10 Things Your Therapist Wishes You Knew About Psychotherapy

Starting psychotherapy can feel intimidating—an unfamiliar experience that requires vulnerability and a willingness to share your deepest emotions.

For some, the prospect of gaining self-awareness with the guidance of a trained psychotherapist is appealing. But for others, therapy might seem like the last place they want to be. This understandable hesitation is something I often see in my psychotherapy practice.

“I would rather walk into a building with guns drawn than be in a therapist’s office,” admitted a former client, a retired police officer named Leanna (name changed for confidentiality). Leanna was only partially joking about her fears. Fortunately, she could laugh at her comment and engage in a conversation about her struggles.

Many people, like Leanna, overcome their hesitation and choose therapy to navigate difficult times. “Therapy helps you learn how your mind works,” says Mental Health America. “It allows you to navigate your feelings, build healthier habits, and change your mindset so that your life looks more like you want.” They highlight research showing that psychotherapy can alter brain function and can be as effective as or better than medication for conditions like anxiety, depression, and OCD.

Psychotherapy addresses a range of issues, including emotional distress, parenting or career struggles, marital and family conflicts, child behavioral concerns, and addictions. Although results can vary based on the therapist’s skill and the alignment of their interventions with the client’s needs, research supports its effectiveness. According to the American Psychological Association, psychotherapy is effective, often reduces the need for additional medication, and its positive effects persist after treatment ends.

Unfortunately, psychotherapy and psychotherapists are often misunderstood and misrepresented in media. Misconceptions include therapy being seen as mere advice-giving, or therapists portrayed as crossing boundaries and forming inappropriate relationships with clients.

Misinformation is damaging as it deters people from seeking therapy when they need it most. Building trust in therapy during a vulnerable time is challenging, and negative misrepresentations only muddy the waters. When doubts linger about a therapist’s ethics or motives, trust may never develop.

In my decades of practice, I’ve witnessed the benefits, limitations, and challenges inherent in psychotherapy. Therapy is far from perfect, but it can be a crucial support, even a lifesaver, in certain circumstances.

In honor of Mental Health Awareness Month, I want to set the record straight based on my experience and perspective. While I cannot speak for every therapist, I’ve heard similar concerns in my collaboration with many psychotherapists over the years.

Setting the Record Straight

Your hesitation is normal. Most people start therapy with skepticism, hesitation, worries, and doubts. Opening up to a stranger about fears, insecurities, and even shame is daunting. Trusting that the therapist understands you and is on your side takes time. Your initial hesitation is a sign of your emotional health; take it seriously, but don’t let it prevent you from getting the help you need.

You, as a client, are essential to the process. Therapy requires your active participation. You will be asked to share thoughts, feelings, aspirations, mistakes, regrets, and unresolved issues. The more open and honest you are, the more you will benefit. However, it’s human nature to present yourself in the best light. A study by psychology researcher Matt Blanchard found that 93% of psychotherapy clients reported lying at least once to their therapist. Taking the first step to openly express your troubles is crucial for getting the most out of therapy.

Psychotherapy is not just about receiving advice. At their best, psychotherapists offer empathetic understanding and witness your struggles. Most therapy involves a collaborative exchange of ideas to help you make the best decisions, rather than giving direct advice. Simplistic advice-giving often bypasses fears and hesitations and may not be tailored to your readiness for change.

Psychotherapists are working hard—even when they look relaxed. Therapists might seem calm, but they are listening intently, considering the causes of your troubles, and carefully weighing what to say. They work hard to gain your trust and provide a safe space for sharing your deepest concerns.

Psychotherapists are real people. Therapists experience joys and sorrows like anyone else. They make mistakes and are imperfect. However, their job is to keep their personal lives separate from their work with you. They are not mind-readers or blank screens but real people with reactions and emotions about what you say.

Psychotherapy is not for therapists to solve their own problems, be your friend, or form a special relationship. Contrary to myths, therapists are not in this career to meet their own needs. They do not use clients to feel better about themselves. Boundaries are crucial, and certain actions, such as forming romantic relationships with clients, are never acceptable.

Psychotherapists are not at work 24/7. Therapists have personal lives and need to relax like everyone else. They do not constantly analyze others or always listen to problems. At social events, they are not scrutinizing your every word.

Ethical behavior is essential to the practice of psychotherapy. Psychotherapists adhere to strict ethical guidelines and only practice within their expertise. Licensing laws and codes of ethics are in place to prevent harm and maintain professional integrity.

Psychotherapists expect to be paid for their services. Therapists need to pay bills and often have significant student loans. What you are paying for is their time and expertise. Many therapists offer reduced fees for those in need or accept insurance.

Psychotherapy is not a luxury or indulgence. Therapy is hard work and involves self-reflection and change. It is not an indulgence but an essential support that can be life-saving. Don’t let stigma and stereotypes stop you from seeking help.

If you’re looking for a psychotherapist, ask your physician, school counselor, religious advisor, friends, or other trusted sources for recommendations. While starting therapy can be daunting, trust your instincts and consider meeting with several therapists before deciding. Be cautious of unlicensed therapists or life coaches claiming to offer psychotherapy.

Psychotherapists are far from perfect, but they can help you gather the insight, understanding, motivation, and self-compassion you need to move forward on your chosen path.

Additional resources about psychotherapy:

• National Institute of Mental Health
• American Psychological Association
• American Psychiatric Association
• Mental Health America