Reblog from Vice News: Things I Wish I’d Known Before Starting Therapy


By Hannah Ewens

Reblogged from


Some advice on how to make the most of your talking therapy if you’ve never had it before.

At the age of 25, I’ve been in therapy for a perfect decade. That includes a child psychologist, various bouts of NHS cognitive behavioral therapy (CBT) and psychotherapy, and various private psychotherapists. If this was a marriage, it’d be a tin-slash-aluminum anniversary—a metal that supposedly represents how a successful partnership can be bent without being broken. Which is fitting, considering I’ve had phases of thinking of canning it all together, convinced it isn’t working, before crawling back with my tail between my legs.

At different points, my therapy has been for anxiety, depression, PMDD, psychosis, and periods of dissociation, mania or eating issues, as well as other things that have fallen short of clear categorization. I absolutely can’t claim to understand how therapy can work for different illnesses, and every person will respond to mental health treatment differently. Still, I’ve realized a lot of things through trial and error that I wish someone had told me before I started.

It’s not easy to get therapy

A caveat before we begin—the NHS is severely underfunded, to the point of being near-hopeless when it comes to mental health. You will truly understand the meaning of mental health crisis when you’ve been on a CBT [Cognitive Behavioral Therapy] waiting list to treat depression for months, only to find out the treatment you’ll receive is for half an hour, once a week, for ten weeks—and that if you miss or rearrange two sessions because you’re too depressed, you’re discharged. If you have a chronic mental illness and need long-term access to a psychotherapist, God help you.

That said, just because treatment is hard to get, resist feeling guilty for getting it. Don’t think you aren’t “sick enough” to have it because that lands you in a cycle of deterring yourself from asking for help when you need to. Similarly, don’t feel guilty because you are ill and can pay for therapy.

Shop around for someone who works for you

Therapists are people, and people can be irritating. It’s probably not imperative that you actively like your therapist—unless your relationship is extremely unprofessional, you’re not about to invite them for birthday drinks—but you do have to find them agreeable and, more importantly, like their approach.

Some therapists are outwardly empathetic. I had one who was such a genuinely kind man that he’d run well over the hour I was supposed to be there, often into two or three, and recommend fiction and TV shows he knew I’d like. Going to his house was a bit like paying to visit your grandad, but with more existential chat. I’d wait until I’d walked around the corner after a session, as he waved me off from his doorstep, and burst into tears because he was nice to me, an uncomfortable reminder that I wasn’t being very nice to myself.

Others are clinical and hard and let you project whatever you want onto their response to you. You sit, deflated, in the crease of their sofa, snotty-nosed and chest heaving with sobs after recalling visceral details of a trauma, and their face is like a mirror. You almost want to say, “Excuse me, did you hear the miserable thing I just said?” Neither approach is wrong, per se, as long as you respond well and feel comfortable with it. I, perversely, have come to enjoy the latter.



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