5 things you should know when starting therapy

Photo of a therapy room by  Felipe P. Lima Rizo . Valerie Beltrán, LMFT  Specializing  in trauma ( EMDR ), couples, and children. With offices in  Lafayette, CA  &  Danville, CA

Photo of a therapy room by Felipe P. Lima Rizo. Valerie Beltrán, LMFT Specializing in trauma (EMDR), couples, and children. With offices in Lafayette, CA & Danville, CA

I remember when I first started going to therapy. I was a very private person, hardly confiding in even the best of friends. Needless to say, I was extremely nervous about seeing a therapist. I walked into the room and saw a couch and some armchairs. Am I supposed to lie down?  I wondered, but was too afraid to ask. I didn't want to look like I didn't know what I was doing. 

I sat in the middle of the couch, wanting to grab a decorative pillow to have something to hold, but didn't know if that'd be ok. Again, I was too afraid to ask, so I just sat still and waited. I waited for what felt like hours until he finally spoke. Had he been waiting for me to speak first? Was I supposed to already know what to say? Am I doing this wrong? My anxious thoughts were interrupted by the realization that he had said something, but I was too nervous to actually hear it. 

Can I ask him to repeat himself? Did he introduce himself? Should I introduce myself? I guess he knows my name already. I filled out his form before coming in. Should I shake his hand?

Thankfully he spoke again. "What brings you in?" It sounded so innocuous, as if I was browsing dresses in the Macy's women's department. I had something huge to talk about -- a deep-seated concern that had been plaguing me long enough to finally send me to a therapist. But I couldn't just say it, could I? Was I supposed to just get right into it? Tell all my deepest, darkest secrets to this strange man I just met?

I suddenly became aware of the sunlight in the room, bright and intense, like a spotlight in those police interrogation rooms we always see in the movies. I wanted to close the blinds or turn off the lamp that was needlessly on in the corner of the room, but I didn't think I was allowed to change anything. The couch was positioned directly in front of the window, sunlight streaming into my eyes, casting a shadow onto his face as he also sat directly in front of me. He's too close to me. Can I tell him to scoot back a bit? 

I decided the answer was no, so I adjusted myself on the couch, leaning back into the corner, creating more of an angle with him. It felt awkward to be leaning back like this, in a position of relaxation when I was very clearly not relaxed. It felt forced. I wondered if he thought I was trying to look comfortable when I wasn't. How am I supposed to sit? How do other people do this?

Although this entire transaction probably lasted only seconds, it had felt like an eternity,

It's hard enough to make the courageous choice to see a therapist, and even harder to find one you like (I always recommend "Therapist shopping" before finding one who'll best fit your needs); but, to know what to do when you actually get into therapy is just too much to expect. 

As a therapist, I'd like to remove as many obstacles to coming to therapy as possible. There are things that people don't usually think about until they're in the room. If you're anything like me, you have no idea what to expect with therapy, so I hope to bring light to some of these things, in an effort to bring more comfort and empowerment to the experience. Remember, the therapist is the guide, but you are the one in control! 

Here are 5 things I like my clients to know right off the bat:

1) Make the room your own

When a client walks in, the first thing I ask is "How does the room feel to you? Lighting? Furniture placement? Temperature? Would you like me to make any adjustments to see if something might feel a bit better?" I want clients to feel empowered to make the room as comfortable as possible. Every client wants things a different way, and I love when my clients ask me to close the blinds or adjust the lighting! It's a sign that they feel comfortable enough with me to say something, and comfortable enough with themselves to be aware of what they need in the moment. 

I then point out the location of the bathroom, tissues, blankets, and fidget toys for use as needed.

2) Make yourself comfortable

I always tell clients that I do therapy barefoot and with a blanket. I sometimes hold a pillow, sit on the floor, stand up, move to another seat, etc. I encourage clients to do what feels right for them in the moment, even if I'm doing something different.

3) Don't worry about making sense or being polite

I explain that this is not the place to worry about making sense, being politically correct, or being polite -- this is a safe space, free from judgment, where you can feel comfortable expressing whatever you need.

4) Start how you want to start

Some therapists wait for you to speak first, some will ask what brings you in, and some will start by saying something about themselves or offering a short moment to reflect. I start sessions differently, depending on what each client appears to want. I love when clients tell me how they like to begin, or when they request a quick centering exercise to allow themselves to fully get into the moment or simply start sharing whatever is on their mind as they walk in the door. 

5) But really, how do we start?

I like to tell clients that if you come in with something already on your mind, we'll start there. But if you have no idea what you want to talk about, not to worry. I'll ask you questions until we find something you want to discuss.

In general, I'll ask questions to understand why you're here and how I can best help you, but I encourage you to tell me what feels relevant to you, even if I don't ask it. If you're not yet ready to talk about something, that's perfectly fine too. We'll go at your pace.

Going to see a therapist takes courage. Your therapist knows that the more comfortable you feel, the better your experience will be, so trust that they want to do everything they can to make you as comfortable as possible! No need to be shy. This is your hour, you're paying for it, and it's about you. Feel empowered to make it your own!