Nowadays, about half of Americans seek treatment from a therapist to help them with a variety of issues in their lives. Anyone who tells you that you don’t need a therapist, or that you should just work it out on your own, is wrong. Maybe you’ve had a traumatic break up, or are struggling with mental health issues — a therapist can help with both of those things. Primarily, a therapist is there to help you clarify your feelings, and can help you make educated decisions about your future actions.
However, there are a few things that they might not tell you during your sessions. Here are a few of them, so you can go into your first appointment prepared.
They will talk about your case with others
During your first appointment, you probably signed a confidentiality waiver with your therapist, where they laid out how they will protect your privacy. However, even if you did sign this, you can be sure that even the most diligent therapist discusses the details of your case at some point with someone else — maybe a spouse, or a colleague.
However, you can rest assured that an ethical therapist will keep your personal details anonymous.
Not everything is completely confidential
In the confidentiality waiver, you may not have noticed the fine print that states that although they will keep the details of your case confidential, they are obligated to tell law enforcement under certain specific circumstances.
If your therapist reasonably believes that what you are saying indicates that you are a threat to yourself or others, they can contact law enforcement. This includes crimes that have already been committed.
When you first start, they may not know if they can help you
Many therapists admit that when patients first start, they may not know 100% whether they can be helpful or not. That doesn’t mean they won’t try, but if you’re looking for an enthusiastic assurance of whether their help will ‘cure’ you, they can’t honestly give it.
If a therapist enthusiastically promises that they have a 100% success rate, be wary.
They want to give you advice, even if they shouldn’t
Despite what you may think, therapists aren’t primarily advice-givers. Therapists are taught that instead of giving advice, they should listen to you and work with you to determine the best course of treatment.
However, it’s almost impossible to resist giving advice, and so many therapists disguise it as ‘homework’ to be completed before the next session.
They’ve probably heard worse than what you’re telling them
You’re almost definitely not as “weird,” “broken,” or “crazy” as you think you are. Your therapist knows this better than anyone.
If your therapist has been an active therapist for more than 5 or so years, they’ve probably already heard worse than what you’re telling them, so don’t be afraid to really go into depth to get it all off your chest.
They may have stumbled into therapy to get help for themselves first
A lot of therapists’ first experience with therapy is actually being a patient themselves. Although this may make you uncomfortable to learn, it really shouldn’t.
If your therapist started out as a patient, what should be clear is they had so much faith in the system that they committed to years of schooling in order to help others achieve the success that they achieved.
Insurance forces therapists to diagnose you, even if you don’t accurately fit into the diagnosis
If you’re lucky enough to have your therapy covered by your insurance, you may be setting yourself up for a much more complicated experience than if you just paid out of pocket. This is because of insurance companies’ regulations, not your therapist’s wishes.
If your therapy is covered by insurance, the pressure is on for your therapist to diagnose you with a named condition, so that your treatment is legitimized. If they don’t diagnose you, you may not be able to claim it under your insurance.
It’s often very hard for a therapist to get paid
If your insurance is covering your therapy sessions, your therapist may be happy for you but secretly dreading having to wrestle with your insurance company’s red tape in order to secure their payment.
This is, of course, not something you should ever feel bad about. It’s just an unfortunate reality.
Changing is harder than you think
Change is much harder than people think. Many people enter therapy with their rose-colored glasses firmly on, and are excited to change their life.
However, it is important to remember that humans are creatures of habit. Any changes, however small, will impact your life in ways you don’t yet imagine, so keep at it, even when it doesn’t feel helpful!
They may not tell you how hard it will be
The more your therapist reveals to you about how hard your sessions may be, the more they’ll put you on your guard – especially in the beginning.
It’s more likely that they’ll underplay the difficulty that lies ahead, in order to ensure that you’re in a good state of mind going in to the session. If you’re relaxed and open, chances are you’ll be more successful than if you’re tense and apprehensive. Really, they’re doing you a favor.
You shouldn’t use your therapist as a paid friend
Many people will begin a therapy session by recounting what they did that week. While it’s important that your therapist knows what’s going on in your life, a lot of times people go way overboard sharing during this part of the session.
A good therapist should encourage you to move past these small details and on to the important stuff. Your time is valuable, after all.
What school your therapist graduated from doesn’t matter
As long as they’re accredited, you shouldn’t really care what school your therapist went to. There’s no evidence that any one school or program produces better therapists than any other.
The true test of a good therapist is whether you enjoy working with them. If they encourage you, and you feel like you’re making progress, you’ve found the right therapist. That’s all there is to it!
Medication recommendations often come courtesy of a pharmaceutical company
If you find that your therapist is pushing a certain kind of medication over and over again, you can probably thank a pharmaceutical company’s representative, who may have just recently paid them a visit.
Be wary if your therapist pushes a certain type of drug. They may be getting kickbacks from the drug’s manufacturer. It’s never a bad idea to get a second opinion.
Therapists can get just as frustrated by your slow progress as you are
While it is true that the longer you remain with a therapist, the longer they receive payment, it can be excruciating to watch someone struggle for longer than necessary. Even if they don’t show it, your therapist is probably just as frustrated as you are if you’re failing to progress.
That doesn’t mean you have to fake progress or push yourself too hard. It’s just an example of the genuine empathy therapists have for their patients.
Often they’ll say they understand, even if they don’t
“I understand” and “Yes, interesting,” are a few stock phrases that therapists keep locked and loaded for whenever they need to say something, but their mind is occupied.
Feeling heard can be very helpful to your progress, but too many “I understands” might mean they don’t understand at all. If you hear these over and over again, chances are your therapist may not be really listening to you.
If they see you on the street, they’ll probably ignore you
But don’t be offended if you get snubbed by your therapist. This is for your benefit more than theirs.
Many therapists feel that even acknowledging a patient outside of their office could be interpreted as a breach of confidentiality. In order to maintain your privacy, it’s common for therapists to pretend not to know patients they see outside the office.
Many times you can get a lower rate just by asking
Don’t let a lack of funds dissuade you from seeking help. Many therapists offer a sliding scale of payment to their customers.
This means that if you come from a lower income household, or if you’re uninsured, you could get a lower rate just by asking for it. It can’t hurt to try. Even if they don’t offer a sliding scale, they may be able to refer you to someone who does.
Don’t look for your therapist to agree with you
You shouldn’t get into the habit of asking therapists if they agree with you. They’re not there to agree with you!
Therapists are there to listen to your feelings, and help you work through them. If you need someone’s approval that badly, ask one of your friends. (Or consider exploring your need for approval with your therapist!)
Helping others is the cure that many people need, but don’t want
Many people seek help from therapists because they feel isolated or lonely. Often, therapists will encourage them to seek the companionship of others through group therapy, but what really has been shown to improve people’s lives is helping others.
This can be simply going to soup kitchen to volunteer, or taking a meal and a newspaper to an elderly neighbor. Acts of kindness give people a reason to leave the house, while simultaneously improving the lives of those around them. If you can do it, you just might reap the benefits.
They do care about you, even if they’re trained not to show it
A good therapist should strive to remain – or at least appear – objective at all times. After all, it’s hard to see the best solution if you’re mired in the emotions of the situations.
Many therapists won’t tell you how much they care about you, but hopefully their actions speak louder than their words.