What to Expect at Therapy (& What Therapy has Taught Me)

After 6 months of therapy I’ve come to the conclusion that every single person can benefit from seeing a therapist. But if I’m being honest: going to therapy was a scary thing for me. I’m known to be overly emotional and sensitive. Pair that with the fact that I hate crying in front of people, and the idea of opening up to a therapist left me feeling vulnerable.

Before I went for the first time, I did a lot of research online trying to find out what I could expect. Most of the resources were created by therapists. I was more interested in getting the other side’s perspective.

What therapy has taught me and what you can expect at your first therapy session.

Also, quick note: I use the words “therapy” and “counseling” interchangeably. As far as I know they are the same thing.

Why I sought therapy

I’ve never been shy about my mental health struggles (lets normalize it, y’all!). So I’ll give a bit of background on why I sought therapy.

In April I lost my grandpa (aka one of my favorite people in the whole world) and the depression that came afterward was unbearable and unrelenting. I started losing sleep and that brought with it extreme anxiety, paranoia, and on the worst days, hallucinations.

Choosing a therapist

My therapist was kind of chosen for me. My dad knows someone who owns a family counseling practice, and he recommended two practitioners to me. I called and asked which had the first opening and that was that.

I was also pretty adamant about not wanting to go on antidepressants or anti anxiety medication unless as a last resort. Luckily my therapist has the same philosophy and didn’t try to push medicine on me.

When you’re choosing your therapist, I recommend going online and researching your local practitioners.

Consider things like: 

  • What do they specialize in? If you’re suffering from anxiety, a therapist whose focus is on teenagers with eating disorders won’t be a perfect fit. 
  • How old are they? Personally, I would feel weird about opening up to a therapist my age. It’s a weird personal thing, but I wanted someone a few decades more mature than me. They won’t have their age listed on the website, but most of them will say when they graduated college.
  • What’s their gender? I also preferred talking to a woman over a man. Again, just a weird personal thing but something to consider.
  • What is their stance on medication? I went to one therapy session in 2016 (it was a total disaster) and after 15 minutes of chatting she was trying to write me prescriptions. My current therapist focuses on integrative medicine. She looks at nutrition, gut health, and exercise habits before considering whether medication is necessary. 

My first therapy session

I needed to arrive 30 minutes early to my first therapy session to fill out paperwork. I was about 40 minutes early, which was perfect because I had a total meltdown in the car realizing that I was about to go and tear myself open to a stranger. 

The questionnaire they gave me was… overwhelming, for lack of a better word.

The intake questionnaire

The questions ranged from the typical family history / recent surgeries / allergies you get at any doctors office. They quickly got very specific and a bit overwhelming. Questions asking if I’d considered hurting myself in the past day / month / year. Questions asking if I had access to firearms, if I’d considered hurting others, and then specific questions about why I was there.

I felt panicked filling it out for a stranger to read and judge and I seriously considered walking out. I’m glad that I didn’t, but the temptation was real. Some questions I decided to leave blank. If she wanted to know the answers I could decide whether I was comfortable telling her after I met her.

Meeting my therapist

My therapist introduced herself and asked basic questions to get me comfortable. A few questions in, she asked what I hoped to gain from therapy and that’s when I started crying. (Spoiler, I didn’t stop until time was up.) 

I did my best to compose myself and explain what I’d been coping with. She had tissues at the ready and was great at directing me and keeping me focused. I talked a lot about my grandpa, and the hole his death left in my life. 

That first session she didn’t do a ton of talking, mostly because I didn’t give her much room to. I brought up that I was using Zzzquil to get myself to sleep every night. My therapist challenged me to replace that with more natural supplements. Melatonin has never worked for me, so she suggested Magnesium. After a few weeks of a difficult transition, I was able to throw the Zzzquil away. 

My second therapy session

At this point, I had scheduled appointments every week. The next week I had (another) breakdown in my car before going in, and yet another one in the lobby. That’s one thing I learned early on: therapy isn’t a magical place where everything automatically gets better and brighter. For me, it was almost a “it gets worse before it gets better” thing. The days I went to therapy were typically my worst mental health days because I was tearing open wounds that I’d been trying to ignore. 

In therapy during my second appointment, my therapist had me talk a lot about my grandpa and it was hard. I recalled my earliest memories of him, the life lessons he taught me, and what I most admired about my grandpa. 

We also talked about strategies to redirect my crying response when he came up. Even now, 8 months after losing him, my natural response is to tear up when anyone brings him up. That’s something I’ve been working on. My therapist said it’s because when I think of him it triggers the feeling of loss, when I can work on rewiring that to trigger feelings of gratitude or joy that I had him for as long as I did.

What I try to do now is when Grandpa gets brought up or I think of him, I try to quickly redirect my thoughts to a happy memory. Every day is a work in progress, but I’ve noticed improvements.

What my counseling sessions are like now

Now that I’ve been going to therapy for months, we don’t focus every session on my grief. Mostly because we’ve established coping strategies that I’ve been working on, but also because I’ve come a long way. 

I don’t need to go as often

I only go to therapy twice a month now. I’m not living with constant pain that requires more attention the way I was this summer, so it’s not necessary to go as often. 

The focus has shifted

Now we have a few main focuses at therapy: improving my anxiety symptoms, coping with seasonal depression, building self worth, and working on self-talk.

When I go into therapy if we had any loose ends at the last session my therapist will bring those up. Otherwise she’ll ask me how things have been going since my last session and how I’ve been feeling. 

If I’ve been feeling bad lately, I’ll share how I’ve been feeling and what prompted those feelings. We’ll try and break those down, and then come up with coping strategies. Around every other session my therapist will check on my progress with coping with losing my Grandpa.

Helpful things therapy has taught me

Therapy has made me a better person in several ways. I’ve learned a lot about coping with anxiety and depression, and how to focus on self-growth. Here are some of the tidbits that I think are super useful to almost anyone.

  • Feel an anxiety attack coming on? Your body is likely going into “flight or fight” mode. If you can remove yourself from your environment you can trick you body into thinking you’re fleeing. Oftentimes that’s enough to all you to immediately calm down. 
  • Stop telling yourself that you “should have” ______. The word should puts unnecessary expectations on you. Instead you can say you expected to ______, or you’d hoped to ______. “Should” sets you up for failure disappointment.
  • If you ever use the phrase, “I can’t help it, that’s just how I am” that’s not true. Don’t make excuses for a bad temper, or a lack of patience by saying you can’t help it. Because you can. (Even if it feels like you can’t). We have total control over ourselves, it’s up to us to make the conscious decision to grow and improve. Oftentimes these are traits that a therapist can help you with, or you can make a commitment to redirect your emotions when you feel these negative traits coming on. 
  • Replacing negative self-talk with gratitude can help change your automatic responses to negative situations. For example, if you find yourself telling yourself that you’re incompetent for missing a deadline, make an effort to turn that thought around and tell yourself that you’re grateful for a work environment where you can make mistakes and still be supported. Or if you drop and shatter a plate, instead of telling yourself that you’re a useless klutz, remind yourself of how grateful you are to be able to afford to replace things when they get broken. 
  • You can’t control what happens to you, but you can control how you respond to the things that happen in your life. Even if it feels like you can’t.
  • Creating boundaries is healthy and necessary.

Is therapy right for you?

Long story short: yes. I think anyone can benefit from therapy no matter where you are at in life, your current mental health status, or anything else. 

Here are a few ways counseling can benefit anyone and everyone:

  • You can get unbiased (and psychology backed) opinions on big decisions or stressors in your life.
  • You can better understand how your past affects your present. You’d be surprised how early experiences have shaped your responses to everyday situations.
  • You can come up with strategies for working on personality traits you possess that you might not be super fond of. 
  • You will learn how to cope with unexpected scenarios that might pop up in your life. 

With that said, therapy can have a barrier to entry for a lot of people. I’m lucky to be in a position where my insurance covers a set amount of visits each year, but many insurances don’t cover therapy at all, or the copays can be quite expensive. 

If therapy isn’t an option for you, there are a lot of therapist created resources online spanning from blogs to YouTube channels to Instagram accounts where therapists create free content. While these options aren’t as personal as you’d get with a 1:1 therapy session, these creators share content that apply to a lot of common scenarios and feelings.