If therapy is meant to feel safe, why does the first step feel so uncertain?
If therapy is meant to heal, why does it bring up the pain we tend to bury?
If therapy is meant to bring us closer to ourselves, why does it begin with the urge to turn away?
Hesitation. Reluctance. Resistance.
Starting therapy can feel daunting. There’s a desire for change, clarity and healing, but the thought of stepping into that office for the first time may hold you back. For many, there’s anxiety in not knowing what therapy will look like. Questions start to arise. Concerns surface. Both deeply human and very common.
Even for those passionate about mental health, it’s natural to carry questions about the therapeutic process. Though the journey unfolds differently for each person, it helps to know what to expect, and to remember that the very act of beginning is already an act of courage.
What should I say in the first session?
One of the biggest sources of anxiety is the first session. Many people imagine it will feel like a test or interrogation. In reality, the first session is more like a conversation with a clear purpose.
As a clinical psychologist, my role is to ask about your history, your reasons for seeking therapy and your goals. But the purpose is never for you to perform. It is to create a foundation for understanding what you hope to work on.
And while it is normal to feel nervous, therapists are trained through years of study, clinical supervision and continuous training to guide the flow, ask gentle questions, and create a safe space where no reaction is wrong. You are not expected to have everything figured out. In fact, uncertainty itself is an important starting point.
How do therapists help? Do they tell us what to do or just charge us money to talk?
Understandably, many people wish for someone who can simply tell them what to do. After long periods of distress, the desire for quick guidance can feel especially strong. But therapy is not advice-giving.
While a therapist may share tools, frameworks or strategies, our role is to foster empowerment, deepen awareness and support meaningful growth. A psychodynamic and interpersonal approach looks beneath the surface: Uncovering patterns, making sense of how your past shapes your present and helping you experience relationships (including with your therapist) in a new way.
In other words, a therapist is not a passive listener; they are a trained clinician and confidant, holding a space that is exclusively yours: A safe, non-judgemental and focused solely on you. Over time, therapy guides you to carry that safe space within yourself, steadily and unshaken, no matter what life places in your path.
Is it normal to feel upset or uncomfortable in a therapy session?
If life is a painting, therapy doesn’t just look at the central figure. It encourages us to look at the details, the colors and what we’ve buried in the background.
Speaking about painful experiences or facing patterns you’d rather ignore can stir difficult emotions. Discomfort is not a failure. It is often a sign that growth is taking place. And you will not face it alone. A therapist has years of training in holding, containing and processing these emotions with you.
Many people fear being vulnerable or crying in therapy, worrying they’ll be judged. But vulnerability is not weakness but the path to healing. With time, what feels unbearable often becomes lighter simply by being spoken and received.And if something feels uncomfortable, it matters that you say so. In psychodynamic and interpersonal work, what comes in the way of the work is the work. Even your emotions towards your therapist are valuable. Bring them forward. Those emotions can reveal unconscious relational patterns, leading to profound insight.
How many sessions do I need before I feel better?
Progress looks different for everyone. Some notice shifts after a few sessions; others take longer. Therapy is not a race. It is a gradual process of understanding yourself more deeply and learning healthier ways to cope, relate and grow.
In psychodynamic therapy, small shifts often reflect something deeper: The surfacing of unconscious patterns into awareness. This doesn’t just help you cope; it reshapes old relational templates that have kept you stuck.
Do I have to tell the therapist everything? Will it stay private?
Trust is a gift, and it cannot be forced. Every patient has the right to decide what they wish to share and when. Your hesitancy is not a flaw. Sometimes it may even be protective. From a psychodynamic perspective, reluctance is understood as an important way you’ve learned to keep yourself safe.
One of the cornerstones of therapy is confidentiality. It is an ethical commitment, safeguarded by professional standards, that ensures your words remain protected except in rare circumstances related to safety. Therapists also maintain boundaries to ensure the relationship remains professional and entirely centered on you.
How do therapy sessions usually go?
Depending on the therapist’s approach, you may be introduced to different techniques. Some use cognitive-behavioral strategies to reframe unhelpful thoughts. Others, like psychodynamic and interpersonal therapists, help you explore your past and present relationships to foster deeper emotional insight and resolve long-standing patterns.
You don’t need to know these methods in advance. Therapy is collaborative. Your input as a patient significantly matters and the best results come when you feel like an active participant in the process.
What if I don’t know exactly what’s wrong?
That is absolutely okay. Sometimes honesty looks like saying, “I don’t know why I am here, but I know I need help.” That alone can open the door to meaningful exploration.
Choosing therapy is choosing to face yourself with honesty, to allow someone else to witness your journey and to believe that change is possible. The anxiety before the first session is natural, but temporary. Once you step into the room, you may find the weight of carrying everything alone begin to ease.Therapy does not promise quick fixes, but it does promise presence, care and a relationship grounded in training, ethics and compassion.
Whenever You’re Ready
Choosing therapy is choosing to meet yourself with honesty, to allow another person to hold space for your story and to believe that change is possible.
If you find yourself standing at the edge of that decision, consider this your gentle nudge forward. Therapy does not promise quick fixes. What it does promise is presence, care and the steady support of a trained clinician who is committed to your growth. And that can make all the difference.Take that step and book your session today. And if you still have questions, you are welcome to explore my library of resources where I share more about the realities of therapy and mental health.
“Our wounds are often the openings into the best and most beautiful part of us.” — David Richo