I grew up in a small Wisconsin town where people didn’t talk much about therapy or mental health in general. So despite having depression and anxiety for as long as I can remember, I didn’t start seeing a therapist until I moved to Los Angeles.
I feel fortunate to have been seeing my current therapist for a year and a half now. I look forward to meeting with her every week—so much that I hate having to miss a session. That said, the experience has had its ups and downs, including many difficult and awkward conversations. But navigating these has helped me grow in ways I never expected, like coming out as queer and owning my sexual identity, acknowledging that my dream of working in Hollywood wasn’t making me happy, and cutting out toxic people who sapped my energy.
I also didn’t realize when I started this journey that my relationship with my therapist would be just as healing and important as the actual subjects we discuss in each session.
Here are eight more things I wish I knew when I started. Knowing these ahead of time would have given me the courage to leave my former therapist a lot sooner. Instead, I stayed with her for six months, not knowing how to speak up or find a better fit.
1. It’s important to take the time to find a therapist who YOU feel comfortable with.
I know a lot of people don’t see a therapist because the thought of finding someone sounds overwhelming. I get it—in some ways, finding a therapist can be like the worst parts of dating: You find someone you think might work and take time out of your schedule to go meet them, only to find out it’s a bad fit. But when it works, it can be incredibly helpful.
When starting out, it’s worth the time to do some research, which can help you find someone who’s a good fit for your particular needs. Have goals in mind: What are you looking to accomplish, and which aspects of your life are you having trouble with? Look into different types of therapy to see what may be best for you. Both Whitney Goodman, LMFT, owner of The Collaborative Counseling Center, and Ryan Howes, Ph.D., a California-based psychologist, encourage people to really focus on what a therapist specializes in—rather than solely looking at their credentials.
“You want to find somebody who is familiar with your issue. That should speak to you from their bio, but also ask if they’ve ever worked with somebody who is going through what you’re going through,” Goodman says.
Remember that you are the client, and the therapist is working for you. You want to find someone who you can be completely honest with and who will be able to help you accomplish your goals. Two good places to start your search are Psychology Today or Good Therapy.
2. Make sure to discuss any financial issues you may be having.
Therapy can cost a lot of money. If you’re interested in seeing someone, but you’re on a budget, Goodman suggests looking into local universities and seeing someone who is going for their masters or doctorate in psychology.
“The clinicians are really good. They’re being supervised by really respected people in the community, and sometimes the services are as low as $5,” Goodman says.
She says you can also call therapists and ask if they have a sliding scale—many do. Another option might be to look into Open Path, where you pay $49 for a lifetime membership and gain access to a directory of therapists who charge between $30-$50 per session (up to $80 for couples or family counseling).
Sometimes your finances or insurance may change after you’ve been in therapy for some time. But before you bail, talk to your therapist about not being able to afford to see them. When my insurance changed last fall, I immediately panicked and thought I had to find someone new. As much as I dreaded the conversation, I told my therapist about my insurance change and said I really wanted to keep seeing her. We were able to work out a price that was still affordable.
Sheila Addison, Ph.D., LMFT, says she always tries to work with her clients whose finances have changed. These options can include having a client come earlier in the day when sessions are harder to fill (at a reduced rate) or simply giving them a temporary reduction in fees.
I know it can feel much easier to just quit, but if you just let your therapist know what’s going on, you can often find a good solution. And if they can’t meet your request, they’ll at least be able to refer you to someone they think is a good fit—while being more affordable.
3. Take the time to learn about their policies.
When you start seeing someone, you’ll get some forms to fill out. And if you’re like most people (hi, me), you’ll just quickly look them over and sign. But there’s actually a lot of useful information on these consent forms. You’ll learn things like what their protocol for calls and emails between sessions is and what to do if you run into a mental health crisis. It’s important to also talk to your therapist about these things in the first couple of sessions, especially if you have questions or concerns.
“A lot of people make the mistake of just signing the forms and not keeping a copy for themselves,” Addison says. She suggests taking a picture of everything or asking the therapist to send you copies.
One thing I regret not doing earlier is setting up a crisis plan with my therapist that includes things like stress-reduction activities, hotline numbers, and contact info for close friends and family. Even if you think you’ll never need it, create one anyway—it’s worth it just to have it.
4. You might feel worse before you start to feel better.
Therapy is hard! There are going to be times when you leave the room feeling worse than you did when you came in. You’re going to resent your therapist and have the urge to just quit. But I promise it really does get better.
A lot of us have adopted unhealthy coping mechanisms that feel really familiar, and when you start to wean yourself off of them, you can feel out of control. You might also have issues in your life that you’ve been avoiding, so quitting therapy is definitely easier in the short-term than having to talk about them. But keep going—in the long run, you’ll learn healthy coping mechanisms and have a better understanding of who you are as a person.
Howes suggests talking to your therapist if you’re feeling overwhelmed. He says you can ask them if they can slow the pace down or provide you with some ways to help manage the stress.
5. You might become attached to your therapist, and that’s OK.
About five months after I started seeing my therapist, I became really dependent on her and even developed some romantic feelings toward her. I tried to get rid of these feelings and hid them for a long time. I spent hours Googling what was wrong with me and why this was happening. I couldn’t understand why I was having erotic dreams about her or why I wanted to be friends with her.
“Any type of positive feelings toward your therapist is really normal,” Addison says. “When you go to a therapist, you’re getting an hour a week where someone focuses exclusively on you and doesn’t ask for anything in return. Having these feelings is actually a sign that some things are going really well. You’re feeling safe in the relationship and you’re feeling accepted by the therapist.”
If these feelings get to the point where they become intrusive or interfere with your daily life, you should think about bringing them up, Addison says. Your therapist can help you figure out what needs aren’t being met in your life and how to change that. There are rules against being friends with your therapist or having any type of relationship with them other than a professional one. And if they start to reciprocate feelings, that’s a big red flag.
I brought my feelings up to my therapist and she responded in a really positive way and is helping me work through them. I know that the thought of talking about something like that feels so awkward, but if your therapist is professional and good at their job, they’ll handle it like a boss.
6. If your therapist upsets you or offends you, speak up.
There will come a time when your therapist says or does something that angers you or says something that hurts your feelings. It’s happened a few times over the course of my own therapy. It’s tempting to not say anything and just try to move on, but it’s so important to bring it up. This is a great opportunity to learn how to stand up for yourself without having to worry about the other person’s feelings.
Goodman says that a good clinician will listen to your feelings and want to figure out why their comment made you feel a certain way. However, she says that if this seems to come up often, and you can’t find common ground, then it might be time to find someone else. Remember, don’t be discouraged if your therapist responds poorly or gets defensive; it just means it’s time to find someone who is a better fit—you deserve a safe space to bring up these issues.
If talking about your concern in person makes you anxious, try writing out your feelings and emailing it to them. I emailed my therapist when she said something that really hurt my feelings, and she responded in a positive way that let me know she cares and wants me to always speak up. Therapists are human and are going to make mistakes. And letting them know how you feel will only deepen the relationship.
7. Go to your appointment even if you think you have nothing to talk about.
I usually have so many things I want to talk about each session, but sometimes, I draw a blank. It’s tempting to just cancel the appointment. Who wants to sit in silence for 45 minutes? I encourage you to go, though: Some of my best sessions have been ones where I had nothing prepared because I was able to dive deeper into previously discussed issues or learn that what I previously thought was a seemingly minor thing revealed a much larger issue.
In one session, I started venting about a friend only to realize that she was a big reason why I was so hesitant to share with others how much I struggled with my chronic illness. I was so scared that other people would react the same way she did—by brushing it off and telling me I don’t “look sick.” My therapist and I spent the rest of the session working through this fear and coming up with a plan to try again with another close friend.
Howe says that when you don’t have anything lined up to talk about, you’re able to tap into what’s going on inside you right at the moment and that the results can sometimes be much richer.
8. It’s OK to leave if you aren’t vibing with your therapist—or if you’ve outgrown them.
Maybe you’ve been with your therapist for six months and just haven’t found a connection yet, or you’ve been with them for two years and feel like you’ve accomplished all you can with them. A good therapist isn’t going to force you to stay, but they can help you transition out. You are the client, and if it’s not a good fit, you have every right to leave. Sure, you can just not show up to any more sessions, but it might be better to talk about it first.
Goodman says she loves when clients let her know that she isn’t the right fit because she is then able to recommend someone else, which saves them a lot of time and stress. She also says the therapist can maybe adjust their style or treatment modality to fit you.
Remember, you decide when you’re done with therapy. Maybe you’ve accomplished your goals and feel ready to handle life’s challenges on your own, or you have some other issues you want to focus on, and they’re outside of your current therapist’s scope. A good therapist will be happy in either scenario and will be more than willing to assist however they can.
At the end of the day, your therapist just wants you to grow and get to a place where you can live an authentic life, so they want you to speak your mind and not worry about offending them.
Allyson Byers is a freelance writer who loves writing about mental health and chronic illnesses. She lives in Los Angeles with her 7-year-old rescue dog. Read more of her writing at allysonbyers.com or follow her on Instagram @byersally.