Carolyn Hax: What is therapy like?


Adapted from an online discussion.

Dear Carolyn: What is therapy like? I am struggling with anxiety and depression that has gotten much worse during the pandemic. I think I need to talk to someone or possibly even get some medication. I keep giving myself pep talks to get in touch with a therapist, commit to doing it, and look up options via my health insurance, but then never follow through.

I feel paralyzed about it. I start wondering what will be expected of me. Will they just sit there and expect me to do all the talking? Will my family members hear me talking, if it’s online? Would it be weird if I go sit in the car? What if I start crying and can’t talk during the session? What if I don’t like the therapist?

All these things start swirling in my head and I end up convincing myself it’s too hard. Can you or some of the other readers offer any insight into what a therapy session is actually like?

Swirling: 1. Yes, go sit in the car.

2. They’ve done this before. Therapists ask questions to get you talking.

3. Yes, cry. I’ve never seen a counseling office without several boxes of facial tissue. When you are finished crying, then you can talk again. They have seen this before, too.

4. If you don’t like the therapist, then choose another one. You can ask your current therapist, appropriately, for a recommendation.

I realize that seems towering, with the barrier to entry on finding one provider seeming too high, much less two or who knows how many — but tell yourself this: You have an illness, and you want a second opinion.

If you need a place to look, try Open Path Collective (same vetting required as with any other provider).

Break this into small steps, and don’t look beyond the step you’re in. Right now that’s making an appointment, so don’t worry about future steps, just this one. Making an appointment. Take care.

  • My therapist mentioned he has several clients that go for a walk during their session. It keeps them from being interrupted or overheard while also giving them exercise, and sometimes the movement helps. Years into this, therapists are used to all the different ways people get some privacy for a session.
  • You can do it! I believe in you! It will make you feel so much better! I have seen three therapists in my life and they all helped me in their own way. I have cried in all of their offices and it was normal and okay. In fact it made me feel a lot better because in watching it happen, my therapist was able to give me advice for coping with overwhelming thoughts that led to the crying. They will ask you lots of questions to get you talking. Their job is to put you at ease and build a relationship so you can work together on whatever is bothering you. The great thing about therapists is that their only goal is to help you!
  • I was in the same boat — waited WAY too long to finally start trying to make an appointment for my depression. I found that getting a referral from my primary care doc was a good place to start.

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