Spiral stairs

by Cindy Trawinski, Psy.D., Dipl. PW & Rami Henrich, LCSW, Dipl. PW

“I can’t believe I’m here… again.”

Some people returning to therapy for the second, third, or fifth time often wonder “why do I need to go back to therapy?” “was there something I should have handled the last time around?” “maybe I am not really getting to my issues…is it me, my therapist, the approach, or the entire endeavor?”  

Some clients say they feel as though they’ve “failed,” that they weren’t “strong enough” to take care of themselves on their own.  Sinking into self-reproach, they feel wonder if they are somehow fated to repeat a cycle of false or temporary solutions to a problems that seem intractable. Maybe a previous, positive experience in therapy imparted a sense of resilience or well-being that now seems shockingly absent. “Didn’t I already go through this?” They ask themselves. “Isn’t that part of my life over?”

For others, returning to therapy is a natural part of their self care and personal growth regiment as getting a haircut, going to the dentist or eating three meals a day.

Clients come back to therapy for many different reasons. Recent trauma, loss, or significant life events—such as a change of relationship, job, move, or other transition—can create inner disturbance or bring up patterns that have not been fully resolved.  Questions about one’s identity, sexuality, or spiritual beliefs can prompt deep-seated uncertainty. Relationship conflicts or disappointments can leave us feeling in need of support.  Ongoing issues like depression, anxiety, addiction, and self-harm can interfere with daily life and relationships. All of these difficulties, worries and questions can motivate a person to make a change and seek help.

This brings me to my main point: returning to therapy is a profound act of self-care—even if you don’t realize it at the time. If you are thinking of returning to therapy, consider the possibility that you are responding to a deep awareness that you want or would benefit from help, support or guidance to find or create a new sense of yourself.

In her article “Starting therapy, again…” San Francisco therapist, Carly Earnshaw, MFT, explains that “[r]egardless of whether your last therapy went great or awful, you have an advantage over the first time you tried therapy.” Here are the some of the reasons she gives for why:

  • You have a better idea of what therapy is about
  • You have a clearer understanding of what works and doesn’t work for you in therapy
  • You’re aware of the investment and the payoff

I encourage you to read her article in full, as it speaks to the different mindsets and assuages the fears I often see in clients who are returning to therapy.

Considering seeing a mental health professional again? Below are a few quick ways you can prepare to make the most out of your next time in therapy:

  1. Understand that you are not alone. It is not uncommon for clients to return to counseling when it has worked for them in the past, or out of a desire to find something that will work. Countless people come back to therapy throughout their lives, building on each experience. In fact, your therapist is likely one of those people!
  1. Take your time. If you have decided to seek help, you do not have to book an appointment immediately or stick with the first therapist you find. Allow yourself the time to research and explore your options—remember, you now have a stronger sense of what you’re looking for.
  1. Be mindful of your therapist’s responses and attitude. Whether calling to get in touch or engaging in your first session, pay attention to your intuition and comfort level, as well as how your therapist reacts to you. Listen to how she interprets your words and recognize that, while she intends to help, she doesn’t have all the answers. Again, take your time and be patient until you find someone who you feel hears and appreciates you on your terms.
  1. Don’t be afraid to ask for what you need. If a certain approach works best for you, or you need to speak to someone who understands specific issues—such as PTSD, polyamory, kink/BDSM, the experiences of racial and/or gender minorities, or religious convictions—speak up. Your therapist may not be qualified to provide what you need, but chances are she can refer you to a colleague who can.

If you have been there before, what do you look for in a new therapeutic relationship? We would love to hear your thoughts, opinions, and stories. Feel free to leave a comment below, or reach out to us on Twitter, Facebook, Tumblr, or LinkedIn.