Choosing a therapist is tricky. There are so many considerations: gender, age, style, location, insurance network, availability, and would you like drugs with that? Then, you need to have a session or two before you can even begin to decide whether or not you made the right choice. If so, great, but if not, then it’s back to square one.
But, there’s another side to therapy: the person receiving the treatment. More specifically, I mean me.
Therapy depends as much on the person receiving the treatment as it does on the one giving it. A patient’s ability to share information honestly will have a huge impact on the results. Yes, an observant therapist can read between the lines and ask the right questions, but ultimately, what the patient shares is up to that patient.
I started seeing a new therapist a few weeks ago, my third since starting therapy about four years ago. So far, it’s very promising. She managed to cut through a lot of garbage pretty quickly and give me some completely new insights. It is my sincere hope that I can be honest and share the right information with her.
In the past, that hasn’t always happened, and it doesn’t come naturally to me. For one thing, there’s a lot more that happens in a week than can possibly be shared in 45 minutes. Most of it is irrelevant (I made a sandwich. I put mustard on it. The bread was a little dry. I added bread to the grocery list.) But what about the rest? It can be very difficult to choose what to share, which stories are most important, and what relates to the topic we last discussed.
Even more limiting, there’s my own personal editing. After years of carefully selecting what I tell (and don’t tell) my friends and family, of pretending to be “fine, just tired,” I’m not always sure who or what I am. Am I feeling pretty good, or just less terrible? I’m not as well-adjusted and content as I want everyone to believe, but am I really as screwed up as I think I am? How much of this is me and how much is the mask I wear and how much is there even a separation?
Then of course there’s the big question: if I actually tell my therapist everything, am I going to be tossed in the loony bin forever? Or, perhaps even worse, will she come to the conclusion that there’s nothing wrong with me at all?
I want my therapist to think well of me. I care what this complete stranger getting paid to listen me thinks about me personally and professionally, so I try to put a positive spin on everything. I’m so desperate for adult conversation that I want to keep it fun and light. I want my individual struggles to be meaningful, so I try to choose my deepest thoughts to share. I want to get better, so I try to include what I think is important, but I also want to edit out my most embarrassing thoughts.
It would be so much easier if I could just be myself all the time, but I can’t. I’ve already alienated so many important people in my life that I can’t stand the thought of losing any more. So, I wear my happy mask.
Generally, this is harmless, at least to others: small talk with the cashier or a friendly chat with a neighbor. These times are enjoyable and a chance to give normality a try. When a stranger asks, “How are you today?” they rarely are looking for an in-depth answer, so it’s an opportunity to not give one.
With friends and family, it can be more insidious. It starts innocently enough: glossing over a few details, not mentioning a new medication. But, the more you don’t talk about it, the easier it becomes to not talk about it. After a while, you never talk about it, except in therapy.
But what happens when these habits creep into therapy sessions? That’s what happened to me. I grew so accustomed to not talking about it that I started not talking about it in therapy. Oh, I still talked about my depression, but I polished it first. At that point, therapy—arguably the most important tool for treating depression—became essentially useless to me.
Now I have a chance to start fresh again, and I hope I don’t blow it.