By Melissa Carlson, LCSW

 

Many people think therapy, or counseling, is a great thing to do – clear stuff up, hold others accountable, maybe hold myself accountable, get rid of less effective parts of our personalities.

Probably just as many people are afraid of therapy for the same reasons, plus one: In therapy we learn to hold ourselves accountable first – to look myself in the mirror with open eyes – and often we don’t really like doing that. We tend to be ashamed or embarrassed that we need help and may have similar feelings about something we’ve done. We don’t want anyone to know we “have problems.”

Another reason is because we fear being judged by the other person. It can be hard to believe our therapist isn’t going to judge what we talk about because we live in a judgmental society, and because we don’t have many people in our lives who provide the emotional safety we can find in a therapist’s office. Until we experience that safety, we don’t even realize it exists. Sometimes our pride gets in the way – we don’t want to admit to some of the things we’ve done, said, or thought, especially if we’re not committed to changing. In a society which encourages a wide variety of viewpoints, we may decide our opinions are not mainstream enough, so we’ll be judged harshly for them.

Some people fear the ‘stigma’ of going to therapy if a workplace, life insurance company, family member, school, or partner could find out. While that is changing in our society, it’s still a real fear for some people. Others fear getting a diagnosis that they must live with forever – which may or may not be accurate. 

Fear of therapy and anxiety about therapy are different things. Not knowing what to expect, probably not knowing the therapist, feeling some shame or guilt, and perhaps not really knowing how to define our goals, makes many people anxious at first.

Therapy is also challenging because if we haven’t decided to be truthful about our thoughts, feelings, and the events of our lives, we may blame the therapist for not being effective after only a few sessions. We need to face the idea that the therapist is not a magician, can’t read our minds, and can only help us according to what we share with them.

 

What can we do about these fears, anxieties, shame, and guilt, if we have them?

Understand that your therapist is trained to help you, but also in how to listen. They aren’t there to assess your goodness or badness, but to help you be the most effective person you choose to be.

You don’t have to speak things you’re not ready to speak. Let trust develop between you and your therapist.

If someone you trust has told you they think therapy might help you, believe them. There is probably a kernel of truth there because others often see us more clearly than we see ourselves. It doesn’t mean you have to stay in therapy forever; look at the first session or two as a tune-up, a way to check where you are in your life and how you feel about it.

Speak up. Tell your therapist you’re nervous, scared, don’t know what to say, don’t know what to do. Being vulnerable in the right situation is healing.

 

Guidance for this article came from:

  • Ogrodniczuk, JS, et al. “Strategies for Reducing Patient-Initiated Premature Termination in Psychotherapy,” Harvard Review of Psychiatry (March-April, 2005): Vol 13, No.2, pp. 557-70
  • Hale, Megan, M.A., “5 Common Fears That Keep People Out of Therapy,” MBGHealth
  • Carlson, Melissa, MSW, LCSW. Article: “Overcoming the fear of therapy.” January 2023 (Unpublished).