What is worth knowing before starting therapy

I’m Christina Caron, a mental health reporter, and I’m filling in for Jancee Dunn this week.

When I was in college, I decided to make my first ever mental health appointment with one of my school counselors. I don’t remember much about that conversation except that I was so nervous I was sweating. I also felt like the therapist often ignored my worries.

Back then, I didn’t understand that it was possible to distance yourself a little. The whole experience was so awkward and uncomfortable that I quit after just a few sessions. My conclusion – although I’m sure that’s not what the therapist had in mind – was that I needed to toughen up, pack away my worries, and push down my fears instead of really delving into what was underneath those feelings.

Since then, especially now as I write about mental health, I’ve learned that therapy can be helpful and even life-changing. However, its success largely depends on the relationship with the therapist and the quality of communication.

If you’re considering seeing a therapist this year or trying to find a novel one, I asked several reputable therapists to share what they want clients to know before their first session.

1. A mighty bond is vital.

All the therapists I consulted with said that the most significant thing to look for when seeking advice is a “good fit” – the bond between therapist and client that mental health professionals call the therapeutic alliance.

“It’s not a kind of therapy. That’s not the type of therapist,” said Yuxin Sun, a psychologist from Seattle. “It’s a relationship that heals.”

Under the supervision of the right therapist, you should feel unthreatening and respected. You shouldn’t feel like you’re secretly being judged.

With this in mind, try to talk to more than one therapist before making a decision. Many of them offer free 10-15 minute consultations. And trust your gut. Within about three sessions, it will likely become clear whether you work well together, says Riana Elyse Anderson, a clinical psychologist and associate professor at Columbia University’s School of Social Work in Modern York.

If the fit doesn’t seem right, move on.

“It’s like dating,” she added. “You want to cut your losses early.”

2. You may feel worse before you feel better.

Experts say breaking free from venerable patterns and beliefs that no longer serve you can sometimes be uncomfortable. And while a therapist should be supportive, therapy is not meant to be an echo chamber.

If you feel awkward or uncomfortable, it may mean the treatment is working, said Naomi Torres-Mackie, a clinical psychologist at Lenox Hill Hospital in Modern York. “Having an open dialogue with your therapist about what you’re feeling is really significant,” she said.

And unlike what we often see on TV shows or hear on podcasts, therapy doesn’t usually involve a dramatic reveal at the end of each session or a huge “aha” moment that solves everything. It’s usually a series of compact changes that accumulate over time.

3. You have an agency.

Therapy is supposed to be about cooperation. Dr. Sun stated that it is not a skewed power energetic where you do whatever the therapist says.

That’s why it’s significant to work with your therapist to set goals and find ways to measure success.

Remember: you can ask as many questions as you want.

Ideally, your therapist will visit you frequently and check in with you to see how you feel about your work together. But if they don’t, feel free to do so. Let them know what works and what doesn’t. It’s your time and you deserve to make the most of it.

Plus, make sure you want to be there. “Going into therapy based on someone else’s advice usually backfires,” said Sherry Cormier, a psychologist in Pittsburgh. “You have to make some personal investment in therapy to get the maximum benefit.”

4. Therapy is not a sign of weakness.

Seeing a therapist doesn’t mean you’re delicate or that other people have it all figured out and you don’t. It simply means that you are taking a step towards improving yourself.

Experts say that for many patients, taking this step requires a lot of strength and courage.

“Therapy is so damn tough,” Dr. Sun said. “It takes a lot of courage and can be tough at times. However, challenges are very necessary for healing and growth.”

It took me years to return to therapy after a failed attempt in college. I found a psychologist who helped me achieve specific goals, and when our time together was over, it was like graduating from high school. I came out stronger and more capable – not the other way around.

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Let’s continue the conversation. Follow along Instagramor email us at well_newsletter@nytimes.com. And check out last week’s newsletter, a conversation with Well’s novel Ask the Therapist columnist, Lori Gottlieb.