The decision to start or restart therapy is a big one. There are practical issues as well as curiosity about what being in therapy means. Here are ten frequently asked questions.
1. Will the therapist talk to other people about me?
No. No. No. Absolutely not. This is a big difference between other professional relationships such as coaching and the client/therapist relationship. The law protects your identity and the content of your sessions in therapy. Not so with coaching. What you say in therapy stays in therapy. Your therapist cannot confirm to a third-party that she or he is seeing you unless you agree in writing. That’s why, if you see your therapist in the community, she or he may not say hello to you unless you say hello first. You and your therapist should talk about confidentiality and the limits of it during your first session.
2. How much will therapy cost?
You and your therapist should discuss fees before your first session. You have the right to know how much you will be charged before you start. Some therapists offer sliding scale fees which means they’ll reduce their fee if you can’t afford their published rates or if you don’t have insurance. While the Affordable Care Act and Covered California make insurance more affordable, some plans have high deductibles and co-pays. While you will know the cost of each session before you begin, no one can tell you how long you will be in therapy. So the total cost of therapy cannot be determined unless you set a limit.
3. How long will I be in therapy?
That depends. Although some people report feeling better after eight to twelve sessions, some people feel worse because the painful topics they’ve been avoiding are being discussed. Deeper work requires a longer relationship. This is another topic to discuss with your therapist. You and your therapist can agree to limit the number of sessions. When you are close to finishing those sessions, you and your therapist can review the work you’re doing and decide if it is in your best interest to continue, start coming more or less often, or take a break from therapy.
4. Will therapy hurt?
Therapy should not hurt. Your therapist should not hurt your feelings. Some of the topics you discuss might be painful. That’s why you’re coming into therapy. You may have tried avoiding painful topics and realized that doing so is a temporary solution. Unresolved painful topics can emerge in unexpected ways or re-emerge if you don’t address them. As an example, some people do not feel comfortable being alone. They avoid the pain of loneliness by having a series of relationships one after the other only to learn that they feel lonely in their relationships as well as when they are alone.
5. Does being in therapy mean I’m crazy?
No. Referring to a person’s mental health as crazy is unfair and judgmental. Many times the term is used in reference to women. But there are no mental disorders that include the words crazy, insane, or deranged. Most people come into therapy because they are responding to painful experiences and relationships in a normal way and need some help sorting through their emotions and thoughts. People who call other people crazy in a derogatory way are at best insensitive or just not thinking, and at worst critical, lacking compassion. If you feel like you’re going crazy, a.k.a. stressed out or overwhelmed, or made to feel crazy in response to the mixed messages from another person, then yes, therapy is a viable option for you. From a lighter perspective, crazy is also slang for busy, having fun, too long of a to-do list, or to express enthusiasm or attachment, i.e. I’m crazy about sushi. Or she’s crazy about her partner.
6. Does being in therapy mean I’m weak?
Another term often used to judge and criticize, weak can mean unable to take care of yourself, undefended, and fragile. Or it can mean being soft and vulnerable–human characteristics that are necessary for intimacy. Maybe you’re feeling overwhelmed and don’t want to let your guard down. Again, these are topics for you to talk about in therapy. Asking for help does not make you weak, it makes you wise. Watch Brene Brown’s Ted Talk on vulnerability.
7. Am I overly sensitive?
Human beings are sensitive to stimuli. That’s part of being human. The level of sensitivity is on a scale from completely removed from emotion to highly emotional. Our sensitivity to stimuli from the outside and inside is how we decide if a person or situation is safe or dangerous. Important note: whoever is using “sensitive” in a judgmental or critical way is probably uncomfortable with your feelings…or feelings in general. If that’s you, therapy is a great way to take a look at why. If someone in your life is uncomfortable with feelings, it’s important to understand that and find support someplace else. If you’re crying, you have something to cry about. If you’re worried, you have something to worry about. And so on. Therapy starts with validation, understanding, empathy.
8. Will I be judged for being in therapy?
Some people may judge you for being in therapy. I would ask what makes them uncomfortable about your taking care of yourself. Your thoughts are more important. You might wonder what therapy is going to be like FOR YOU. Yes, you may feel uncomfortable, you might feel judged, you will certainly feel unsure. This is what therapists call grist for the mill, material to explore and talk about in session. The thoughts, feelings, responses, and reactions that you experience in session are more than likely going on in your other relationships as well. The difference is, you can talk about them without judgment, criticism, anger, or expectations from the therapist. In other words, you’ll be able to talk and express in a SAFE space.
9. What happens when I don’t have anything to say?
Silence in any relationship can be really uncomfortable. Depending on your therapist’s way of working, he or she may at times sit quietly during your sessions. The therapist is giving you time and space to process a thought or feeling. Sometimes the uncomfortable silence leads to the most insightful and productive moments in therapy.
10. I don’t like my therapist. Can I stop seeing her or him?
Yes, definitely. You have the right to continue or discontinue seeing any therapist. You can discuss your feelings with your therapist. But if you find you cannot trust the therapist or feel uncomfortable talking to her or him, or just don’t feel the relationship is a good fit, find another one. The relationship between you and your therapist is the most important part of your healing process. Therapists are human beings. Each of us brings to the work our philosophy, personality, life experience, wisdom, kindness, compassion, theoretical preferences, and ethical responsibility. The qualities one therapist offers might not be what you want. You might prefer a male therapist or a therapist who is your age. If you are a baby boomer, you might want a more mature therapist, someone who has more life experience than a younger therapist. Or you might prefer a young therapist who understands first-hand the life challenges of millennials.
Therapy is a topic around which questions swirl. If I’ve missed anything that is on your mind, Contact me and I’ll write a follow-up post or answer your question privately.
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