Curious about therapy? Therapy is a valuable tool, perhaps needed more now than ever, and yet it's still intimidating, or unknown to most. As we know healthy dialogue around mental wellness is key, and we're diving in!
Q: My friend suggested that I try therapy because it's really helped her. I don't know if I have anxiety or not, is that something that a therapist can help me understand?
Hunter: Yes, for sure. If you were looking for a very specific medical diagnosis, of course a therapist is well versed and can help you determine that in a more formal sense with a little code in the DSM (Diagnostic and Statistical Manual of Mental Disorders).
Anxiety though is a word that has synonyms like worry or fear. Phobias are also anxiety disorders; so there's a huge range of what makes us anxious or what makes us worried.
Anxiety often also is the fear of being out of control, or fear of something in the future. We rarely get anxious about the past as that usually is kind of a paradox. So the therapist might be able to help you understand the nature of your anxiety. I can report to my therapist, “These are my symptoms: my heart is racing, I feel kind of out of breath, I start sweating and I have racing thoughts, I find it hard to sleep”, and a therapist can say, yeah, these are very common symptoms of an anxiety disorder.
But you will really be the judge of how much that impairs your life, how annoying it is, how debilitating it is, and that’s what you’ll work on together in therapy.
Q: How do I know if a therapist is a good fit for me? Are there certain questions I should ask a therapist before I meet with them in person?
Hunter: This is a great question, and there are two kinds of perspectives about this. One is that people will know ahead of time exactly who they want, and why.
For example, someone might say, “I want to see someone who is the same gender as me, or someone who's around the same age as me. Or, NOT the same age as me. I want someone older and wiser, or I want someone that is more motherly and that can kind of nurture me. I want someone who is more passive and is a good listener. Or, I want someone who is more challenging and strong-headed”. These are all personal preferences that are completely up to the client. So by all means shop around and go down the checklist.
I do have another perspective though, where I really encourage people to only have a deal-breaker checklist. For example, if you don't feel attuned to by the therapist, or maybe you feel like the therapist is un-engaged, or personally distracted - these are issues that could really disrupt the therapeutic relationship and of course I understand that's going to hinder a person's progress and that therapist might not be the right fit.
In scenarios like my first example where someone is really dead set on seeing a male therapist, let's say, there might be a really good opportunity to investigate that desire, or that norm. Maybe there's a reason they were avoiding having a female therapist. Maybe there's a reason they don't feel comfortable opening up to females or, or having intimate relationships with females.
Me, being a male therapist, I'm in a distinct minority in Marriage & Family Therapy. I confront this constantly and it always ends up being a useful conversation to have with clients if they say “I wasn't really expecting to see a male therapist”, I’ll ask why. Why does it matter so much? It is a great conversation starter because it often leads to insights that people might have in other areas of their life.
People will leave the therapy room saying, wow, why do I find it so difficult to have intimate relationships with males, or females, or younger people, older people?
When you call a potential new therapist, right away you may get a gut feeling about how comfortable you might feel with this person. And if the therapist is worthwhile, they will be able to handle that conversation with you. You can absolutely come into therapy sharing that it’s really uncomfortable for you to talk to them because they are “fill in the blank”. Therapists know not to take it personally, instead they'll be able to help you investigate what that is in other areas of your life. And you'll, you'll hopefully benefit all around, not just in the therapy room.
Q: I had my first session with a therapist, but I feel like she just asked me questions and didn't give me any advice. Is this normal? I was hoping to make some big changes in the first session.
Hunter: This is a great question and a very common feeling. There is a stereotype that therapists simply say, “Just do this one thing” or “Just react like this”, and then it becomes the client's responsibility to go enact that thing in their life.
If you think about it, however old you are, you've spent that many years in certain patterns and behaving a certain way. It's very unlikely to change in 50 minutes. Not just because it's a very short amount of time, but also because the therapy relationship hasn't really been established entirely at that point. Think about how many hours you spend with your friends or family members. These are often thousands of hours with the same person and they still are not always on the mark when they're trying to understand us and trying to help us sort things through. Some people are remarkably good at this and, and the therapy moves very fast and it's great. But also I would say give it some time.
If I were the therapist of the person asking this question, I might say, Wow, what is it that gave you the impression that I was going to know what to do immediately for you in your life? I also would wonder about being impatient, that maybe there's maybe some urge to move very, very quickly for some reason. If time is of the essence, if there's a genuine clinical emergency, like suicidality, of course, you need to solve that problem in the near term. But if someone comes to me and says, “I feel anxious most of the time, can I stop being anxious tomorrow?” I would say, well, maybe incrementally, but not entirely.
There are a myriad of reasons and, so, so, so much causation to get us to the place that we're at. It will take time to parse that out and pick apart all the details.
It's very normal to expect, or want, someone to tell you what to do, but again, like any good therapy hopefully it's all discovery.
You might discover why you're so eager, why there's such a pressure to figure it out. I recommend bringing it up! If you go back to your second session with your therapist and you share that you were expecting you to get more advice, hopefully the therapist would be able to have a discussion with you about that. It can lead to just great discussion about your expectations, and problem solving patterns. I recommend bringing it up and being a little more patient with yourself.
Q: I've never been to therapy before, and I'm nervous for my first session. I want to make sure that I get the most out of my session. What should I expect? And is there something I should prepare?
Somebody who has never been to therapy before will almost always have some sort of expectation or some sort of preconceived notion about what therapy is just like the last question. It’s often “They're gonna help me solve my problems. I'll go two or three times and everything will be fine.”
Things in our life rarely get solved that quickly, and therapy is no exception. It’s important to remind yourself of that.
For a first session the therapist might take a little more inventory like asking about family history and mental illness, your career, etc, but it's not necessary to prepare anything.
It is perfectly normal, and permissible however, to have a list or notes of things that you want to ask your therapist about as well as things that you'd like to let them know. Oftentimes when we're in therapy, we might get distracted or go down conversational tangents that will distract us from what we originally came here for.
I would never want a client to feel pressure to have to perform in therapy, or to feel like they owe me something. I have no expectations that somebody is going to amuse me or fill the time in a particular way. I let my curiosity be my guide and I like to see how a person's life fits together. Especially when there's nothing really prepared.
I like to stress being honest with how you’re feeling about your sessions with your therapist. Tell your therapist what's going on for you. Like I said, they should not be taking things personally, the way a friend or a family member might. The therapist is there to have those conversations, including the difficult ones. You can get anything you'd like out of the therapeutic relationship and it's a great practice space for other areas of your life that are more difficult to manage, or less safe than therapy.
(Read: 4 Things to Consider Before Your First Therapy Session)
Q: How often do I need to go to therapy after I've found a therapist that I connect with?
Hunter: The “industry standard” would be once a week, for a 50 minute session.
Many therapists are flexible about it, I know I am in my practice, but I recommend once a week to start because there's a momentum that you build and if you wait a lot longer than one week, you might start playing catch up. It's great to have that touchstone every single week, same time, same place and not always just for reporting what happens to you, but people can change a lot, even in a short amount of time. So it's really nice to have that be a regular part of somebody's schedule.
And then of course, more than once a week is great because you have even more momentum and you can just accelerate through that. Also for systems, where somebody is working with couples or families, some therapists will prescribe a specific timeline or frequency because they're working with a big group of people.
You want to make sure that not too much happens outside of the therapy room that is going to lead to just catching up and filling in the blanks in your sessions.
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