What I Wish My Patients Knew About Therapy


You’ve been putting it off for a while, but you know you need to do it. You’re not happy, something is affecting your life and you’ve tried to fix it for too long, but you realize you can no longer do it alone. So you do it: you decide to get professional help. You make an appointment with a therapist, half ready to back out any minute, and nervously wait for the day. Finally it arrives and your pounding heart accompanies you to your first session. You may feel wary of speaking. You know that sooner or later this person will know your secrets, your most intimate thoughts, your most embarrassing moments, your biggest regrets. You know you will be vulnerable to the response of this person and that he or she will be an important part of your life.

It’s not easy being vulnerable, so you get emotional when you describe what’s happening to you and why you need help. She allows you to let is all out and, after the stipulated time, she suddenly says the session is over. You may really dislike the abruptness in which sessions are over, but eventually you will learn to accept it. When the first bill arrives, you may question if you really need this, but then you’ll remember why you decided to get help in the first place and brush it off.

After a couple of sessions, when you have already fully accepted this person as your therapist, you may start thinking frequently of what to tell her, you may start looking forward to the sessions (although you might still be nervous about going) and the subjects of the sessions will usually be important experiences from your past (in an unconscious attempt to explain how your past made you who you are) and a few current issues. The more you talk about your past and cover significant topics, the more you start focusing on the present. You may start to look forward to talking about things that happen during the lapse between appointments.

And then… things may start getting confusing. You relive your past from a different point of view, you become more conscious of your present and the awareness of it all hurts you deeply. You and your therapist are working at training your brain into seeing life with a different pair of eyeglasses, ones that work for you. But your core beliefs, your old eyeglasses, feel like home. They don’t work well for you anymore but they are all you know and replacing them is tough and very painful. In these moments you may feel very tempted to walk away. Therapy is like taking medicine that makes you feel sick, but will ultimately help you. Opening yourself up to dealing with situations so deeply painful that they control you, to deal with a darkness so intense you can’t escape it, to deal with fear so incapacitating you stop functioning — takes strength. You keep going to your appointments, terrified of fighting your demons and yet too drawn in to walk away. Everything seems to be worse now, even worse than before.

RESOURCES FROM TREATMENT RESOURCES

But slowly, almost imperceptibly, you start feeling better. You don’t even notice it but when you look back, you realize you have been handling things a bit differently more often than not. You don’t get as frustrated or as affected by things. You know yourself better and you learn how to take better care of yourself. While that happens, you will have many ups and downs. Getting better is never a straight increasing line, it’s more like the graph of a potent earthquake. In the downs, you may doubt anything will ever change. You may not understand why you keep resorting to old mechanisms. You feel hopeless with the therapy and with yourself. In the ups, you may be amazed at what has been accomplished and you’ll diligently attend therapy, putting into it your best effort and truly believing the future will be better. I don’t think life ever becomes a straight line and, even if it’s what we long for in the middle of a turmoil, a straight line hardly ever gets the best out of us.

A therapist has the difficult challenge of navigating through choppy waters with her patient, doing whatever it takes to keep her patient’s head above water as the storm rages while, at the same time, teaching him or her how to swim more effectively. The patient, however, is willing to throw himself or herself into choppy waters with unseeing trust they will relearn how to swim even though they feel like they keep drowning. When a patient tells me he wishes he wasn’t so “weak” or that she wishes she wasn’t such a “coward,” I wish they’d all know sitting in that sofa in front of me makes them some of the bravest people I know.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to 741-741.

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Thinkstock photo via macrovector.


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