Where to start.

“Where do I start?” This is one of the most common questions that I hear as a therapist. People who are new to therapy, or possibly even returning to therapy, will often share that they feel so overwhelmed with their problems that they just don’t even know where to start. Most people are capable of solving a few problems. It is usually layers of issues that have been building for a long time that send people in search of therapy. The pile-up of challenges often seems impossible to untangle and many people share that they feel defeated before they even begin. Most people share that they don’t know how to begin, or where to start. This is such a common issue I think it is important to address. Where to begin…

Let me begin with the most basic description of therapy. First of all, therapy is really about self improvement. That’s all…we don’t need to make it unnecessarily complicated. Therapy is intentionally trying to work through your personal issues, knowing yourself better, and increasing your self-awareness. It is about improving your self-control and your ability to make thoughtful choices. Regardless of the “type” of therapy, the endgame is the same; therapy is a process of intentional emotional growth and personal development.

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Although there are many “types” or models of therapy, I have found that this isn’t really very important. All of the different therapy approaches have merit. They all have value, and can be helpful. What is important, is making the decision to start on the journey. Therapy is typically envisioned as formal private meetings with a client and trained therapist. These special relationships can be profoundly helpful and life-transforming. Therapy can also take other forms as well. Many forms of therapy can be more self-directed, such as self-help books, e-courses, groups, following blogs like mine, and forums.

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Regardless of what type of therapy you are interested in at this time, I suggest you start with a journal. This is my absolute #1 answer to the question “Where do I begin?”  Of all the tools that are available to people, I believe this is the most useful for the initial plunge into therapy. A journal can be any format that works for you. It can be a small book, a school notebook, a pad of paper, a document in your computer, notes in your phone, or even a verbal recording file if you really hate to write or absolutely cannot find the time to sit still.

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So, what do you do with this journal? You write. Without censoring. Without editing. Without criticism or judgment. You write your questions. You explore your problems. You vent about your feelings. The journal is a very important first step because it is where you can clarify the confusing thoughts that rumble around in that brain of yours. It’s where you will learn to work things out. It doesn’t matter how you write; it is not meant to be read by anyone but you. You can choose to write in bulleted points, run-on sentences, or lengthy prose…how you write is not important. This is simply a tool to help you better understand yourself.  I also suggest locking or protecting it so that you can feel free to be truly honest.  

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So, where do you start? Well, I suggest that you start where any therapist would begin; start with an assessment. And, what the heck is that? Simple really, it’s basically a list of the problems. As a therapist, I always begin by assessing the problems. This means that I go through a checklist and identify what particular challenges my new clients are facing. Often, this can be a fairly long list. Initially, I don’t try to get all of the details or even understand the issues, this is just a summary of problems. Your initial list might look like this:

·      Ongoing depression

·      Relationship falling apart

·      Need a better job

·      Insomnia

·      Anxiety

·      Anger issues

·      Lack of support/friends

·      Past trauma

·      PTSD

·      Self-harm

·      Gender dysphoria

·      Physical health issues

·      Difficulty with boundaries

·      Family of origin dysfunction

·      Substance issues

·      Low self-esteem

·      Etc.

This is where you start; with a very basic, written, self-assessment. We write it out so that we can see it clearly.

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It’s vitally important to keep in mind that in this very beginning stage, you are not looking for solutions to the problems. You are only trying to identify what the problems are. Some people may have a very, very long list of challenges which may leave them feeling overwhelmed and hopeless. I want to urge you to do your best not to nosedive into the pit of despair. Although it may initially feel insurmountable, clearly identifying the problems is the first step to finding solutions.

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The next step is formulating a general plan. Do you want to work with a therapist? A male? A Female? Christian? Gay? Transgender? Do you want them to have any particular specialties? Perhaps you consider talking to a psychiatrist about possible medications?  Or, do you want to tackle this on your own on the self-help train? A combination of both? There are so many different methods and approaches to improving your emotional and mental health. You can begin with regular journaling, reading self-help books, and workbooks. Exercise, meditation, yoga, and dance are powerful movement therapies. Art and music can be used as expressive therapy. Perhaps you join a 12-Step program or enter rehab. Take some classes, join forums, learn new skills. Building social connections, volunteering, and helping other people are all therapeutic and potentially life-changing. Learn about CBT or DBT. Dive into some spiritual studies. Commit to better sleep, less alcohol, and healthier eating habits. Less pointless mind numbing screen time!

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The beginning is about small steps. You will not accomplish everything that you want instantly. Personal evolution is a process. This road is usually life-long; be patient but persistent. I encourage you to become passionate about mental health. Obsess about self-improvement! You have absolutely nothing to lose and everything to gain.

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For those of you who are resisting, if you don’t think you are worth it, I would like you to ask yourself who would benefit from you being a healthier version of yourself? Your children? Your family, friends, your dog? What about work, your neighbors or the community? A healthier version of you impacts everyone else around you. If everyone on the planet took their mental and emotional health seriously, we would live in a better world. So, you are worth the effort...

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Back to the initial question, “Where do you start?” Start where you are. Start now. Right now. Take the first step on the therapy path. Decide that you are going to do this. Commit to yourself, your journey, your self-discovery, your growth. Grab a journal, find a therapist, and dive in.

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