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  • Writer's pictureJosh Killam, LPC

And Then it Gets Better


It is common practice in an initial therapy session for your therapist to go over consent, expectations, and boundaries with you. These initial few minutes are an opportunity for you to understand what to expect from the psychotherapy process and how it might feel to work with this particular therapist—at the same time, trying to find a sense of trust and compatibility. Although beginning therapy can feel overwhelming and scary, the initial conversation is a way to calm the nerves and identify if you might feel comfortable with this new therapist.


One way to feel safe with therapy is to know what you might expect from treatment. There is an apparent list, such as duration of therapy, frequency, or types of therapy modalities that could be used. This is not an exhaustive list; every therapist has a unique style. As part of my unique style, I make it a priority to highlight an additional point that is often looked over. After our initial conversation, I offer very gently the idea that once you commit to therapy, it can often feel worse before things get better.


More often than my client will have a bit of a mild reaction to this statement. You do not usually reach out for help and are told the support will make things worse before it makes them better. The initial reason I bring this to awareness in session is to establish a sense of safety and expectation. It is not uncommon for clients who report no anxiety before therapy to come into session after a few months of psychotherapy and disclose that they have felt anxious for the first time. Or more intense anxiety than they had ever previously experienced. Understanding what might be happening to them offers them a sense of safety that can ease the overwhelming feelings that come with anxiety.


The message I hear in the sessions after the initial felt emotional experience: "why do I feel worse than before I started working with you?" When you peel back the emotional defenses that have served you so long, you open yourself up to unresolved emotions and memories. Or trauma or painful memories, or any form of emotions. When you experience a physical awareness of sensations and feelings in your body, and you have not previously can lead to a fight/flight nervous system response. This is not true for everyone, and felt experiences vary for everyone. However, a felt sense of negative emotions can be painful. Identifying the source of your pain can help mitigate the onset of anxiety or other emotional defenses.


And then it gets better. Imagine shaking up a bottle of carbonated soda and quickly removing the lid. An explosion of soda and fizz, then the soda loses Co2, and it calms down. Slowly, you proceed to pour out, little by little, what is left of the drink. I'm not a soda drinker, nor do I like the complete emptying part of this metaphor, but it gets the point across. It can feel overwhelming at first, then it slows down, and eventually, you will find relief. I urge you to lean in for support from your therapist and those you rely on. This process of initial healing does not need to be done in isolation. You have permission to receive help, although I recognize that accepting help is hard for some. To those who struggle with help, I would say you can learn to feel worthy of help. All you have to do is not give up too soon.

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