Questions That Come Up When Considering Therapy

Today, I thought I would answer a few questions that people commonly ask when they are first starting therapy or are considering making an appointment.


I feel like I’m going crazy. I get these intense moments of adrenaline that come out of nowhere. I can’t explain them. Is there something wrong with me?

That rush of adrenaline is often linked with your fight-flight-freeze response system being activated. It’s a great system for keeping you safe when you are threatened, but it can activate when you are no longer in danger. If you have situations or experiences in your past where you felt you were in danger, your brain may associate similar events with being in danger. This system was evolutionary advantageous because it kept us safe when danger situations threatened our survival. It makes sense to generalize because it is better to be over-prepared than underprepared for danger. However, this generalization less helpful now that we live in a society that protects us from most of these dangers. There’s not anything wrong with you if that system is activating now, but it can cause significant distress. Through EMDR or talk therapy, we can review these past events so that they are less likely to be tied to current situations.


I’ve been to therapy before and worked through stuff, but it feels like I’m back in the middle of it again. Help!

Many people experience “bumps in the road,” whether that’s a life transition, the perfect storm of stressors, or something else, that can trigger the stuff that you might have worked through in therapy before. It is perfectly okay to come in for support again. Therapy does not have to be a forever fix, and you shouldn’t need therapy forever. We all experience events in our lives that overwhelm our ability to cope. The great part about coming back to therapy is that you have already worked on these things once so you can build on the insight and skills that you already have. You are not starting from square one. A fellow therapist, Allison Puryear, describes it like a spiral staircase. Each time we come back to work on our “stuff,” we level up.


Therapy seems like a bunch of hooey to me. Why would you want me to get better? Then, I’d stop coming and you’d stop making money.

That’s true that I would no longer have the money coming from you and/or your insurance company, but there are many other people out there who might also need help. While I like to believe it’s possible to put myself out of business (and gosh, that would be great if no one needed therapy anymore), it’s not likely that we will see the end of mental health issues in my lifetime. Just like any other health issue, there is lots of evidence to suggest that mental health issues are real and treatable, and people often get better. That is a good thing! If you have questions about the theories or techniques I use and whether they are supported, I would be happy to share the evidence or point you in the direction of sources so that you can do your own research.


What makes therapy the most effective?

Effectiveness depends on a number of different factors, and we could debate for days on what types of therapy are the most effective. However, there is one thing that is correlated with success in therapy across treatment methods: the relationship between you and your therapist (Martin et al. 2000). Basically, that means that it’s important that you find a therapist who is a good fit: someone who you jive with, who you feel like understands you and why you are coming to therapy. While I encourage you to give it a couple sessions, it is important that you feel understood and not judged in therapy. That’s why I also offer a free 15-minute fit consultation so that you can ask questions and we can talk more about what’s going on and whether I’d be the right person to work with you. 


Have a question that I didn't answer? Feel free to give me a call or send me an email. I would love to chat!