A toe in the water
Starting therapy is an important moment. How does it work?
The consulting room is a confidential setting where you can talk about things that might otherwise be difficult to voice. Many people come to therapy knowing the facts about their lives but they are unsure about their feelings, while others believe that their feelings are unwanted, inconvenient or destructive. The therapist creates a safe, supportive space for the patient’s emotional experiences to come to the surface. Together, you and your therapist will try to understand those emotions and, over time, you will both work to name the implicit thoughts and feelings that determine how you make sense of the world. None of us can change the events of the past but our understanding of the past can and often does change in the meaning that therapist and patient create together.
Before you make contact with a potential therapist, here are some things to think about:
What are the feelings or life circumstances that have led you to this point? Search terms used by people looking for a therapist include guilt, shame, anxiety, depression, overwhelming emotions, relationship difficulties, life changes (such as mid life, retirement and bereavement), stress and repetitive disturbing thoughts. These are common experiences for many adults.
What are your hopes for the therapy process? Perhaps you are feeling stuck emotionally and you would like to experience a wider range of emotions. Perhaps you’re struggling in your relationships and you want to feel more confident in intimate situations. Maybe things are going well in some areas of your life but your coping strategies are near to breaking point in other areas.
Where do you want to see your therapist? Are you looking to meet online or in person? Are you looking for an open-ended, exploratory approach or would you prefer to define your goals from the outset? If you are unclear, it can be helpful to discuss this with the therapist, who may have a preferred way of working. It’s possible that you may start out seeing your therapist once a week but as the work progresses, you may find you want to meet more often.
What is your budget? Therapists’ fees vary from person to person. Fees may also vary depending on the time of day, with higher rates in the evenings and at weekends. The therapist will usually discuss their terms of engagement at the outset, including whether or not they charge for missed sessions. Sessions usually last for 50 minutes.
What type of therapy or therapist are you looking for? The Society of Analytical Psychology, where I trained, offers some useful information here about the difference between counselling, psychotherapy and psychoanalysis. The British Psychoanalytic Council, where I am registered, provides further information here.
What might be holding you back? Hidden feelings can be painful and isolating and you may be seeking therapy because you want to feel less lonely. However, there may also be reasons why you have a tendency to keep certain things to yourself. Perhaps you believe there is something wrong with you for feeling the way you are feeling or perhaps you’ve always thought that you shouldn’t talk about such things to other people. Instinctively, you may be aware that you want someone’s else help yet at the same time you may also encounter deep feelings of shame and confusion in response to the idea of telling your story to another person. You may worry that you won’t be believed or you may fear that no one else can understand you. Your therapist will be sensitive to these concerns and they may encourage you to share your fears.
What happens next? Once you’ve found a therapist you would like to contact, you can send them an email. In many cases, the therapist may offer a brief introductory phone call for no charge. This is an opportunity to talk about your reasons for seeking therapy and explain what you are looking for in a therapist. If you are both happy to proceed, you can then arrange an initial session, which allows you to speak at greater length about yourself. It also gives you a chance to see how you feel about talking to this particular person. Finding a good fit with a therapist is important and if you are unsure, it can be worthwhile meeting a few times before deciding whether to continue.
Starting therapy can sometimes feel like an admission of defeat but I see it as a moment of reaching out in many different ways: towards one’s self, towards another, and towards a more fulfilling future.