The first time I went to therapy, I did it wrong.
That’s the hard conclusion I’ve come to, after starting therapy for the second time in a year. I found myself back on the couch (for the record, you don’t have to lie down) in a moment of actual crisis. When the universe was raining problems on me heavily enough that my world had tilted on an unfamiliar axis, and I had no choice but to pay someone $250 an hour to help me find level ground again.
I’m happy to be there and to be making real progress, but a huge part of me wonders: if I’d done it right the first time, would I be here now?
When I attempted therapy for the first time by selecting a random therapist included within my insurance, I expected to walk out completely “fixed,” or at the very least, with a plan to heal myself. And then I left and, well, nothing happened. Nothing changed. I left and didn’t try again until I really, truly had to, perhaps believing on some level that I didn’t deserve to be in therapy until I was in an actual ordeal. I couldn’t have been more wrong.
If you’re considering therapy for yourself, learn from my mistakes and from two practicing psychoanalysts in New York City to help you avoid common pitfalls and get on the right path:
Who is therapy for?
Therapy isn’t just for sick people or crazy people, and it’s not even just for people in the throes of an acute, painful situation. It’s for anyone desiring a change in their life, whether you’re facing a transition or wishing you were. That said, getting started is also not as easy as throwing a dart at a laundry list of PhDs, PsyDs and LCSWs.
I actually felt guilty when I began therapy the first time, like I was taking away valuable time from a person who really needed it. If you’re feeling the same way, relax—your therapist doesn’t think of it that way at all. “Therapy is not just for sick people. It can be a real joy as an analyst to work with someone who has those basic questions about love and work. When you talk with your friends, their mind is wandering and they’re taking what you say and turning it into a story about themselves. Your therapist is really listening, and they become sort of the repository of your whole story,” Jamieson Webster, PhD, a psychoanalyst in private practice in New York, explains.
How to find and select a therapist
That alphabet soup of letters up there? Those are just three of the many kinds of academic credentials a therapist can have, and depending on their level of training and licensing, they may describe themselves in multiple ways. Beyond that, there are twice as many different treatment modalities each individual therapist might employ. So does the degree matter? The answer—as it often is in therapy—is “it depends.” “All qualifications can be quite expert in the work that you’re doing, so I wouldn’t exclude one over the other,” Dr. Audrey Dawson, a psychoanalyst certified in gestalt therapy, hypnotherapy and EMDR, says. But really, it’s more about the rapport you’re building than about the specific degree your psychotherapist holds.
Which brings me to the next and biggest mistake I made: interview, interview, interview! While I certainly never felt obligated to return to the dentist who kept losing my X-rays, or the gynecologist who left me sitting in stirrups for over an hour, for some reason, I didn’t assume I had the same amount of agency in choosing a therapist. Turns out, most therapists expect you to treat the first session as an assessment, and they understand you may not return. “I really think you have to do some work and get some recommendations—you would for any other doctor. You should see a number of people to start—often, our first sessions are free. See what it’s like to be in the office, how you feel with them. Let the therapist lead, and ask questions at the end. A preliminary period can be beneficial for both of you, so you don’t enter blindly into something,” Dr. Webster says.
Both doctors suggest getting recommendations from people you know, within reason. “You don’t want to see your best friend’s therapist!” Dr. Webster notes. Focus on whether you can see yourself trusting the person you’re talking to. “It’s very important in the first session to see if you feel comfortable. That’s very basic to therapy,” Dr Dawson says.
Google and read up on each professional, and create a short list of ones you’d like to meet in person. Take note of your reactions to that person after you meet with them to help you make your final decision. In my case, I found my new therapist through a dear friend who had met with her and thought she was great, but who lived too far away from her office—which is how I ended up with a talented professional whose workplace is actually down the street from where I live.
What it’s like to start therapy
In your first session, your therapist will probably ask you some basic questions about what’s brought you there and what you’re dealing with currently. “Often, there is some history-taking in the first session, to see what their experience was like in school, and what it’s been in the first part of their professional career, depending on how far along they are. With women, there is often also the juggling between how much time and energy they want to put into developing their career, and how they are also developing their personal life and relationships. We are trying to get a picture of the component parts of how they are making their decisions,” Dr. Dawson explains.
While you’re chatting, make sure to ask them how they approach therapy and treatment. And remember, there is no overnight success in therapy, especially when you’re there for no particular reason other than feeling unsatisfied or discontent. “Open-ended treatment is probably more what you have in mind if you’re not quite sure why you’re there,” Dr. Webster says, adding that a general approach does have the ability to fix specific problems.
The first time around, I went because I was unhappy being single and wanted to work with a therapist to help me meet someone. But that’s not exactly how it works, hence my frustration. That’s common, Dr. Webster says. “People come to therapy often because they can’t meet people, or aren’t meeting the right people, and it does change,” she says. “Not because they’re obsessively addressing the question, but because they’re in a better place as a person. Our job as an analyst is not ‘get the patient married, get the patient a better career,’ but people do get married and they do find better careers as they come through the things they need to come to in asking questions about themselves.”
How to think about therapy
Even if I had found the perfect doctor for me and asked all the right questions upon first meeting, I’m not sure my first attempt at therapy would ever have succeeded, because I was thinking about therapy all wrong. I didn’t have the kind of major issue I associated with why I thought people started therapy—though I ended up with one about 18 months later. There’s no need to wait for that, like I did, Dr. Webster says, who recommends asking yourself this: “How stuck do you feel? Do you feel like you’re encountering the same problems over and over again? If you feel your mind is in a loop, on one of those ‘why can’t I…’ or ‘why doesn’t anyone…’ things, therapy is a good way to get you out of that. All those tropes about positive thinking are true, but you can’t actually positive-think your way out of things. You have to remove the negativity.”
Sound familiar? Yeah, me too.
You don’t have to wait for something like a major depression, divorce, or even a specific event to justify therapy—you just have to want a change, and be willing to commit to the process. Because yes, it is a process. “Probably the biggest [misconception about therapy] is that you can be fixed in an instant, that there’s a silver bullet. You don’t get a breakthrough after one or two sessions. Even a wonderful realization in one session might be followed by a rough session where you wonder what happened to that vision, that instant resolution of everything. It doesn’t happen that way,” Dr. Dawson says.
How to take it slow
The thing that made it hard to leave therapy the first time was actually the same thing that brought me back the second time. It was clear to me my underlying problems with relationships hadn’t gone away, and had in fact manifested themselves in a rather dramatic fashion right in the middle of my new-and-improved life.
I’d worried that giving up on therapy meant giving up on ever resolving my issues, and I knew I was walking away too soon. After all, my problems didn’t create themselves in five months, and they sure weren’t resolved after that time. “I don’t believe in keeping patients forever, but if someone is coming in to work through a particular problem, like something in their marriage or their job, it probably takes a least a year,” Dr. Webster said. “If you go from not exercising at all to getting in shape, you would give it time, right? It’s the same mentally. To change your body and your habits with your body, it’s difficult, and it’s not so different with the mind.”
So much like committing to my workouts, I’ve recommitted to my mental self-care, and I’m ready to be better, healthier and happier in every way in 2017. I hope you will, too.