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23 My Step-by-Step Guide to Therapy

Once upon a time, counselling was an intimidating and unfamiliar concept for me. The idea of opening up to a stranger about my innermost thoughts and feelings felt daunting. I've found it challenging enough to discuss personal matters with people I know, let alone with someone entirely new. It's unsettling to think that this person is being paid to listen to my problems; although they reassure you they are non-judgemental, I always have a nagging doubt about how they may perceive me.

 

However, in recent months, my perspective has undergone a significant shift. I've connected with a psychologist who not only validates my feelings but also creates a safe space where I can comfortably explore and challenge my thoughts and beliefs. Together, we work on practical strategies that enhance my daily life.

 

If, like me, you have a busy mind, you might be wondering: even if these positive experiences are possible, how do you navigate the process? How do you find the right therapist? How do you start that first conversation? Is it awkward or uncomfortable?

 

Fear not! This step-by-step guide is here for you, regardless of whether you identify as neurotypical, neurodivergent, or neuroconfused.

 

Glossary


To begin with, I wanted to introduce terms I will use throughout my blog.


  • Therapist is a broad term used to encompass any mental health worker (British Psychological Society, n.d.).

  • In the NHS, counsellors typically have a master’s degree and focus on short-term therapy for specific issues like stress or relationship problems (NHS, 2024a).

  • Psychologists, on the other hand, require a Doctorate in Clinical Psychology and provide more extensive, long-term treatment for a range of mental health conditions, including diagnosis and psychological assessments (NHS, 2024b).

To ensure the information in this blog is relevant whether you encounter the terms "counsellor" or "psychologist," I will use these terms interchangeably throughout the blog. This approach aims to make the content clear and useful regardless of the specific title or role you are familiar with.


Step 1: Acceptance

 

If you have made it this far, you are already possibly on the first step! When broaching the topic of counselling, the first and most important step is acceptance. Accepting that you would like to open up to someone, accepting you have things you would like to discuss, and accepting that you are not perfect. For me, this has been the most crucial step in my journey.

 

The first time I experienced a counselling session, I was 14 years old—a naive teenager with numerous mental health struggles, unwilling to accept or address them. My mum, recognising my struggles, felt counselling was the best option for me. So, one day, I found myself in a mental health clinic, facing a young-looking lady in an overly minimalistic white room—the kind you now see as the wallpaper of a bougie professional on a corporate Zoom call. She addressed me with the softest voice, but I found it a little too soft for my liking. I was asked to fill out a questionnaire about my mental health, and then we would go through it together, breaking down each question one by one. I sat there, huddled in my school jumper, on an uncomfortably stiff sofa, wishing a hole would open up and swallow me whole.

 

As I watched the clock painfully tick by, I counted down the hour. The session itself felt incredibly awkward. She could tell I didn't want to be there, and I'm pretty sure she didn't want to be there either. My answers were minimal, often just "I'm not sure." As the hour drew to a close, I walked out of the room to see my mum waiting, "How was that? Should we book the next appointment?" she asked, beaming. I couldn't let her down. She was so hopeful so I continued for another three painful sessions until finally breaking down, and screaming that I would "never, ever step into a place like this again."

 

Moral of the story: I was in denial. I was determined that I didn't need help and needed to be left alone to wallow in my thoughts and feelings. The psychologist was probably lovely, but in my eyes, whatever she may or may not have said was never going to be right. I wasn't in a state of readiness.

 

So, what has changed between my many, and I mean many, unsuccessful attempts at therapy and the last few months? Acceptance. After seven years, I finally opened up to the idea of therapy and the fact that I needed help. I accepted that I needed the guidance of a professional to work through my struggles.

 

Step 2: Exploration

 

... struggles. But what exactly? What did I need help with? Honestly, a whole list of things. By the time I reached acceptance, I had a buildup of circling thoughts and feelings that needed to be addressed. Before finding a psychologist, I found it helpful to write a list, (you may prefer to draw a spider diagram instead) to visualise my challenges. Once identified, I created a list of aims. What did I want to achieve by investing in therapy? What was I willing to put forward, to dissect and analyse, to reflect on? Therapy is an investment of time and money, but it takes hard work and dedication on the client's part to get somewhere.

 

Here are a few aims from my list (as examples if you feel lost or need clarity), but remember, everyone is different, so your challenges and aims will be unique to you!

  1. Learn how to understand my emotions—what they feel like, how to identify them, and what to do when I feel a certain way.

  2. Try to reduce the constant feeling of overwhelm in my brain.

  3. Work through my rejection sensitivity dysphoria and setting boundaries (explored in my next blog!).

 

Once you've identified what you want to explore, these aims may help you find a professional who can cater to your needs. Especially if you are neurodivergent, you may want to speak to someone whose speciality is with neurodivergent individuals!

 

Step 3: Find Your Person

 

Searching for a psychologist who is the right fit for you is akin to finding a close friend in my mind. This individual will be privy to some of your most private thoughts, so establishing trust, safety, and a sense of connection is crucial. Like any relationship, the process of finding the right psychologist can involve trial and error. There isn't a short cut for this as even if someone is recommended, having been tried and tested, they may not be right for you.


Different psychologists have different communication styles, and it’s normal for there to be an initial period of adjustment. Building a mutual understanding takes time, and it's important to find someone who resonates with your unique needs and preferences.

 

Sometimes, a psychologist may feel they lack the specific tools or expertise to fully meet your needs, which is okay—it may prompt a search for someone better equipped to help. There is no singular "right" psychologist for everyone; the key is finding someone who aligns with your unique preferences and needs.

For example, I’ve found that psychologists who are neurodivergent often understand my challenges more intuitively. It’s important to be honest with your psychologist and communicate openly if their approach isn’t working for you. Similarly, being honest with yourself is crucial. I once found myself dreading weekly sessions with a counsellor, diverting conversations to her personal life to avoid addressing my own issues. Over time, I realised our connection was one-sided, prompting me to seek a more suitable therapist.

 

Personally, I've consulted with three or four professionals before finding one I truly connect with, and that's perfectly alright. Initially, I had concerns about potentially offending or upsetting them. However, it's crucial to remember that attending sessions where you're not engaged or simply going to avoid upsetting someone serves no purpose. Ultimately, if you're not connecting with them, chances are they feel the same way! It's about finding the right fit for both parties to ensure effective and meaningful therapy.

 

Step 4: Navigating Therapy Sessions

 

So, you think you may have found someone who works for you! But where do we go from here? Once again, there's no right or wrong when it comes to therapy. I've found that in some sessions, I do most of the talking, while in others, I spend most of the session listening. There are times when I know exactly what I want to discuss, and other times when I feel awkward and unsure about what to speak about. This variability is normal and underscores the importance of building a trusting relationship with your psychologist so you can openly express how you're feeling in the moment.

 

Personally, I like to refer to my list of challenges and aims during sessions when I feel a bit lost. I find it helpful to add to these lists randomly when I think of something I want to discuss. They serve as a fallback on days when I'm not feeling quite up to it.

 

Therapy sessions are all about taking baby steps. Initially, I was skeptical about what I could achieve, but over the past few months, I've noticed a significant improvement in how comfortable I feel in my own skin, largely thanks to these sessions. Some sessions feel incredibly productive—like my recent session on setting boundaries—while others leave me feeling like I rambled or didn't make the most of our time. However, it's important to remember that, as cringey as it might sound, it's about the journey, and each of these baby steps adds up.

 

Navigating a Therapy Session

 

Let me run you through a potential therapy session:

 

In a therapy session, the psychologist may begin by greeting you and setting a comfortable tone. They may start with a simple question like, "How are you feeling today?" This opening allows you to reflect on your current emotional state and sets the stage for what you may want to discuss.

 

You may then talk about what has been happening in your life recently: significant events, challenges, or emotions you've been experiencing. This initial sharing helps to establish context and gives the psychologist insight into your current concerns.

 

As the session progresses, the conversation may naturally flow into different topics based on what you bring up or what's been pre-identified on your list of challenges and aims. The psychologist may gently guide the discussion towards exploring a specific issue or goal you've mentioned, using techniques like reflective listening and asking clarifying questions to deepen their understanding.

 

There's often a back-and-forth communication style where you and the psychologist exchange thoughts, feelings, and insights. Some sessions may involve more listening on your part as you process your thoughts aloud, while others may see you actively engaging in dialogue and brainstorming solutions.

 

During the session, your psychologist may introduce resources or worksheets tailored to your needs. These could include cognitive-behavioural techniques, mindfulness exercises, or journaling prompts. These tools are designed to help you explore your thoughts and emotions more deeply or to practice new coping strategies.

 

Discussing possible strategies to address specific challenges in your daily life is a key part of the session. Together with your psychologist, you may brainstorm practical steps or behavioural changes that could help you manage stress, improve relationships, or work through emotional difficulties.

 

Towards the end of the session, there's typically a wrap-up phase where key insights or action points discussed may be summarised. Your psychologist may provide you with resources to take away, such as articles to read, exercises to practice, or reflections to journal about, that support the strategies discussed in session.

 

Step 5: Routine

 

Building therapy into your routine is crucial to fully reap its benefits. As I mentioned earlier, therapy is an investment in yourself, and it's an ongoing process rather than a quick fix to your problems. By incorporating therapy into your regular schedule, you create a dedicated time and space to focus on your mental and emotional well-being, as well as building rapport with your psychologist.


For someone like me who struggles with commitment, I've found it immensely useful to book the next session at the end of each appointment. This simple practice ensures that I have a set date for my next session, allowing me to jot down any thoughts or reflections in between appointments. It also provides an opportunity to mention to my therapist any topics or concerns I'd like to explore further in our next meeting.

 

Conclusion

 

In conclusion, embarking on the journey of counselling has been a transformative experience for me. From initial apprehension to eventual acceptance and proactive engagement, each step has contributed to my personal growth and emotional well-being, however, I recognise that I still have a long way to go.

 

I encourage anyone considering counselling to approach it with an open mind and a willingness to engage in self-reflection. It's a collaborative process that can lead to profound personal growth and a deeper understanding of oneself. Remember, your journey in therapy is unique to you, and each session is an opportunity for progress and discovery.


Thanks for reading,

Nidhi :)


P.S. - a special thanks to my psychologist for her continued support and guidance :)


 

References

British Psychological Society. (n.d.). What is a psychologist? Retrieved from https://www.bps.org.uk/about-psychology/what-psychologist


NHS. (2024a). Counselling. Retrieved from https://www.nhs.uk/conditions/counselling/


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