What Does Starting Therapy Actually Feel Like? A Therapist’s Honest Guide
Episode 5: Behind the Therapy Door
This article draws on a conversation between therapists Sarah Thome and Matt Gallagher. Listen to the full episode for the stories behind the takeaways.
Naked and afraid. That is how starting therapy can feel. You are about to share the most embarrassing parts of yourself with a stranger, and it is normal to worry that your stuff is the worst they have ever heard. It almost certainly is not. Licensed therapist Sarah Thome tells nervous new clients, “We have probably heard every iteration of any story.” Knowing what to expect when you are starting therapy can take some of the fear out of that first session.
Related: About Sarah and Matt.
What to Expect When Starting Therapy: Why It Feels So Vulnerable
Almost everyone walks in with the same fear: my stuff is the worst you’ve heard, it’s the most embarrassing, I’m the most flawed. A good therapist can see the human in your story and is not sitting in judgment of you.
Related: How therapy connects to PCM®.
Related: PCM® vs traditional personality tests.
What Is the Window of Tolerance and Why Should You Care?
Your window of tolerance is how much you can take while still regulating your emotions in a healthy way. Pop out of it and you either shut down or blow up. A reasonably stable upbringing tends to give you a wider window. Chaos, abuse, or loss tends to narrow it, so it takes less to push you out. Therapy works on widening it.
Everybody is worried when they come in: “My stuff is the worst you’ve heard. It’s the most embarrassing. I’m the most flawed.”
Sarah Thome, Behind the Therapy Door
Different personality types blow out of the window in different ways. Harmonizer energy can get really passive and weepy, or turn passive-aggressive with snarky little jabs. A more conscientious, mission-driven pattern looks different: an intense laser gaze, a longer and faster stride, hyper-focus, and the sense of every second slipping away. Catch those early warning signs and you can head things off and make different choices.
How Do You Know If a Therapist Is the Right Fit?
One story shows what a good fit conversation can sound like. A sweet elderly woman called to inquire about therapy. Sarah disclosed upfront: “I cuss like a sailor.” The woman responded, “I am working on not saying those words, so I do not think this will be a good fit.” Sarah gave her a referral to someone she thought would be a better match, and both of them came away feeling accepted.
Her standing offer to new clients: “If at any time I am not the right fit for you, you will not hurt my feelings.” A good therapist can mean that, because they cannot need you to like their style. The right fit is the one where you can stop performing and be yourself.
“We are not yes-people. That is not why people choose to explore their inner demons with us. They need the real.”
Sarah Thome
What Actually Happens in the Healing Process?
Sarah uses a glass-and-wound metaphor. Imagine you accidentally punched your hand through a glass window or a glass table. It would be more comfortable to just wrap it up and hope for the best. But infection would set in; the body needs to release what is trapped. Trauma work is a deliberate, slow process of going in, pulling out the glass, and cleaning it all up so the wound can fully heal, scab, scar, and integrate. It hurts more in the short term. An injury that heals badly can leave you limping for the rest of your life, and we do the same thing emotionally. “Emotional limping through life” is the alternative to doing the work.
- Healing is not linear. Expect two steps forward and sometimes a step or two back. When something new surfaces after a lot of work, it usually means you have done enough work to reach it.
- The 6th stage of grief is meaning. David Kessler added meaning to Kubler-Ross’s five stages. You do not have to find meaning in suffering. But choosing to is what transforms pain into growth.
Related: Explore workshop options.
Frequently Asked Questions
What should I expect in my first therapy session?
Your first session is usually an intake where the therapist gets to know you, your history, and what brought you in. It is normal to feel nervous, exposed, and uncertain about how much to share. A good therapist will meet you where you are without rushing you. You do not have to reveal everything on day one.
How do I know if my therapist is a good fit?
A good fit means you feel safe enough to be honest, even about the hard stuff. Therapist Matt Gallagher closes most first sessions by asking, “Do you feel like this is a good fit?” You are the boss of that answer. If the style does not match your needs, say so. A good therapist will not take it personally and can refer you to someone better suited.
How long does therapy take to work?
It depends on what you are working through, and you set the pace. Some clients share something new after six months, a year, or five years of work, because the right thing had not triggered it before. If your therapist uses the Process Communication Model®, it can give you shared words for your personality and distress patterns.
Find Your Communication Style.
Ready to take the first step? Sarah and Matt offer consultations to help you find the right fit, whether that is with them or someone else.