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  • Writer's pictureFilza Khan

Anxieties about Starting Therapy

Updated: Jun 19, 2020

Recently, I've had many clients tell me in their first session that it was their first time seeking help through a therapist for their problems. Sometimes these clients were going through recent difficulties based on a new situation - for example, the recent death of a loved one, conflict with their significant other or conflict with their employer. But often, I've had clients tell me that they have been struggling with their particular problem for years. In such cases I wondered, "Why did this client take so long to reach out?"

Well as it turned out, it actually helped me in my work with my clients to start asking them exactly that question. "Why did it take you so long to reach out and try therapy? Why now? What was difficult about making this choice?" In this post, I'll be highlighting just a few of the recurring themes I've encountered in people's worries about using therapy to help address their problems. And hopefully, if you can relate to any of these, you'll be able to see that you're not alone in experiencing some of these anxieties.


1. Underlying Beliefs about "Keeping your problems to yourself" - This is usually the number one reason that comes up in sessions as we work on identifying what messages clients may have received from their own parents/guardians in childhood and internalized into their own thoughts over time. These messages, whether obvious or subtle, can have a lasting impact on one's personal beliefs and values even decades later. For example, if you were raised in a high-conflict household where the problem was never addressed internally, much less with outside help, that experience may affect how comfortable you feel about addressing conflict with a third-party in the room. Maybe you were discouraged from "airing out your dirty laundry" to others, or maybe you were explicitly told to hold in your feelings (like the old adage, "boys don't cry").

2. Fear of Being Labeled as "Crazy" - Even as talk-therapy becomes a bit more mainstream with public figures and celebrities advocating for mental health and sharing their own journey with therapy, there still exists a stigma about being in therapy. People still seem to hold a belief that if you have to seek out professional help to manage your problems, you must be "crazy." Clients with this belief are usually defensive about how others may perceive them, and often clarify that they don't really "need" therapy. However, a lot of the time these same clients often minimize their own struggles and are more likely to put their own needs aside to focus on others. Struggling with even mild symptoms of anxiety and depression for long periods of time can cause a significant strain on a person's wellbeing, and it's important for people to assess their problems from an outside perspective. A quick thought exercise could be: Imagine you had a best friend struggling with the exact same situation you are struggling with now. How would you label their reaction to the situation? Would you use harsh, negative words to explain away their pain or tell them it's not a big deal, or would you encourage them to seek help?

It's important to note that the words we choose to label an experience with has a big impact on our feelings about that experience.

3. Misconceptions about Therapy - A lot of defensiveness about therapy also occurs because people don't always know what to expect in a first therapy session. Clients need to be informed and reminded that they are the ones with power in the session to ultimately dictate what they want to share and what they'd like to focus on in the session. Therapists do have the right to suggest topics and challenge thinking patterns, but clients have the right (and should be empowered) to set comfortable boundaries. It's important to remember that not all therapeutic experiences look alike. Some people may experience a significant therapeutic breakthrough in their 3rd session, while other people experience small epiphanies throughout the course of a year in therapy. Everyone's journey in therapy is going to vary based on their unique situation and goals. Understanding what you hope to get out of your work in therapy will help you mark your own progress and feel a sense of accomplishment.


Again, these are only a few themes I've come across in recent work with clients. Maybe your struggles are different. It's important to identify what anxieties or beliefs you may hold about therapy that's kept you from reaching out. Hopefully, bringing these worries up to your counselor can only add value to the work you do in sessions and enrich your experience in counseling overall.

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