Accept that growth and change can feel uncomfortable at times. Yes, psychotherapy should offer you hope that things can get better for you as well as tools to move you in a positive direction. However, therapy requires that some things change within you, your thoughts, interpretations, and behaviors – otherwise, meaningful change will not occur. If you’ve ever had braces on your teeth, for instance, you know that that every time the braces are tightened (in order to facilitate movement), your teeth are sore for a few days – and you’ve paid for this privilege, because you desire change. The analogy between getting braces and psychotherapy breaks down a bit here, because psychotherapy requires more active participation on your part, in and between sessions, but the inevitable, transient achiness is similar.

Accept that choosing to enter into psychotherapy does not mean that you are damaged. While conditions such as anxiety, depression, or trouble with relationships can seriously impair your ability to function, the presence of these in your life is not an indication that you are inherently “bad”. Please do not make matters worse by labeling yourself as a problem or as defective. The issues that bring people into therapy are multifaceted in their origin, some of which were and are out of your control. Therapy can supply you with tools, insights, and a supportive environment in which to get a different and more constructive way of viewing your situation, and to practice responding differently in the future, in the areas that you can control.

Accept that your therapist cannot (or should not) tell you what to do about important decisions. Whether or not you believe it, you are the expert when it comes to your life. A therapist can aid you in developing a stronger connection to your “wise mind” (intuition, gut instinct, Higher Self) and following its direction, rather than being at the mercy of your emotions or mere logic. Also, a therapist can point out what you seem to be saying (beyond what you are verbalizing) and behavior patterns that you may not have noticed. In therapy, you can practice interpreting and responding to your feelings, thoughts, and other people in new ways – but your decisions remain your own. Although at times you may want someone else to make choices for you, even when it comes to expert advice from others, the final decision is ultimately yours. Any other stance would delegate you to the position of being a child rather than an adult, and you presumably would prefer the latter.

Accept that lasting change does not usually happen overnight. For instance, sometimes people enter into therapy with a long-standing issue such as binge eating with which they’ve struggled for years, if not decades. Consider how deeply engrained such a habit must be, and how often it’s been practiced. Much like a path we’ve trodden in the woods for a long time, it can be very tempting to continue down this path when experiencing discomfort or coming into contact with a familiar trigger (attending a holiday party, walking by our favorite bakery, seeing a bag of cookies in our pantry, especially if we’re tired or anxious). Indeed, it’s much easier in the short run to walk an established path than to forge a new one, which would entail our fighting our way through the brush and being unsure of the outcome. There can be comfort in the ritual of a habitual behavior, even if it hurts us. However, in the long run the new path can become more familiar to us and more rewarding. Therapy is much the same way. You may not see your progress from day to day, but it may suddenly dawn on you some months (or years) down the line that your episodes of binge eating have decreased in frequency, stopped altogether, or that you don’t lash out in anger or have anxiety attacks the way you used to. Hang in there.

Accept that not every therapy session will contain “aha” moments. Psychotherapy is a relationship between you and your therapist, and as in all relationships, there are intense moments and easy-going, seemingly trivial, moments. “Seemingly” can be deceptive. We don’t always recognize at the time the value of unconditional positive regard and sharing good news. Just because a therapy session doesn’t address a “problem” doesn’t mean that it was unproductive. Some people have difficulty acknowledging the good in their lives and how they’ve contributed to bringing this about, for instance. Therapy can help you to see what’s already working, what’s begun to work for you, and how you can accept and capitalize on your strengths and resources.

Accept that your therapist keeps boundaries for good reasons. Sometimes you may be in the middle of an especially emotional interaction, and your therapist tells you that it’s time to end your session for that day. Your therapist isn’t being insensitive or rude, and he or she does care about you. In fact, ending sessions on time indicates that your therapist wants adequate time to reflect on what has transpired in your session, probably write down some progress notes, and consider plans for future sessions. In addition, your therapist may have another client after you and wants to give them the same consideration as you have received. Accept the fact that you are no more or less important than someone else. The way in which you respond to this fact can itself be illuminating and a teachable moment.

Therapy can offer benefits above and beyond the original reason you began treatment. If you stay emotionally engaged, take responsibility for your attitudes and actions, practice self-compassion, and are patient with the process, you stand a great chance of emerging from therapy with positive and long-standing changes in your outlook, level of happiness, and ability to cope with life’s challenges.