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Mariana Plata


6 Things to Expect When You Start Therapy

Your inner world is not the only one that changes.

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You've done the research, cross-referenced your options, and chosen the clinician with whom you want to start psychotherapy. And then, the day finally arrives: your first therapy session. Mixed feelings build up inside of you—ranging from anticipation to anxiety, and from fear to relief. They all show up at once, making it difficult for you to pinpoint exactly what you're feeling.

What should I say? How should I start? Who speaks first? These are all questions that get answered during the first 15 minutes of your first session. Less likely, though, is knowing how to prepare yourself for what will happen when the real work starts. Because it's not only you who changes when you start therapy—it's everything around you.

What most people don't realize is that psychotherapy not only provokes a change in your inner world, it also disrupts your outer world, including your friends, your job, and your relationships. And there's no surefire way to prepare whoever is embarking in therapy for this change, because each therapeutic journey is so different and so personal. There are, however, certain things you can expect when starting psychotherapy. Here are six of them:

1. You might see "more" and "deeper" than you used to.

When you start psychotherapy, you typically devote about an hour of your time each week to talking about yourself, your fears, and your anxieties. This can open the space to dig deep into your life story and discover what has shaped you to become the person you are today. If you and your therapist can create a strong alliance, it's possible you might end up in a long-term therapeutic relationship. And the longer you attend psychotherapy, the more you'll be able to exercise your "seeing beyond" muscle—a skill that will come in handy even after therapy has concluded.

2. You might find yourself lost in your thoughts more frequently than before.

Once you start therapy, it's not uncommon for you to become more reflective about your life and everything surrounding it. When you have a professional constantly throwing you open-ended questions, it's likely to spark your self-curiosity and self-awareness. As a result, you may think more about the conversations you have, the choices you make, and the relationships you cultivate with others. Don't be surprised that after activating that "thinking brain," you find yourself lost in thought more often than before. 

3. People might resist this "new" version of you.

Something that many people don't expect when starting therapy is how much their relationships with other people change. Think of it this way: You've spent much of your life "fitting" into certain relationship puzzles by behaving, thinking, and feeling in a pre-determined way—but when someone starts therapy, all of those behavioral patterns gets challenged. You'll grow; you'll change; you'll transform. Undoubtedly, this will affect the way you "fit" into your "relationship puzzles." That, in turn, will likely force those around you to either adapt to your new "shape" or resist what you're transforming into.

Though this may seem disheartening, it's important to be aware of it so you can have patience with the way other people adapt to the "new" version of you. Remember, however, that it's not your responsibility to make others adapt to you. Though you can certainly play a part, most of another person's response to you will depend on their experiences, emotional maturity, and intelligence.

4. You might identify "toxic" or "harmful" patterns more easily than before.

It's no surprise that the way someone reacts and behaves with other people is largely because of their family patterns or learned behaviors—some of which might be healthier or unhealthier than others. When you go to therapy, you will likely start to identify the unhealthy, toxic, or harmful patterns from your generational lineage and past experiences. When you can name them, you can make an active change to, ideally, transform them into healthier patterns that can then repeat for generations to come.

5. You develop a fuller emotional vocabulary.

Naming your emotions is one of the basic goals of any therapy process. It doesn't matter what "type" of psychotherapy you attend or what "kind" of therapist you have—they will undoubtedly help you name your feelings. The more you do this, the more extensive your emotional vocabulary becomes.

6. You might end up with more questions than answers.

As you dive into your history and identify what has shaped you to become who you are today, you might soon realize that there are many more questions than answers. Some personal hypothesis you might never fully corroborate. It's healthy to ponder how your life history has shaped you to become who you are today. But as you ponder, it's critical to keep in mind that it might take you longer to find the answers to some questions—and that's okay.

Therapy can be a challenging process, and the mere fact that you've embarked on it means you're determined to understand more about yourself. For many therapy-goers, the first session is the first step on a road toward a happier, healthier, and more resilient self.

Check Psychology Today's directory of therapists to find a professional near you.

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