"Seeing a Therapist for the First Time"

By:  Tina R Flaherty, LISW

June 27, 2016

It is hard to come through the door the first time you see a therapist.  It just is.  I hear it described in different but similar ways, and it is often tracked back to the same thing...shame.  "I should be able to do this on my own", "I'm a private person.", "Why can't I figure this out?", "Will I see anyone I know?" These are just a few of the many statements and questions I hear that are shame based about seeing a therapist for the difficult first time.  For some, pulling into the parking area, walking across the parking lot, and stepping through the doors into the waiting room is EXCRUCIATING.   And then once in the therapist's office, if there are tears- -oh boy do these feelings intensify and the apologies begin, "I'm sorry.  I promised myself I wouldn't cry."

I wonder what exactly are these apologies for?  Being human?  Being overwhelmed?  Hurt?  Confused?  Afraid?

I would like to think that we have gotten better with this stigma of seeing a mental health therapist.  And overall, I think we have...for others.  However I don't know that as a population we have gotten better at the self-expectations about topics such as therapy.  We have gotten better at someone else going to therapy.  This has become much more a part of the social norm, and is frequently suggested by one person to another. .  Yet, how is it different when it is the person themselves that will see a mental health professional?  VULNERABLE, and unfortunately for many, shame based.

Do you know who Brene Brown, PhD, LMSW is?  She is much more interesting, clever, humorous and down to earth than you might think given that she researches shame and vulnerability.  She is a therapist, an educator, a researcher, and author who studies the toxicity and prevalence of shame.  You may wonder what vulnerability has to do with shame...EVERYTHING.

Let's go back to coming in the doors of a therapy office for the first time.  Is it vulnerable?  Yes.  Is it shameful?  Well that would depend on your internal dialogue.  To me, there is no shame to it at all.  In fact, it takes courage to say things out loud; to own problems, heartaches, and to ask for help.  BUT, if someone has an internal thought process of "I shouldn't need a therapist to help me solve my problems", well then the door is open to a chain of more critical and even condemning thoughts, leading to feeling ashamed. The real kicker is that this internal beat down leads a person (couple or family) to avoid therapy and live with a problem until it feels insurmountable.  This in turn intensifies the SHAME all the more.

So why would someone like Dr. Brown study shame?  My interpretation is that shame based thinking is so prevalent in what we do to ourselves and to others, that it creates a culture of unhappy people with expectations of needing to be and live perfectly. Unfortunately then, when life does not go smoothly, the resilience is not there.  This promotes the 'not good enough' thoughts. I see it often in individuals, couple's and families, where people are left feeling "not good enough" for all sorts of reasons.  Dr. Brown says in her books and public speaking:  "Guilt is I made a mistake, shame is I AM a mistake".  She goes on to say in one of her TED talks,

Shame is highly, highly correlated with addiction, depression, violence, aggression, bullying, suicide, and eating disorders.

I would certainly add to this list at a minimum that shame is also directly correlated to trauma, and anxiety.  My personal and professional questions about this "not being good enough" business are this:  what is the measuring stick? How does anyone know when he or she is "good enough'"?  How do you know when you have attained it?  Who decides this?

See the problem?  It is elusive.  People struggle when they try to attain self worth through external means.  They may have an idea of "I will be good enough when...",  but darn it the goal post moves when they achieve it, and they are left not feeling good enough despite their achievements.  However, I stress, these feelings are NOT factually based.  Self worth can be obtained internally when people accept as their baseline that they are already worthy, already good enough.

So, if you are coming to therapy for the first time, hold your head high.  It is courageous.  And as Dr. Brown identifies, Courage is not the absence of fear, it is doing something despite the fear.  And maybe, just maybe you will find, what so many others have found and share when they say, "It is hard work, but I LOVE therapy" or "This is the best thing I ever did for myself and my family" or even "This has become the safest four walls I know".

If we happen to see you at our facility, well then WELCOME, and come on in.

Tina Flaherty, LISW

Licensed Independent Social Worker

*If you are interested in checking out Brene Brown PhD, LMSW, you can watch her on TED.com online.

1) The power of Vulnerability

2) Listening to Shame

And/or you can read one of her books, here is a list of a few:

"I Thought It Was Just Me (But It Isn't)"

"The Gifts Of Imperfectionsim:  Let Go of Who You Think You're Suppose to Be and Embrace Who You Are"

"Daring Greatly:  How the Courage to Be Vulnerable Transforms the Ways We Live, Love, Parent, and Lead

"Rising Strong:  The Reckoning, The Rumble, The Revolution