The first therapist I saw happened to be really good, or maybe I was really ready to hear her, possibly both. One thing she mentioned and really affected me at the time: observing how I expressed how guilty I felt about how mad I was about XYZ, that often the “secondary” feelings (guilt) give us more trouble than the primary feeling (anger). This helped me start to drill down into what my actual feeling/reaction to XYZ was, and I could feel less plagued/affected by the guilt/shame/whatev that had been drilled into my head over time (by mom, teachers, whomever).

I went to one therapist in my late 20s for about 6 months, then in mid/late 30s spoke with 2 different psychiatrists and 2 different talk therapists / social workers, plus have experienced 3 different couples counselors (oh joy). Some are not a good fit. I recommend trying someone for a few sessions — at least 3 — and then allowing yourself to try a different person. They will not be offended!

I’m not a bad person for saying no and my intrusive thoughts do not define me.

For therapy to work for you, you have to show up for it in a big way. Therapy is work. Not only is it work, but you have to be ready to work, which often includes letting go of your ego and admitting to yourself what patterns you engage in that aren’t serving you well. While advice giving can occasionally play a small role in therapy, it is not therapy.

Counterintuitively, many people are really, really attached to their negative patterns that perpetuate feelings of anxiety or depression. They may say they’re unhappy, but they aren’t ready to do anything different to change that.

Maybe take a look at yourself and try to gauge your own readiness for change. If you’re not ready to acknowledge that you yourself play a huge role in how you feel, therapy will not be productive. If you’re expecting a therapist to do the work for you, therapy will not be productive. If you’re not ready to do work to break out of patterns in your life outside of therapy, therapy will not be productive.

Here’s my take: therapy only works if you give yourself over to it. That is to say, you have to be committed to take the advice that your therapist gives you, regardless of whether or not you (in the moment) believe it or not*.

You also have the right, and expectation, to push back. But, you have to do it in good faith. If you do the work, and take their advice, and it genuinely isn’t working for you no matter ho hard you try, tell them it isn’t working and what you’ve done.

I’ve been in therapy for almost 3 years now. It’s done wonders. But it’s been a long, difficult, and often painful journey. My therapist and I have had our moments. It happens. But we both kept at it, and I actually feel like a “normal” person for once.

Also: if you genuinely feel like you’re not connecting with your therapist, then don’t be shy about it. Let them know, and go find someone else. Don’t settle for someone just because you think you can’t do better or that you don’t deserve better.

* Obviously don’t do anything that would cause you or others harm.

Not me but someone close to me:

• There is a difference between “ready for therapy” and “ready for change”. Some people will sit in therapy for years but never see much progress because they are so stuck in doing or thinking something that holds them back.
• Your therapist will tell you things that don’t make sense to you. Listen to them anyway. If they tell you something that seems impossible, don’t ignore it, ask how you can do that. If they tell you something that seems useless, try it anyway, then report back if it doesn’t work and be open for an explanation for why it didn’t work.
• Be brutally honest. Your therapist won’t be able to help you unless you tell them exactly how bad your situation is. If you spend 90% of your day in bed and tell your therapist you’re doing okay, they won’t be able to correctly identify what kind of help you need.
• It is completely normal to miss some of your goals. Therapy takes time and nobody will judge you if you take longer than others. Figuring out how much you should push yourself and when you need a break is hard. Either way, don’t be angry at yourself when something doesn’t work out. As long as you tried, you’re fine.
• Most of your problems are in your head. That doesn’t mean they aren’t real. It doesn’t mean they don’t hurt. It doesn’t mean they aren’t difficult to overcome. It just means that the only person who can solve them is you. A therapist can explain how to solve them but they can’t change your thoughts or your habits.