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  • Natasha J. Thomas, MD

Under Construction: What to Expect When You're in Counseling

Updated: May 13, 2021

Not too long ago, I was taking a lovely, leisurely drive to work. The sky was blue, I was listening to classical music, and I was feeling pretty positive. Then I made a left turn onto a full street of construction that I had no idea was there. I laugh to myself now at how quickly my peaceful little morning drive vibes turned into, "Oh, come on! I don't want to be late - this is going to take forever!" vibes.

I slowly rolled along the street, and finally ended up sitting just before an intersection, manned by policemen. Knowing I couldn't go anywhere, I sat and looked around at the construction. There were all sorts of machines I don't know the names of unearthing our tawny Georgia clay. Men held signs that said "slow" or "stop". Exasperated drivers sat leaning their heads against the windows of their cars. There was even a giant orange and black sign warning us of the rough ride ahead with a sign that simply read "BUMP."

Thankfully, because I had been having a calm morning, I was able to see a little more than just the construction before me - and could see, instead, a reminder.


Therapy is a beautiful opportunity to clear away the obstacles that have prevented you from living your purpose and reaching your highest potential.


Two months earlier, I spoke with someone who was disappointed with a therapist I asked them to see. They said, essentially, they felt worse leaving sessions because they expected that a therapist's job was to make them feel better. It was an interesting conversation - about expectations and the realities of counseling or psychotherapy, terms some mental health providers use interchangeably.

Counseling and therapy refer to a process in which an objective party helps you discover, understand and improve yourself. This may be through talking, using workbooks or worksheets, reading books, doing meditation or mindfulness exercises, exploring family patterns, and more. It is not easy. Reconstructing the self, through therapy or counseling, is not a "feel good" endeavor but it is work that grants emotional healing and mental clarity. And it is worth it.

Now, of course it's important to have a good therapeutic relationship with your therapist - which requires rapport and trust. And, of course, you will eventually get to a place where you feel much, much better than you did at the onset of your counseling.

But it takes more than encouragement and cheerleading from a therapist. Instead, it takes a lot of reconstruction - and commitment to that process. You may have lifelong misconceptions about yourself that need to be first realized, and then undone. You may have maladaptive patterns of behavior you learned from family members that need to be "unlearned." You may live in a state of constant fear and worry due to trauma that you've experienced. That has to be cautiously explored and healed and your brain soothed. You may really need the opportunity to have someone there to bear witness to your lived experience - to validate you and help you remember your worth as a human being.

I don't mean to intimidate you but let's be honest - none of that kind of work can be done in 3-4 sessions. In fact, I've seen the best progress in patients who commit at least a year to doing the work of healing themselves. And if you've enrolled in therapy that your counselor tells you from the outset is meant to be "brief," you still must fully engage the process to see success.

I am a very big proponent of psychotherapy/counseling because many studies show its benefits for patients who are (or are not) receiving psychiatric care. Therapy can physically benefit your brain, improve your self-concept, prolong your life by enhancing your ability to make health-promoting choices, and can strengthen your family as they are inspired to change by your growth.

Therapy is a beautiful opportunity to clear away the obstacles that have prevented you from living your purpose and reaching your highest potential. If you get started and it seems like the process is more difficult than you expected, remind yourself that the luxury of open, smooth roads first began with breaking down, digging deep, and creating a new path, on a solid foundation.

*None of the information in this blog post serves as medical advice. You can find therapists in your city by visiting

Call 1.800.TALK if you or a loved one is experiencing a mental health crisis.

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