What to Expect During Therapy


Megan McGinn, PsyD

In this blog entry, we delve into the complex dynamics of therapy and why it can be a challenging yet transformative process. Therapy is not a quick fix, and it requires facing discomfort, acknowledging vulnerabilities, and exploring wounds. By understanding the need to confront our pain, take responsibility for our actions, and step out of our comfort zones, we can embark on a journey of self-growth and healing.

Most people have experienced that moment of desperation, consumed by stress or despair, where you pour your heart out to a friend, colleague, family member, or bartender. When you take a breath from venting, you are met with uncomfortable silence and a look of helplessness. Your confidant, feeling equally as overwhelmed by your problem as you, resorts to deflection: “Have you tried talking to a therapist?”

Many people enter therapy after difficult interactions like these – they feel exposed, embarrassed, and reluctant to open up and revisit painful struggles again. The therapist seems like a magical solution to circumvent the pain of opening old wounds and admitting vulnerability. Many people imagine that the therapist will provide a toolbox of coping skills to eliminate discomfort, anxiety, depression, and create happy and fulfilling relationships. In actuality, the toolbox of coping skills is underwhelming and usually contains things you’ve heard of already but are not inspired to practice regularly – meditation, breathing exercises, gratitude lists, etc. In fact, we already know about what we are supposed to be doing to help ourselves and maintain a healthy life, but for mysterious reasons we are simply not doing it.

Why? We are creatures that are highly susceptible to self-sabotage due to fear, self protection, and shame. To avoid risking hurt, rejection, or disappointment, we maintain familiar, predictable but destructive patterns that make us feel stuck and unsatisfied. Consider the person who wants to fall in love but has been rejected in the past. This person may enter into relationships but unconsciously push the partner away during moments of vulnerability or uncertainty in order to maintain a sense of control and not give the partner the opportunity to do the rejecting, Or the person will pursue emotionally unavailable partners that are not available for genuine intimacy that can lead to a painful loss. However, the result is the same and the person will never establish long term emotional closeness. What about the constant procrastinator? This person is likely afraid of failure, so they bring it on themselves by not meeting deadlines. This is instead of putting in their best effort and exposing themselves to the fear inducing scrutiny of the grading system.

It is imperative to understand that you cannot succeed in therapy without a certain amount of discomfort that comes from being 100% honest about acknowledging your weaknesses, the shame you feel, your vices, the things you do that you hide from everyone else, and even have a hard time admitting to yourself. You must be willing to revisit the pain and hurt that you have experienced in your life, which is a difficult and uncomfortable process, and explore how this has affected your thoughts, feelings and behaviors. Many people are dismissive of this – they say things like other people have it worse so I can’t complain, or my parents did the best they could so I have no right to be upset. While these things may be true, if you do not acknowledge the pain you experienced anyway, you will not be able to heal from it. Finally, although the world can be an unfair place, full of external causes of suffering, you must be willing to take responsibility for your own actions, including how you are contributing to your own struggles and your pain. You must be willing to acknowledge that unhelpful thoughts about yourself, others, and the world may be problematic, not rooted in reality, and must be disposed of since they are not serving you. Finally, you must be able to step out of your comfort zone and take the necessary risks that lead to self growth, even if they may cause more pain.

As such, you may go into therapy with specific, practical goals, such as quitting drinking. Certainly we can make a plan to moderate and eventually eliminate drinking. But not before we understand what triggers you to drink and what deep wound inside you compels you to self medicate with alcohol. What was it about the environment you grew up in that encouraged you to deal with your problems through alcohol rather than take the time to process your feelings and seek others to receive emotional support? Do you have enough self esteem to connect with others and move through your life without the help of being inebriated? If not, where did your poor self image come from? In short, there are no simple solutions in therapy, and any one issue is likely associated with a host of psychological vulnerabilities and learned behaviors. So it’s imperative to go into therapy expecting that there are no quick fixes, and all progress is derived through vulnerable, honest self exploration that takes time.

If you’re thinking about therapy, I would be happy to start this journey with you and aid you in this process. Please feel free to schedule an appointment with me and start exploring how therapy may help you reach your goals.

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