I last visited my Roswell-based therapist in 2012, and last week I arrived for my appointment with far less trepidation than I once had. Therapy has been a significant part of my life since 2008. With some back-of-the-napkin math, I estimate I have spent over 400 hours in therapy. Not including hospitalizations and intensive outpatient programs.
That’s over 24,000 minutes digging into the innermost workings of my mind with an expert guide.
About 1,440,000 seconds of conversations ranging from mundane to operatic.
At minimum, I spent ten work weeks in therapeutic interventions. That is a not-inconsiderable amount of time dedicated to simply talking to another human being. Because of this, I like to think that I’m pretty good at sitting on the couch.
I started therapy in my teens with a counselor at Presbyterian College. She asked what classes were causing stress in my life. I barked out a laugh.
“Actually, none of the classes are causing stress. I barely leave my dorm room and I’m consumed with thoughts of creatively breaking some of my bones in appendages that I no longer like.”
She was a bit taken aback; test-taking anxiety was not my problem, but she was pleasant-enough and helped to guide me as best she could. Therapy really took off for me when I met Jess (not her real name). She listened with her entire body, alert when I told half-truths or shaded a situation with distorted perceptions. Jess challenged me to think about how I thought. She introduced me to Cognitive Behavioral Therapy, and the poem Wild Geese, by Mary Oliver. Two resources that are part of my permanent recovery to this day.
I almost always felt trepidation before stepping into her office. I was frightened in the same way I get frightened before a workout I know is going to hurt, or before a practice following a loss and coach had to light a fire under the team.
I was going to put in work, and it would demand my attention and effort for the entire time.
Looking back on eleven years of meetings with therapists, psychiatrists, prescribing nurses, group therapists, and peer support groups (shout out to DBSA Roland Park!), I can confidently say that, despite a few hiccups, therapy gave me a strong foundation to practice new skills for developing a more resilient and more agile mind. Therapy has impacted my life so positively that it is my long-term goal to become a licensed professional counselor and run my own practice.
Many people think about seeing a therapist, but avoid scheduling an appointment for a variety of reasons. Embarrassment, fear, uncertainty, and doubt are powerful thoughts and feelings that stop people from exploring a potentially helpful path.
I think it is valuable to have a corner-person. Fighters don’t venture into the octagon without supporters in their corner. Imagine how odd that would be - seeing a fighter walk through the crowd alone. We talk about fighting for our lives and the lives we want, and then get squeamish about having someone nearby who can see what we cannot and provide valuable advice. There is a reason fighters have a corner - because after getting hit in the head repeatedly, it is hard for the brain to make good decisions. Much better to outsource strategy reminders to the person who isn’t getting pounded with leather.
My therapists acted as amazing corners when I was fighting for my life while stuck in suicidal thought, and provided wise reminders during the rounds where I dominated my mental adversary. I also could not dismiss their advice as easily as I could the advice given by my parents and friends. I would think: “You’re just saying that,” or, “Right, what do you know about this?” A professional therapist stripped away many of my excuses to think or behave differently. Some might argue that a therapist is only interested in seeing you indefinitely, and you must be suspicious of their intention to bill you forever. Sure, there are unscrupulous therapists, like every profession there is a below average population to the left of the bell curve. This is why it is important to ask your therapist about their philosophy for long-term care.
In my experience, the therapists that I valued the most were the ones that recognized when I was more stable and encouraged me to space out my visits. At my worst, I saw a therapist and a psychiatrist twice a week each! At my best, once every two or three months. I liken my visits to my therapist now as mental health check-ins. I talk about what is going on, Jess is on the lookout for anything that might cause an adverse reaction in my mind, and we develop a plan of attack if I run into a rough patch.
If you are not sure where to start, I recommend visiting www.goodtherapy.org. You can search a database of therapists based on their proximity to your home or work. Finding a therapist is the easy part. What is hard is selecting a therapist. There are many reasons why a certain therapist may not work for you. Here are some things to be aware of that I learned after 400 hours in therapy:
You need to like your therapist. No sense in talking to someone who grates on you. You’ll spend more time angry talking to someone you don’t like and not enough time discussing what you need.
Quality therapists are expensive, sometimes prohibitively so. I’ve been in dire financial situations and some of the therapists I had worked with me to continue therapy at a reduced fee for a period of time. Be honest about your financial needs, and remember - this is an investment in yourself. Put some money aside for prevention now, or you can do what I did for a time and pay more for the treatment later.
Drop the bomb early. If you are comfortable with your therapist, then introduce your major concern(s). You both may not work on the biggest problem or problems right away, but it will help direct your appointments to eventually address them. Therapy is expensive, why spend $150 a week and drag our disclosing why you want therapy for a few months after starting?
This will be uncomfortable. Do what you can to make the experience more pleasant. I like to wear clothes that I feel comfortable and confident in. For morning appointments, I’ll wake up early so I can take my time with a morning cup of coffee. For afternoon appointments, I’ll make sure to eat a really delicious lunch. Do something to perk yourself up, and you’ll start training your mind to associate therapy appointments with more enjoyable feelings.
Your conversations are confidential. The laws vary somewhat by location, but generally your therapeutic discussions are not for anyone else’s ears. I lack the legal expertise to help you navigate more specific questions, so I’ll refer you to this resource from the American Psychological Association - “Protecting Your Privacy”.