If you are considering psychotherapy for the first time, you are probably filled with questions. Even with prior experience, you may feel uncertain about returning to psychotherapy (in a new place or with a professional unknown to you). Feeling anxious makes sense, given the general expectations for a first session: tell a stranger all about your most personal concerns and review your life story in less than an hour. Just reading that description can evoke a gasp of apprehension!
You may find comfort knowing you are not alone. Despite fearing that we are unlike others, human stories have not changed for millenia. If this were not true, psychology would not be possible. Psychologists depend on the regularities of people's experiences in order to recognize familiar patterns and rely on promising solutions. We do each have our own specific history. Nonetheless, our discoveries, trials, and decisions have been faced before. As the saying goes: "you are unique, . . . just like everyone else."
Remember: your psychotherapist is on your side. When you are uncomfortable with your emotions, distressed by your thoughts, perplexed by your habits, or dissatisfied with your relationships, it is common to fear that others will judge you harshly. We can feel shameful, unworthy, undeserving, or rejected by others. Others of us can feel righteous, alienated, disenfranchised, or unappreciated by others. When the social fabric seems frayed around us, we might expect reactions from a psychotherapist like those we've come to expect from others.
On the contrary, the psychotherapy relationship gains healing power by its special nature. Psychotherapists generally want to help. Professionals in this field understand that little progress can be made without cooperation. They also understand that judgmental attitudes and simple-minded mandates are not likely to inspire cooperation. Most people feel relieved and supported during their first session of psychotherapy. Should this not occur, patience through another session or two is often rewarded by the desired rapport. If there is not a good fit between a psychotherapist and his or her clients, it is normal practice for the professional to make an appropriate referral to a more promising resource.
Psychotherapy is known as "the talking cure." It is true, a few theories of psychotherapy emphasize the role of the body, of movement, or of ritualized techniques for promoting well-being. Nonetheless, telling your story and reporting your reactions will almost certainly be expected of you. When you talk, there are ethical rules and confidentiality laws protecting your privacy.
Since you seek help or guidance to promote change in your life, you can expect exposure to options and perspectives you may not have considered. If proposed choices are already familiar, taking them seriously, and giving tried and true solutions a chance, may be in order. Psychotherapeutic benefits come from experimenting with new responses. Various schools of psychotherapy are more or less explicit about this reality. A popular definition of "insanity" is: repeating old habits while expecting new results. Habit change is thus the remedy.
Psychotherapy is usually effective and most consumers are satisfied with their treatment. These two conclusions are well established by scientific research conducted over the past forty years (equivalent testimonials date back more than one hundred years). Your specific experience will depend on your life history, the severity of your difficulties, unforeseen events intruding in your life, and the shared success enjoyed when you and your psychotherapist forge a working partnership. Nobody can predict how long the process will take at the outset, but some general measures can be a guide.
In my practice, about 65% of all the people I work with reach a mutually satisfying point of met goals on or before the 13th session. An additional 20% or so (85% in all) come to an agreeable conclusion by the 23rd session. By the 50th session (usually less than one year), 98% of all the people I meet for psychotherapy have reached their goals. There have been several individuals who were satisfied in three sessions or less. Over the course of 30 years of conducting psychotherapy with thousands of clients, only sixteen of my cases lasted beyond two years. In the research literature the general claim is made that most of the measured changes resulting from psychotherapy occur during the first six months. Of course, there are individual exceptions and unpredictable circumstances to consider.
I hope this essay answers some questions, allays some fears, dispels some myths, and encourages you to make an appointment, when you feel ready. From time to time, all of us can benefit from support or direction in our lives. Many of us suffer needlessly from emotional, behavioral, interpersonal, or health-related distress. Life often presents challenges we are neither familiar with nor prepared to meet. Professional guidance, informed interventions, and a nurturing relationship can ease your adjustment to a more satisfying life.