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I’m Christina Caron, a reporter covering mental health, and I’m filling in for Jancee Dunn this week.
When I was in college I decided to make my first ever mental health appointment with one of the school’s counselors. I remember very little from that conversation except that I was so nervous I was sweating. Also, I felt that the therapist often brushed off my worries.
At the time I didn’t understand that it was OK to push back a little. And the whole experience felt so awkward and uncomfortable that I quit after just a few sessions. My takeaway — although I’m sure this isn’t what the therapist intended — was that I needed to toughen up, pack my worries away and squash my fears rather than really digging into what was behind those feelings.
What I’ve since come to learn, especially now that I report on mental health, is that therapy can be helpful and even life-changing. But its success largely depends on your relationship with your therapist and the quality of your communication.
In case you’re thinking about seeing a therapist this year, or trying to find a new one, I asked several reputable therapists to share what they wished clients knew before their first session.
1. A strong bond is essential.
All of the therapists I consulted said that the most important thing to look for as you seek out counseling is a “good fit” — or the bond between therapist and client, which mental health professionals call the therapeutic alliance.
“It’s not the type of therapy. It’s not the type of therapist,” said Yuxin Sun, a psychologist in Seattle. “It’s the relationship that heals.”
With the right therapist, you should feel safe and respected. You should not feel as though you’re being secretly judged.
With that in mind, try to speak with more than one therapist before committing. Many offer free 10 or 15 minute consultations. And trust your gut. Within about three sessions it will most likely become clear whether you work well together, said Riana Elyse Anderson, a clinical psychologist and an associate professor at the Columbia University School of Social Work in New York City.
If the fit feels off, then move on.
“It’s like dating,” she added. “You want to cut your losses early.”
2. You might feel worse before you feel better.
Breaking out of old patterns and beliefs that are no longer serving you can be uncomfortable at times, the experts said. And while a therapist should be supportive, therapy is not meant to be an echo chamber.
If you are feeling awkward or uneasy, that might be an indication that treatment is working, said Naomi Torres-Mackie, a clinical psychologist at Lenox Hill Hospital in New York City. “Having an open dialogue with your therapist around how that’s feeling for you is really important,” she said.
And unlike what we often see on TV shows or hear on podcasts, therapy doesn’t usually come with a dramatic revelation at the end of each session or a big a-ha moment that solves everything. Rather, it is usually a series of small changes that add up over time.
3. You have agency.
Therapy is supposed to be collaborative. It’s not a lopsided power dynamic where you do whatever the therapist says, Dr. Sun said.
So it’s important to work with your therapist on setting goals and finding ways to measure success.
Remember: You’re allowed to ask as many questions as you want.
Ideally your therapist will check in frequently to see how you’re feeling about your work together. But if they don’t then you can feel free to do so. Let them know what’s working and what’s not working. This is your time, and you deserve to get the most out of it.
In addition, make sure you want to be there. “Getting therapy because someone else prompts you to usually backfires,” said Sherry Cormier, a psychologist in Pittsburgh. “There needs to be some kind of personal investment you make in therapy for maximum benefit.”
4. Therapy is not a sign of weakness.
Seeing a therapist doesn’t mean that you’re fragile or that other people have it all figured out and you don’t. It simply means that you’re taking a step toward bettering yourself.
For many patients, taking that step requires a lot of strength and bravery, the experts said.
“Therapy is freaking hard,” Dr. Sun said. “It takes a lot of courage and it can be challenging at times. However, the challenges are very much needed for healing and growth.”
It took years for me to return to therapy after my failed attempt in college. I found a psychologist who helped me work toward specific goals, and when our time together ended, it was akin to a graduation. I left feeling stronger and more capable — not the other way around.
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Let’s keep the conversation going. Follow Well on Instagram, or write to us at well_newsletter@nytimes.com. And check out last week’s newsletter, a conversation with Well’s new Ask the Therapist columnist, Lori Gottlieb.
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