Whether you are a first-timer, returning to treatment after a gap, or looking for a new provider, you may be wondering if therapy is right for you. While you are ultimately the best judge, here I share my perspective on a few common barriers to starting therapy, and how some people are able to overcome them.
Anxiety, Ambivalence, and Fear
I have worked with many clients who are anxious or ambivalent about entering treatment. This is completely understandable. Some people fear what may emerge in therapy, and whether they (or the therapist) will be able to handle it. While certain feelings or experiences that come up in sessions may feel temporarily distressing or overwhelming, your therapist can serve as a guide or partner to help you bear the burden and weather the emotional storm. Part of my skillset, for example, is the ability to hear, hold, and try to understand distressing thoughts and feelings that may be too difficult to access or process on your own.
Time and Budget
Finding the time and money for therapy can be difficult, and many people are unsure they will be able to make the time or financial commitments needed. You certainly will want to ask yourself if and how these investments could pay off for you, and whether therapy is worth prioritizing at this time. (You may decide that it’s not, or, on the other hand, you may find value in therapy that makes it well worth the investments.)
Regarding cost, many people with health insurance have out-of-network benefits that can be applied to healthcare costs from providers who do not accept their insurance plan. This kind of coverage is usually reimbursed after the fact, which means that you would be responsible for payment up front. I generally encourage clients to discuss their coverage and expected out of pocket costs with their insurance company before their first appointment. If you are uninsured or otherwise cannot afford private, out-of-network therapy, there are many low-fee resources in NYC. I share a partial list here.
Prior Negative Experiences
Perhaps you have had a negative experience with a prior therapist and are worried about feeling hurt (or frustrated, or not helped, etc.) again. These concerns are valid, and worth exploring in therapy. Often, problems in relationships with former therapists have been left unresolved, and may impact your expectations for what future therapy will be like. I find voicing these concerns to be very helpful in the work. Still, getting started may require you to step out of your comfort zone and take a risk trusting someone new. Keep in mind that if it is not a good fit (I’d give it at least a few sessions to get an initial sense), you are (a) allowed to advocate for yourself and (b) not locked in.
Sharing with a Stranger
It can feel uncomfortable to be vulnerable with a stranger, especially for some people of certain cultures and identities. You may feel more familiar speaking with a partner, trusted friend, family member, or community or spiritual leader, and those social supports are wonderful. For some people, however, processing painful issues (especially things that bring up anger or shame) with a trained professional outside of your everyday world can offer the safety, confidentiality, and freedom to be as honest and to go as deep as you need to. And over time, there is potential for that relationship to become quite connected.
Am I Bringing Enough? Too Much?
You may wonder if your concerns are “enough” to warrant therapy, or on the other side of the coin, whether your problems are too serious and if you can be helped. These are not questions I can answer in any universal way, but excellent concerns to raise in an initial consultation. As far as the former, I generally believe it is better to be proactive and preventive than to wait for a crisis (when this is possible). At the same time, therapists tend to understand that motivation to reach out can be fairly low when you’re functioning adequately. As for the latter, sure, there are certain concerns that are best addressed by particular specialists or in specific settings. Try not to let that stop you from reaching out to ask about fit; if they are not right for you, most therapists will try to make appropriate referrals. For most people and concerns, however, whether a particular therapist can help you is in part a question of experience – are your needs in line with their qualifications and scope of practice? – and, perhaps more importantly, one of fit – do you feel the potential for a safe and trusting relationship (even if it is not fully realized right off the bat)?
Maybe therapy is not among your top priorities at this time. That is okay. Even when you are ready, it may still feel like a leap of faith, and there is a wide range of how tolerable that uncertainty feels for people. I encourage my clients to maintain an open dialogue about how the process is going, to raise any concerns about the therapy in therapy, and to explore how we might adjust our work to better address their needs and concerns.
Naturally, the above information may or may not apply to you. Every person and situation is unique. If you have questions about getting started, please feel free to contact me.