Over the last few years, there has been a significant change in the public perception of mental health issues and treatment. This is a field that has endured a lot of historical stigma, often related to the invisible nature of mental health issues, and confusion about mental health practices. A primary source of this stigma is the way mental health and therapy have been portrayed in Hollywood and the media. These images and portrayals are often sensationalized, brutalized, and used as plot devices to explain some sort of deviant behaviour. As with any paradigm shift, this change requires time to develop, and there is still some stigma and confusion lingering from the past. One of the questions we always ask during an initial appointment is “What are your expectations for therapy?” While some clients come into that first session with an idea of what therapy will look like and what they hope to achieve, the majority do not know what to expect, because they don’t know what, exactly, is involved with therapy. While every client is different, and every therapy session unique, there are some common factors that clients can expect when they consider the option of therapy. To help illustrate these commonalities, we can use an analogy to a more widely known, less stigmatized practice: a fitness class. Essentially, you can think of going to therapy like going to a fitness class for your mind. Just as with a fitness class, there are some things to think about before trying therapy.
You must have a goal. There must be some reason that you are seeking out this fitness class, and the reason must be important to you. Many people start a fitness class as part of a New Year’s resolution, and quit within the first two weeks because their heart was not really in it. When you come for therapy, it is important to think about what you hope to achieve or gain from your sessions, because where you hope to end up will determine the course of therapy.
The fitness instructor must have the right training and credentials. If you’re going to be learning and taking directions from a fitness instructor, you’ll want to make sure they know what they’re doing, to make sure that you’ll see some gain from the class, and to make sure you don’t injure yourself from performing an improper technique or overexerting yourself. With therapy, there are standards in place that dictate who can call themselves a psychotherapist, a psychologist, or a psychiatrist. These standards require practitioners to have sufficient education and experience to ensure that they are helping, rather than harming. So if you see a Peanuts-inspired stand offering therapy for 25 cents, check for some kind of certification before you sit down.
Simply showing up is not enough – you have to put in the work. This one seems very obvious when we use the fitness class analogy. If you show up for a spin class and don’t spin, you’re basically just listening to music and watching people sweat. If you want to see progress, you have to push those pedals and start spinning yourself! In therapy, you have to engage in the process. Just like a fitness instructor, a therapist cannot simply fix your problems or accomplish your goals for you. Rather, they help you build the skills and confidence to accomplish your goals. This means that you have to engage in the process, and participate in the activities, in order to see gains.
You must do other activities outside of fitness class time. If you attend a one-hour fitness class once per week, and spend the rest of the week engaging in a sedentary lifestyle and eating unhealthy foods, you’re unlikely to see any gains. In fact, if you’re only exercising once per week, you’re more likely to injure yourself or be very sore afterwards. The same is true for therapy. There are 168 hours in one week, so if you come to therapy for an hour every week, you’ll be spending 99.4% of your time outside of therapy. You must use the tools you develop when you are not in session, and practice them in your everyday life, if you want to see consistent change.
You will not necessarily attend this fitness class for the rest of your life. Many people join a fitness class because they need that extra motivation of having a scheduled class, or they need the accountability of going with a friend, or even because they’re not sure where to start and need some direction. The same is true for therapy: just because you decide to come, doesn’t mean you’re locked in for life. Depending on your goal(s), you might decide after four sessions that you’ve accomplished what you wanted to. Or maybe after eight sessions. Or maybe after 24 sessions. There is no guaranteed timeline for therapy; it all depends on what you want to achieve, and what obstacles are standing in your way.
If you don’t like a fitness class or instructor, you’re not obligated to stay in the class. This is a huge one! Finding the class that’s right for you will help you achieve your fitness goals. Similarly, you must find a therapist that you can connect with in order to achieve your treatment goals. If you aren’t connecting with a therapist, if there is not a good fit between the two of you, you are not obligated to stay with the same therapist! In fact, in these situations it is the therapist’s obligation to suggest different treatment options, or even a different therapist that they feel would be a better fit to help you accomplish your therapeutic goals.
At the end of the day, whether we’re talking about a fitness class or therapy, the important thing to remember is that you are the client. The purpose of the class, or therapy, is to offer direction and support in accomplishing your goals. And just like in a fitness class, you have to put in the work if you hope to make any progress.