These days many of us may have experienced what it is like to have therapy, or else may be thinking about having therapy in the future. In the past we may have been reticent about telling others, but thankfully we have moved into an age when we are embracing what it is to be human and how important it is to seek help when we need it. We all have mental health, and sometimes we may experience mental ill health or mental distress. It's just a natural part of the life cycle.

Missing Ellie

Missing Ellie

So how can we prepare ourselves for the therapy journey? Are there ways to get the best out of therapy that are universal, regardless of what your issue is, or what modality of therapy you choose?

Here are my recommendations as a psychotherapist who has sat in the patient's chair as well as the analyst's chair!

1) Realise now that whatever modality of therapy you choose and whatever issue you wish to work on, your therapist will (and most definitely should) ask you about your childhood as part of your initial assessment. Therapists will wonder 'why this and why now' when thinking about your presenting issue. They will need to understand you in the context of your life journey and therefore, even if you think your childhood was fantastic, or you can't see the connection between your childhood and the problem you are now experiencing, be prepared to be asked and be as open as you can with your answers.

2) Be prepared to be honest at all times with your therapist, however ashamed or embarrassed you might feel. The therapist needs to understand what part of what you're saying or what you are not saying is causing you difficulties and can only target your therapy appropriately for you if they really understand what it is you are struggling with.

3) A therapist cannot do anything to you or for you, only with you! Therefore be prepared to undertake homework that will not always be comfortable or easy. For some modalities of treatment such as Cognitive Behavioural Therapy you will be asked to keep diaries of your thoughts and feelings outside the session. You may also be asked to undertake behavioural activation work, particularly for anxiety-based problems (eg social anxiety, generalised and health anxieties, OCD and phobias) and also for depression. Most modalities of therapy will expect you to take responsibility for challenging difficult thoughts, feelings and behaviours outside of the therapy room, and this is important to embrace. Otherwise you can spend a long time in therapy becoming an expert in your problem but not climbing out of it!

4) Be prepared to be patient! There are no quick fixes or magic wands. Therapy is hard work. Sometimes you will feel things are changing, and at other times you may feel that you are not moving forward as quickly as you would have hoped. This is life reflected in therapy!

5) Be prepared for therapy to be an uncomfortable process at times which may leave you feeling vulnerable and upset. It is a good idea to arrange your therapy sessions on days and times when you will not have to go back into work on that day. This will give you time and space to process your feelings and think through things that you may have learned that day in therapy.

6) Be prepared to let your closest friends and family know that you are starting therapy. Rally up as much support as you think you may need. If you can let people know, they will forgive you when you cancel arrangements, when you aren't your sparkling self and when you're not in the mood to see them. Build rewarding things into your week as part of the commitment to take care of yourself. For some, increasing dopamine by focusing on achieving and doing will be most helpful - activities like running, swimming and going to the gym may help with this. For others, more soothing activities which will increase the natural opiates and oxytocin in the brain are helpful - meditation, a warm bath with candles and activities like crafting may help. Just see what works for you, and there is nothing stopping you mixing and matching between doing and being!

7) Finally, and this is really important, make sure that the therapist you have chosen to see is professionally trained and accredited in their mode of therapy. They should also be registered with a recognised professional body with a code of conduct that they have to adhere to. Your therapist should also be happy to show you evidence of their qualifications and insurance to practise and what data they will keep about you and how they will keep it safe.

And finally, be kind to yourself! You are taking the difficult and brave step of starting your therapy. Take every opportunity to give yourself the kind of support, encouragement and love you would give to a best friend embarking on this journey.

Dr Jane Graham


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