On Tuesday my friend Rachel sent me a text; she was in need of urgent advice. She had had three sessions of therapy following an initial assessment. She had left the last session early, convinced that the therapist was not for her. And the therapist had told her that she didn’t seem ready or committed to dealing with the issues she presented with. Later, as I listened to her doubts and complaints, I smiled inside. I had experienced all of these issues during my therapy journey. First with CBT, then psychodynamic psychotherapy and now my sessions of cognitive analytic therapy are at an end. I feel like an old hand at this now.

In the last session my therapist and I had both prepared letters that we read to each other. My therapist’s piece was insightful; it summed up where I’m at and gave me a couple of pointers for the future. The documents represent an end to the hand-holding and the start of me walking alone. This is not daunting, I just fear I won’t be alert enough and will fall back into my old ways. But I think I’ve done some good work that gives me confidence.

Now, I haven’t sworn any non-advice-giving pledge, so I’m going to give Rachel the benefit of my experience and anyone else who asks me about therapy. Obviously it is different for everybody. Therapy is as varied as the number of client/therapist relationships. And so perhaps it is impossible to prepare at all for what happens to you while you are in therapy. However, some of the same issues seem to come up with a number of people I’ve talked to. This is a relationship like no other and, for many, that is hard to grasp. It is a relationship that may not feel comfortable to begin with as the person is not on your side as a friend would be. This person is not your mate. Rachel says that she feels that her therapist just doesn’t get her and she wonders whether a woman would be better. A rotund middle-aged man doesn’t work for her. She questions whether he is intelligent enough. I’d say to this, put aside your prejudices based on age, gender and appearance. The lumpy and old or the painfully young, lithe and beautiful can all make good therapists armed with a personal aptitude and some well-honed skills.

I feel I am able to reassure Rachel that the therapist may not get her in a very short space of time, but that this does not matter. Whether what he reflects back is right or not, it gives you the chance to really think about who you are and how you behave. The process of correction and discussion enhances your understanding and that is what matters.

I also tell her that what she does in relationships is likely to be played out with the therapist. Do you usually become defensive and flounce out because you fear being rejected? Yes, she says. I advise her to pull her neck in and give this guy another chance.

I am sure there are some therapists who are better, more empathetic and more skilled than others. I am sure that there are some types of therapy that are more suited to one person than another. It’s a lottery win if you do find the ultimate therapy experience, and the odds are long. What I advised my friend is that most of the work has to be done by her. What therapy gives you is the time and space to explore. To get the most out of it, it is best to do homework. By this I include leaving time before the sessions to prepare yourself and afterwards to get over the emotional trauma it can be. I found it important to read and think around my issues, using self-help books to supplement the work I was doing. You won’t become a concert pianist if you just go to lessons and never practise in between. Therapy is no different.

Most people want to be liked. You have to get over this. You will feel judged as the therapist is challenging you and making you face difficult aspects of your personality. But after a while you get over this and you stop caring what the person thinks of you. It is irrelevant.

We go into a therapy room a squirming bundle of genes, conditioning, prejudices, baggage and assumptions. It takes a propensity for truth, open-mindedness, courage and hard work and no small measure of faith to get the most out of the experience. And when it’s all over, you have to put what you’ve learnt into practice. I don’t expect to be a healthier person overnight and I am not going to give myself a hard time when I fall at the first hurdle. I know myself and like myself a lot better. And I am thankful for the presence and commitment I was given by the therapists I have had the honour of working with. 

Some details have been changed to protect identities.