Therapy Requires Commitment: Here’s What to Expect

The digital age has been defined by rapid access to information and the promise of quick, easy solutions for a multitude of problems. From one-click ordering to “life hacks,” most of us have grown accustomed to getting what we want, when we want it. The arduous nature of the therapeutic process can therefore feel overwhelming at first: Getting help for a mental illness, personality disorder, addiction, or emotional crisis often requires a lengthy course of treatment and a great deal of effort on the part of the patient. Seeing a therapist is unlike visiting the doctor or the dentist, where you can expect to passively receive treatment until your doctor tells you that you’re cured. Therapy may take months or years to produce meaningful results (even with the assistance of medication) and it always requires patient-practitioner collaboration.

To avoid getting discouraged, you should learn what to expect before you formally begin therapy. Preparing yourself to make a real and lasting commitment to treatment will help you overcome its challenges and stay the course.

Three Things to Know Before You Start Therapy

1. Medication can help, but it won’t fix everything.

Medication can be a vital supportive tool for some patients. Still, it’s important to understand that finding the right medication won’t immediately “cure” you, whether you’re trying to address depression, anxiety, mood swings, or another issue. Medication can improve your ability to function, but it won’t help you develop healthy coping mechanisms. Medication also cannot improve your relationships, rebuild your self-esteem, or give you a sense of purpose. Indeed, in some cases, medication may not even be useful (e.g., if you’re seeking therapy for marital problems).

Addressing the complex issues that surround and underpin your behaviour will require a great deal of discussion. You can expect to work through difficult subject matter, and at times this will feel very uncomfortable. During therapy, you’ll need to remain as open and honest as possible; resist the temptation to censor yourself or gloss over especially troubling subjects. Remember: Your therapist is not there to judge you and he or she will keep everything you say strictly private.

2. Showing signs of progress doesn’t mean you can quit.

Though therapy is very rewarding, it can sometimes feel emotionally exhausting. Many people also balk at the expense or time commitment associated with this type of treatment. Owing to factors like these, some patients feel tempted to declare themselves “cured” at the first sign of progress. They tell themselves they can handle things on their own and quit therapy prematurely. Unfortunately, this almost always leads to relapse.

If you feel the urge to “go it alone” early in the therapeutic process, think about why you sought therapy in the first place: After years of trying to solve a challenging problem on your own, you came to the realization that you needed outside assistance. That probably won’t change simply because you attended a few weeks of therapy and made one or two breakthroughs.

The roots of the problem you’re dealing with are probably both numerous and deep. Most of our behaviours are shaped by myriad experiences and environmental factors over a number of years, so they cannot usually be changed by a single eureka moment (or even two or three of them). Adopting healthier behaviours requires exploring your formative experiences and fearlessly getting in touch with your true desires and motivations. Then, you need to develop a plan of action to modify your unhealthy behaviours and gradually implement it. Changing ingrained ways of coping and navigating the world is extremely difficult. Doing so requires time, patience, and an outside observer to tell you when you’re veering off track.

To illustrate this fact, think of how common it is for people with addictions to relapse after attending 28-day rehabilitation programs: Though these patients usually feel like they made progress while in rehab, they’re not yet prepared to manage day to day life without returning to the only coping mechanism they know. As soon as they encounter significant stress or resume their unhealthy relationships, they therefore slip back into old habits. Leaving therapy before you’ve successfully implemented long-term behaviour modification strategies will leave you similarly vulnerable to backsliding.

3. Therapy can be a slow and frustrating process.

Changing unhealthy behaviours and coping mechanisms can feel all but impossible at times. It’s important to understand that this isn’t your fault: Everyone struggles to alter these patterns, no matter how intelligent or dedicated they are. How we perceive and interact with the world is largely shaped by our formative experiences. As such, by the time we’re capable of rational analysis, most of our behaviours have already become automatic.

Generally, problematic behaviour patterns have their origins in how we coped with pain and anxiety as children. Some people learn to repress uncomfortable feelings, for example, while others might deal with them by lashing out, and so on. As adults, we know these behaviours aren’t really going to help us, but we repeatedly engage in them anyway because doing anything else feels “unsafe.”

Overcoming the urge to fall back on learned coping mechanisms is every bit as difficult as going against our basic instincts. Many people therefore discover that the improvements they make in therapy come in small increments. Setbacks are also common, especially early on in the treatment process.

None of this should suggest that therapy ought to be a lifelong process, of course. Patients should have a sense of progress during therapy, and for many patients, therapy eventually becomes unnecessary. You should just keep in mind that your behaviours and thought processes have been shaped over decades and therefore cannot be altered overnight. Don’t get frustrated with yourself or your therapist if you discover that this is indeed the case. With time, patience, and persistence, your efforts will slowly create real and lasting change.

Few things that are worth doing are easy, and therapy is no exception to this rule. When you find yourself questioning whether or not therapy is worth the work involved, remind yourself that you’re investing in your future—And that is absolutely invaluable.