Making The Most Of Therapy

Awkward encounters seem like an inevitable part of life. Doing a quick inventory, any of us could come up with a handful of examples – slow songs at high school dances, mingling at work conferences, syllabus week at the start of each semester, first dates with someone from Hinge. Here's the real kicker. Occasionally, sessions with a therapist might make that list, too. 

Having been on both sides of therapy, I know that talking to a stranger about the most intimate and intense aspects of your life feels confusing, scary, and overwhelming. Therapy arguably combines elements of every awkward encounter fathomable. Who leads the session? How do I start the conversation? How do I finally tell them this big secret I've been keeping? How do we fill the time if nothing has happened since we last met? Where do I sit? What does this person really look like? What does my therapist think of me? The list goes on. 

What cuts through all of the apprehension and questions is that we all want therapy to feel worthwhile at the end of the day. This is true regardless of where we are at in our therapy journey. Everyone walks into each session wishing therapy will actually help. With such high hopes on the line, no one can fault us for feeling a little keyed up regarding therapy. 

My gentle suggestions below are meant to help you prepare for any session. However, take a bit of caution as you read. My intention behind providing these ideas is not to remove every ounce of awkwardness, uncertainty, or fear that might be present in therapy. Instead, I share these strategies so therapy can feel satisfying and so you can get more comfortable with some of the discomfort that is naturally supposed to be part of the experience.

1. Name Your Expectations – Whether you realize it or not, you probably have many preconceived notions about therapy. At this point in history, most of us have been exposed to what therapy could look like thanks to depictions in a favorite TV show or movie, lectures given by our high school psychology teacher, or stories from people in our inner circle. Our experiences with other medical providers or past therapists also serve as a framework for what therapy could look like. These observations and interactions undoubtedly influence our expectations. 

Tip: Spend time writing down your expectations of therapy, your therapist, and even yourself as a client. Then, take a moment in a session to share these with your therapist. A conversation about your expectations can help address what is (versus what isn't) realistic, clue your therapist into what you actually need, and open the door for honest feedback as therapy progresses. Discussing expectations might also cue your therapist to share more about how their sessions typically flow. 

2. Getting Through "I Don't Know" – Eventually, you will have a session where you don't know where to start or what to talk about. Don't be alarmed if this creates a lot of anxious energy at the start of a session. Therapists have been through sessions like this several times before. I wish clients knew how normal it is to look to me as a therapist for guidance in getting started during these moments and how okay it is to have nothing bad to report. 

Tip: Come out of the gate being honest about this at the start of the session. Any therapist, myself included, would be glad to take the lead if you're unsure how to begin or happy to hear that you've been well since the last time we met. This could be a sign the universe finally cut us some slack or that our mental health is beginning to take a turn for the better. These sessions usually allow us to get something difficult off our chests and/or give us a window into what it is like when things go well, sometimes making for a surprisingly fruitful discussion. Further, we can revisit unfinished themes or topics from past sessions when life is going well. 

3. Balance Events with Reflections – There might come a time when you present to therapy for several sessions with nothing much to report. If this begins to feel disconcerting or unsatisfying, take comfort in knowing there is so much more to you than events that unfold between appointments. This stuff deserves time in the therapy spotlight, too. I promise your therapist is as interested in hearing about your inner world as your outer one. 

Tip: Get in touch with your inner world by turning inward. This might look like asking yourself what you've noticed since your last session, mulling over how certain events affected you, pondering how you relate to specific people, and getting curious about your relationship with yourself. If these recommendations feel too vague or open-ended, consider investing in some journal prompts. Ask for time at the start of your session to explore these reflections.

4. Establish Pre- and Post-Therapy Rituals – You may wish therapy sessions were longer. 50 minutes quickly go by in a blink of an eye when we are doing meaningful work in therapy. The concept of rituals and their relationship to therapy is often overlooked. This is unfortunate because rituals prolong the "feel good" part of therapy and are part of healing. 

Tip: Catalog what you do before and after therapy. This is part of how you ease in and out of a session. See if there are any patterns (e.g., grabbing a cup of coffee, jotting down important notes from a session) or any parts that feel less-than-ideal (e.g., rushing to a session, stressing to find your laptop charger). Find ways to maximize the activities that feel good while minimizing the ones that don't.

Parting Thoughts — As counterintuitive as it may seem, heading into therapy sessions can be full of angst. It is not lost on me that many of these suggestions to bring down and embrace the angst take courage -- to be open and honest with your therapist, to change how you go about therapy, etc. If finding that courage feels daunting, remember you already managed to find it once before when you uttered your first words to your therapist on a consultation call or at your initial session. You have it within you to do difficult things, and you already took the hardest step.

Find yourself intrigued by (re)starting therapy after reading? Schedule an initial consultation.