It started as a whisper: a little voice in my head telling me to do the thing I already knew I needed to do. The whisper ebbed and flowed in its frequency—with each bout of heightened OCD, anxiety, or depression; with each issue in a relationship I didn’t quite know how to face; with the very steady rise of self-doubt in my head, all throughout the middle years of my twenties. It started softly, and it grew in urgency as time passed by—this little voice in my head, the one telling me I needed to go to therapy.

I gently tucked the idea of it under the rug each time it arose in my mind, avoiding making an appointment like the plague. Because it was too hard to find a therapist; because the mere thought of opening up to a perfect stranger made my chest tight and my hands clammy; because the depths of depression does not tend to be the easiest place from which to make decisions and appointments and to, generally speaking, advocate for your own well-being!! I was terrified, I was overwhelmed, and for years I convinced myself I was fine without it. (I wasn’t, though. I was only pretending to be.)

And then, one day this past fall—thanks to some very good and generous advice from a social media friend—I finally called and made the appointment. I’ve been in therapy for three and a half months now—weekly sessions that I sometimes Do Not Want to Go To and am sometimes Desperate to Go To. In some appointments I have breakthroughs; in some appointments I have mini-breakthroughs; in some appointments, I feel like I learn nothing big at all. But I’m realizing that every single one is worth it, if only because they all make me—a person who does not open up easily—remember that I’m worth being heard, that my feelings and opinions matter and are warranted.

Therapy has led to numerous vulnerable conversations with friends about their own experiences with therapists, about their own mental health struggles—conversations I doubt we ever would have delved into had we not had the middle ground of this one shared experience from which to start. You know that thing they say about how vulnerability begets vulnerability? It is very true, folks. And there is a deep, deep comfort that can come from having these conversations, from realizing you’re not alone.

In therapy, I’m learning what my patterns are, and I’m ever so steadily figuring out how to change them. I’m learning how to process the things I’d swept aside for many, many years. I’m learning that whatever swirl of opposing feelings are present within me on any given day are okay; that we all contain multitudes; that it’s fine and good to feel things deeply. I’m learning that I am not my thoughts and that I don’t have to give them nearly as much credence as I have in the past. I am learning a lot of things, okay!!

Tough Conversations and Big Lessons

Some therapy appointments have broken me down completely, but… in a good way? If that makes any sense? They’ve knocked down my firmly built walls so immeasurably, so much more than I ever allow in my day-to-day life. Those appointments have taught me the most of all.

There’s one session in particular that comes to mind. It was the Monday after Thanksgiving weekend, the latter two days of which I had spent dealing with A Lot of Anxiety. And on that Monday morning, said anxiety only amplified. It was a mix of work and OCD symptoms and lack of sleep and general stress and I felt awful, all morning long—a unique blend of anxiety I had never really experienced before. I was exhausted, I found it hard to form sentences, I had chills, every body part felt simultaneously jittery and tense, it was hard to focus on any one thing: the works. I remember feeling like I was falling apart.

I got to therapy in the afternoon and we spent the first half talking about the anxiety—trying to get to the root of why it was so awful and what had caused it. Halfway through I looked up at the clock, noticed the time, and said to my therapist, “There’s something else I should mention before the end of the appointment.”

She said, “Okay,” and before I could even get the words out, I started crying. I remember being shocked by the expediency of my own tears. I hadn’t expected them, not in the slightest. I even said to my therapist, “I don’t know why I’m crying. I haven’t felt anything about this.” And I hadn’t.

My grandpa had passed away the previous Wednesday night. I found out on Thanksgiving morning, just after waking up. I remember lying in bed, right after learning the news, saying out loud, “Why don’t I feel anything? Shouldn’t I feel more?” I journaled about it for a little while and cried exactly one tear as I did, but the rest of the weekend, I felt… nothing. I felt like I was broken for being so devoid of feelings.

Yet the second I brought it up to my therapist, I started crying—real, big tears, from someone who hasn’t historically been a crier. I thought I had no emotions over my grandpa’s passing; I thought it wasn’t affecting me at all. But it was. It’s just that it wasn’t emerging as sadness but as the worst bouts of anxiety I’d had in years.

Talking it all through, crying all those tears, made me realize that loss is not benign; grief is not benign. More broadly, negative emotions in general—in whatever form they take—are not benign. If we don’t talk about them, if we don’t let them out, they’ll emerge as something else. In the case of my grandpa’s passing, that something else was extreme anxiety. 

It scared the shit out of me, honestly. If I could repress grief so deeply, to the point where I didn’t even feel it, what else had I been repressing? Where had all of those emotions, all of that energy, been going?

The Best of What Therapy Offers

I felt better when I left my therapist’s office that day. You know that saying, “It felt like a weight had been lifted”? It was exactly like that. It was like I could breathe again. Not everything was perfect, of course, but after talking things through, I wasn’t falling apart anymore.

That’s what therapy does, in its best moments. It gives you a space to let things out so you can breathe again. It allows you the time to process your stuff with a human who’s there to listen. It becomes a place where you can unpack your baggage, bit by bit, sweater by sweater, until the load you’re carrying is lighter, more manageable; until you finally feel like yourself… again or, maybe, for the very first time.

I very much so understand that for someone struggling with grief or mental illness or awful life circumstances, the mere thought of seeking help can be so overwhelming you never do it. I’ve been there. I was there for years. The wholllle process can feel staggering at the onset. My intention in writing all of this is to make it feel a little less so.

If you’re at a place where you do want to go to therapy, first, let me say to you, that is great. Reaching that conclusion can be hard enough in its own right. I am proud of you for getting there. Next up? You’ve gotta actually get your butt in the couch or the chair or the chaise lounge or whatever seating option your chosen therapist has decided to offer. Below, a few thoughts on how to approach the process. Take what you will. Leave the rest behind. And please, by all means, comment if you have any additional suggestions (and thank you in advance for doing so!!).

Research, research, research.

First things first: you’ve gotta decide where you want to go to therapy. Factors to consider can include office location, specific mental health issues/therapeutic approaches you’d like them to specialize in, whether or not they accept your insurance, etc. When looking for a therapist, here are a few places to begin:

• Try Psychology Today. They have an entire database of therapists with bios, clinic locations, what each therapist specializes in, the kinds of patients they see. This is a very useful place to start and, actually, when I asked my own therapist for her own advice on finding someone to see, this was the first thing she recommended.
• Use Google Maps. Type in “therapy [insert your city name]” and only browse therapists in the neighborhoods you frequent. Click on a few of their website links, read their bios, and make a call or two to the local option(s) that seems particularly fitting.
• Ask a friend. Or a social media friend! Or anyone you have a rapport with, really. Beginning with a recommendation from a trusted source can feel a hell of a lot more comfortable than approaching the process on your own. They certainly don’t have to provide their exact therapist (and may not want to!), but I’ve found that folks are often willing to share where they started with their own search, what clinics they called, or the name of a therapist they’ve heard is great through the grapevine.

Make an appointment.

Pick up the phone, dial the number, make the appointment. If phone calls tend to exacerbate your anxiety (raises hand), you can usually set up your appointment via email instead. If the whole entire thing feels like too much, ask your partner or your mom or your friend to call for you. We’ve got options, people. Options are great.

When scheduling an appointment, be prepared to answer a few questions—general human intake info (name, address, you know the drill), insurance info, and a brief overview of what you’re looking to address in therapy.

Ask questions liberally.

Whether you’re talking with a receptionist at a clinic, or your potential therapist themself, know that you’re welcome to ask questions before committing to an appointment. Any therapist should be willing to set up a brief phone call or reply to an email ahead of time in order to answer any inquiries you may have. A few helpful questions to ask could include:

• How would you describe your style of therapy?
• What therapeutic approaches do you typically use?
• Do you provide a sliding pay scale?
• How does therapy work/what should I expect in terms of timeline?
• What is the process for being matched with a therapist?

Your first appointment.

Before the appointment, I’d suggest thinking of or writing down the primary things you want to cover in therapy, a few things you want to make sure you mention at the start. Once you get there, you can expect to go over paperwork and begin to provide an overview of your general history / any pertinent background info. It’s likely that you won’t go into anything too specific in the first session. 

On the whole, know that there aren’t really any rules to therapy: You can ask whatever questions you want and talk about whatever is on your mind on that particular day. Remember that if you don’t feel like answering a question or covering a topic at any given moment, you don’t have to. You can take things at whatever pace you prefer. You can approach your first appointment, and any appointments going forward, however it is that you want.

Assess, evaluate, keep moving forward.

Allow yourself the time to process each appointment after the fact—what you learned, what you may need to reflect on before your next session, and what, if anything, you want to work on changing in your life going forward. Keep in mind that if you don’t love your therapist, you are absolutely, unequivocally allowed to try another one. I’d recommend giving them at least a second appointment (unless they are truly awful and/or an objectively bad fit), but again, that is totally up to you. Assess as you go, and alter your course if and when needed, if and when something doesn’t feel right.

Therapy, like anything in life, is a process. Even if it took you months or years to get to this point, and now that you’re finally here you just want to fix everything as quickly as possible thankyouverymuch, please try to allow yourself the grace of time.

Additional Options

I understand that therapy can be a cost-prohibitive endeavor. I understand this because, while I can technically afford it, I would be lying if I said the four to five times per month copay doesn’t still hurt my monthly budget. I am also deeply aware that mental healthcare coverage and the overall healthcare system in the US can be a confusing, restrictive, extraordinarily flawed pile of garbage. However, some more cost-friendly therapy options are available. Allow me to include a few of them below.

You can talk with someone via online therapy options like Talkspace. There are college clinics, which generally offer a range of counseling options that are covered if you’re enrolled as a student. Some medical schools also offer counseling services provided by supervised resident physicians. There are places like the Walk-In Counseling Center in Minneapolis, which offer free counseling altogether. And as I mentioned above, you are always welcome to ask any therapist whether they offer sessions at a sliding scale. All of these options, of course, come with their own caveats, but if you do want to go to therapy and the cost is a concern, I think it’s worth exploring a few additional avenues before ruling it out entirely.

A Closing Note

Whether you’re setting out to try therapy for the first time, or the second (or the third); whether you want to dip your toe in the proverbial therapy pool; whether you’re not interested in therapy right now but are tucking this info away for later, I hope some of the above was at least mildly eye-opening or useful. I hope you remember that you are so, so not alone in your struggles, of whatever variety they may be. I hope you allow yourself the chance to seek out someone who’s willing to help and listen.

Your feelings matter. Your opinions matter. You are worth being heard. And whatever is going on inside that brain of yours is not your fault. Okay? Okay. Therapy is not a quick fix, nor is it the only fix, but it can be a very safe, healing format in which to break down your issues and then build yourself back up.