Feeling Unsure About Starting Therapy
- aphillipsarts
- Nov 19, 2025
- 10 min read
Updated: Jul 25
It is very common to feel unsure about starting therapy
You may have been thinking about it for some time, perhaps repeatedly reaching the point of making contact and then deciding to leave it a little longer. Alongside the hope that therapy might be helpful, there may be anxiety, embarrassment, scepticism, or uncertainty about what will happen.
This can be true whether you are considering therapy for the first time or have worked with a therapist before.
Beginning therapy does not require complete certainty. You do not need to arrive with a perfectly defined problem, know exactly what you want to say, or feel entirely comfortable with the idea. Your hesitation may itself tell us something important about what beginning therapy means to you.
This article explores some common worries about starting therapy and how they might be approached within depth-oriented psychotherapy.
Common worries about starting therapy
You may recognise one or more of these concerns:
These are not signs that therapy is necessarily unsuitable for you. They may reflect uncertainty about an unfamiliar process, but they may also connect with wider patterns in how you have learned to seek help, trust other people, express vulnerability, or respond to attention.
I feel embarrassed to talk about it
Knowing that a therapist is there to listen does not automatically make it easy to talk about your life.
Some experiences may feel private, shameful, confusing, or difficult to explain. You may worry about how you will be seen once something has been spoken aloud. You might also fear that the therapist will think your feelings are unreasonable, that you have made poor choices, or that you should already have dealt with the problem by yourself.
There is no expectation that you will tell me everything immediately.
Trust develops through the experience of meeting regularly and discovering how the therapist responds to you. It is often better to approach difficult material carefully than to feel pressured into disclosing more than you are ready to share.
If something feels too embarrassing to describe directly, we can begin by considering the embarrassment itself. What do you imagine might happen if you spoke about it? What kind of response do you fear? Have there been earlier experiences of being criticised, dismissed, exposed, or misunderstood?
You can enter the shallow end before gradually moving towards deeper water. Beginning therapy involves some risk, but it does not require a leap from the highest diving board.
My problems are not serious enough
Some people imagine that therapy is only appropriate during a crisis or after every other possibility has failed.
You may compare yourself with an imagined person whose suffering seems more serious and conclude that you would be wasting the therapist’s time. Perhaps you believe you should be able to cope by yourself, or feel that seeking help would be self-indulgent.
Therapy does not require you to prove that your difficulties are severe enough.
The feeling that your concerns do not deserve attention may itself be worth exploring. It can sometimes reflect a history of not being taken seriously, learning to minimise your needs, or feeling that care and attention properly belong to other people.
There may also be more happening beneath the surface than you can presently describe. People do not always begin therapy with a complete understanding of why something has become difficult. What first brings someone may remain important while gradually becoming part of a wider picture.
You do not need to establish the seriousness of your experience before making contact. We can begin by considering what is happening, how it affects your life, and whether my way of working appears suitable.
I will not know what to say
Therapy is sometimes imagined as an hour in which the client must arrive prepared with a sequence of important subjects.
In reality, some sessions begin with something immediate and specific, while others begin with uncertainty. You may talk about an event from the week, a relationship, a dream, a memory, a feeling, or simply the sense that you do not know where to start.
Not knowing what to say is not a failure to participate.
It may mean that you need time to settle, that something is difficult to approach, or that your experience has not yet taken a form that can easily be expressed. We can pay attention to what happens when there seems to be nothing to say, rather than treating the silence as an empty space that must immediately be filled.
There is also no need to speak continuously. Pauses can allow time to feel, think, and notice what might otherwise be passed over.
My experience cannot be understood
The wish to be understood is often accompanied by the fear that understanding will not be possible.
You may have tried to explain your experience to other people and felt dismissed, simplified, or met with advice that did not address what you were actually saying. Perhaps important people in your life were unable or unwilling to understand you. Over time, it may have become safer to assume that no one will.
A therapist will bring knowledge, training, and experience, but should remain careful about claiming to know you too quickly.
Within depth psychotherapy, understanding is not something I impose from outside. It develops gradually through what you express, how I respond, and what we discover together. At times I may offer an observation, make a connection, or invite you to consider something from another perspective. But I am not an expert who possesses a hidden explanation of you.
There are periods in therapy when neither person fully understands what is happening. Remaining with uncertainty can be frustrating, particularly when there is an urgent desire for change. Yet a premature answer may close down the very process through which a more personal and truthful understanding could emerge.
My task is not to fit you into a ready-made account. It is to bring my experience into a relationship in which we can learn more about your particular life.
I have had therapy before and it did not help
A disappointing previous experience can understandably make it harder to begin again.
Perhaps the therapist felt distant, overly directive, insufficiently engaged, or simply not right for you. You may have felt misunderstood, or found that the approach did not suit what you needed. Therapy may also have ended abruptly or left you uncertain about whether anything had changed.
Past therapy is something we can discuss during the initial consultation. It can be helpful to consider:
what felt helpful
what was missing or unhelpful
how the relationship with the therapist felt
what you hoped would happen
how the therapy ended
what you would need to be different this time
There are many forms of therapy, and much also depends upon the individual therapist. A poor experience with one person or approach does not establish that every form of therapy will be the same.
At the same time, I cannot promise that my approach will suit everyone. I will explain how I work as clearly as possible so that we can make a considered decision about whether to begin. We can then review the work as it develops rather than assuming that starting therapy obliges you to continue indefinitely.
You may also find it helpful to read my article about how to find the right therapist and what “right” might mean in practice.
It is too late for me to change
“It is never too late” can sound encouraging, but it may feel hollow when a pattern or situation has shaped much of your life.
The belief that it is too late may relate to age, missed opportunities, a longstanding way of relating, or the sense that too much has already happened. You may struggle to imagine who you would be without a familiar difficulty, even when it causes considerable pain.
It can be helpful to distinguish transformation from replacement.
Transformation does not necessarily mean becoming an entirely different person. It may involve developing a different relationship to aspects of yourself that are already present, recovering neglected possibilities, or becoming less governed by patterns that once seemed inevitable.
There are also real limitations. Therapy cannot reverse time, remove every consequence, or guarantee a particular future. Sometimes meaningful change involves recognising what cannot be recovered and allowing space to mourn it.
But accepting what is not possible is different from assuming that no new relationship to life can develop. The question may become less “Can I erase what has happened?” and more “How might I live from here?”
I am worried therapy will make me feel worse
Beginning therapy can bring increased awareness of feelings or situations that have previously been avoided, minimised, or managed at a distance. This can sometimes feel uncomfortable.
That does not mean therapy should automatically be distressing, or that becoming worse is proof that meaningful work is taking place. Difficult feelings need to be considered in context.
If therapy feels unsettling, it is important that you can tell me. We might consider:
what “worse” means in your particular experience
whether something difficult is being brought into awareness
whether external circumstances have changed
whether the pace of the work needs adjusting
whether something within the therapeutic relationship feels unsafe or unhelpful
whether another form of support may be needed
A therapy that is helping may still contain uncertainty, frustration, sadness, anger, or periods when progress is difficult to recognise. But these experiences should be open to discussion rather than treated as something the client must simply endure.
The relationship needs enough trust for difficulties to be approached together. If the work is not appropriate or is no longer in your best interests, that also needs to be recognised.
I do not deserve the attention
Psychotherapy offers a sustained kind of attention that may feel unfamiliar.
For someone accustomed to putting other people first, minimising their own needs, or expecting criticism rather than care, an hour devoted to their experience can feel uncomfortable or undeserved.
Simply contradicting this feeling by saying “of course you deserve it” may not reach the deeper experience. We may first need to understand how you came to expect that kindness, interest, or care would not be available to you.
Perhaps attention in the past was conditional, intrusive, critical, or unreliable. It may have been withdrawn at important moments, or accompanied by demands that made receiving it feel unsafe. Feeling undeserving can sometimes offer protection against the pain of hoping for attention and losing it again.
Therapy provides an opportunity to approach these experiences without assuming that your discomfort is irrational or something to be quickly argued away.
I am afraid of being judged or closely observed
Some people experience the therapist’s attention almost like stage fright. You may feel pressure to perform, produce interesting material, or behave like a “good” therapy client.
You might worry that I will notice things you do not want me to see, interpret everything you say, or decide that you are doing therapy incorrectly.
The purpose of attention in therapy is not surveillance. It is to help us notice your experience with greater care.
This includes what is happening between us. You may feel that I have misunderstood you, lost interest, become critical, or responded in a way that feels uncomfortable. Such experiences can be discussed. Sometimes they connect with familiar expectations from other relationships. At other times, the therapist may genuinely have missed something or responded imperfectly.
A useful therapeutic relationship does not depend upon the therapist never making a mistake. It depends partly upon whether difficulties can be acknowledged and thought about without defensiveness or blame.
As an HCPC registered Art Psychotherapist, I also offer the possibility of working with images. Some people worry that an image will reveal something they are not ready to know, or that I will interpret it and tell them what it means.
That is not how I work. Art-making is optional, and I do not decode images. An image is explored in relation to your associations, the context in which it was made, and what develops through our shared attention to it. Its meaning belongs primarily to you and may emerge gradually.
Will the therapist tell me what to do?
People sometimes seek therapy hoping that an expert will provide the correct answer.
I may offer thoughts, ask questions, notice patterns, and help you consider possible choices. But depth psychotherapy is not primarily a form of instruction, and I do not assume that I know what you should do with your life.
Advice can occasionally be useful, but it can also bypass the more important work of understanding what makes a decision difficult, what different possibilities mean to you, and what fears or desires are influencing your position.
The aim is not for you to become dependent upon my judgement. It is to support a fuller relationship with your own experience, so that choices can be made with greater awareness and discernment.
This does not mean leaving you entirely alone with a problem. Therapy is collaborative. We think together, and I remain actively engaged, while recognising that the direction of your life cannot ultimately be determined by someone else.
Will the therapist sit in silence?
Another familiar concern is that the therapist will remain distant and silent while you struggle to fill the hour.
My approach is attentive and responsive. I will speak, ask questions, offer reflections, and take part in a real conversation.
There will also be times when I listen without immediately responding. A pause may give you room to continue, allow an emotional response to develop, or help both of us consider what has just been said.
Silence should not be used to create unnecessary anxiety or maintain an air of mystery. Neither should every space be filled so quickly that quieter or less familiar aspects of experience cannot emerge.
The balance varies between people and between sessions. At times the work may be conversational. At others, more spaciousness may be needed. What matters is that you experience me as present and engaged, even when we are not speaking.
Beginning without complete certainty
Feeling unsure about starting therapy does not mean that your hesitation should be ignored. It may be useful to listen to it carefully.
Sometimes uncertainty indicates that more information is needed. You may want to understand the therapist’s qualifications, approach, boundaries, or expectations before deciding. At other times, the hesitation may arise because asking for help, receiving attention, or entering an unfamiliar relationship touches something emotionally significant.
An initial consultation provides an opportunity to discuss what brings you, hear more about how I work, and consider whether beginning therapy together seems appropriate. It is not necessary to arrive already certain that I am the right therapist.
You can find further information about my approach and the practical process of beginning on the psychotherapy pages of my website.
You are welcome to contact me with any questions or to arrange an initial consultation (details can be found at the foot of each page). Beginning therapy does not have to feel like a decisive leap. It can begin with an enquiry and a conversation.
