed out on at times in her youth because of her parents’ intermittent availability. She learned to be good at making sure others were okay but didn’t realize she wasn’t doing this for herself. Empowered with this new knowledge, Lorraine was able to start making changes.
Tip #3: Work on things in between sessions!
Depending on how often you meet with your therapist, you likely won’t get more than 2-3 hours with them a week. That leaves over 160 hours that you aren’t in therapy! While consistent sessions are a big predictor of success, your work in between sessions can accelerate your progress. Homework from a therapist can be a question to reflect on or journal about, a behavior to track over time, or an anxiety-producing situation to slowly expose yourself to. Your therapist will collaborate with you to determine what suits your needs and current problems.
Lorraine’s main focus was to bring her confident self from work into the rest of her life. She realized over time that she felt comfortable being assertive professionally because it was expected of her as a leader. However, being confident and self-assured had not been praised in her past relationships. Lorraine did not recognize nearly as many choices for herself personally as she felt entitled to professionally. Her homework between weekly sessions focused on tracking situations when she felt inadequate – situations in which she almost always looked to someone else to make a decision for her. Once she began to recognize these situations more clearly, she could start entertaining other choices that didn’t involve giving away her autonomy. With lots of practice, Lorraine become more comfortable taking up space in her relationships in her personal life, more similarly matching the self-confidence she possessed at work.
Lorraine’s journey demonstrates the value that one can get out of therapy. Hopefully, it will help you consider whether therapy is worth trying for you!
Author: Sadfah Shohatee, LLMSW
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