Reflections on a Year in Therapy

I started seeing a therapist early last December, which means I’ve been in therapy for about a year now, and I want to take some time to reflect on my progress with my therapist.

The therapist I’m seeing now is the only one I’ve ever had. Before I started therapy, I had lots of conversations with people who knew me well in which they assumed I’d been to therapy and then were surprised when I told them I hadn’t. For as long as I can remember, my life has depended on being my own therapist, on cobbling together techniques from CBT and DBT, relaxation gifs, ASMR videos, harm reduction, and strategies from friends and strangers on the internet to make myself a path to survival. I don’t know what assuming I’d had professional support says about those people or about me, but I’m proud of myself for managing as well as I did for as long as I did without therapy.

I had a really difficult childhood, and I’ve wanted therapy since I was a kid. I remember my mom threatening me with it as punishment once. Inside I was begging for it, but she never followed through. I asked her directly for therapy a few times when I was a teenager. She always found some way to brush me off or drop the subject, usually saying something about money or insurance. She obfuscates our family’s finances, but we’re pretty well-off and I suspect it was always a lie.

During my first attempt at college and the time I spent as a dropout, I grew into some complexities that made it harder to trust any hypothetical therapist. I was bi, agender, chronically ill, a survivor of parental abuse and child-on-child sexual abuse. My problems included getting into internet fights with mansplainers in the bi activist community and other niche conflicts of politics and identity. It was a lot to explain to anyone, let alone a stranger, a medical professional whose background I barely knew at all.

When I finally did start therapy, it was because I’d hit a wall in trying to get by on community-based support alone. The people I consider my friends and community are mostly trans, disabled, and otherwise marginalized. The struggles we go through with oppression and sometimes our own bodies mean we’re often stretched thin trying to care for ourselves and each other. Thankfully one of my friends was able to recommend a therapist, with more nuance than a basic “gay-friendly.” I started seeing that therapist, and I’ve been happy enough (and in the beginning, search-averse enough) to stick with her.

I liked her intake paperwork, which asked about identities, including gender and pronouns, in open-ended ways, but the first couple of months of therapy were rough. My therapist kept forgetting things I’d told her about myself and my life, and forgetting she’d already told me her story about a Buddhist with progressing Alzheimer’s. I shrunk, as I usually do with even friendly and respectful authority figures, and went through those conversations again and again without saying anything.

My therapist’s attitudes about diagnosis often frustrated me as well. She was pleasantly indifferent to diagnostic labels at first, saying they were often arbitrary and just a box to fill in on the insurance paperwork, but other times she’d use diagnostic labels to pathologize people. We wouldn’t dream of being Facebook friends with each other, but I happened to see her comment on a mutual friend’s post, giving Trump the usual armchair diagnosis of Narcissistic Personality Disorder. I didn’t identify as having Borderline Personality Disorder in my intake paperwork because I know how medical and psychiatric ableism goes. My therapist never seems to have thought about BPD as a diagnosis for me, maybe because she sees me as too well-adjusted or morally good for it, but she asked me if I thought my abusive mother was Borderline. In reality, I think it’s possible but mostly an ableist, anti-Borderline moot point. To my therapist, I responded with less politically charged apathy.

While my therapist understands that I’m agender and identify as trans, she’s also made a lot of common cis slips. She fumbles with other trans people’s pronouns sometimes, and I’m sure she does with mine if she ever talks about me. She sometimes refers to me as female, a woman, my mother’s daughter, and so forth, then struggles to frame more accurate and sensitive statements in terms of socialization or how other people see me. Early on, she asked me what I think therapists should know about serving trans people. I was frustrated that she was asking to be educated while she was supposed to be helping me, but I didn’t want to say so. Instead I stared out the window for a long time before answering, which was an admittedly unclear communication strategy. I eventually said that dysphoria and other trans-related problems won’t always be what we’re in therapy for, which her other interactions with me showed she already understood anyway.

I’ve been open with her about being a writer, but not about my pen name or all the specifics of what I write about. She expressed interest in seeing some of my writing early on, and my deep-seated fears about snooping clashed with my hesitation to deny any request. If I showed her any of my writing, she’d be able to google and find more of it, so I’d have to just trust her not to. Rationally, I did trust her, but my trauma-brain was just not having it.

I spent those first couple of months comparing therapy to the therapeutic value of other things in my life, and therapy usually lost. I wished insurance and/or my mom would pay for other kinds of professional support, like artistic mentorship, or compensate my friends for all they ways they’ve helped me.

I’m not sure when my opinion shifted and I started to look forward to therapy more, so I guess it must have been gradual. I still have to repeat myself to my therapist sometimes, and she still unknowingly repeats herself to me sometimes, but it’s gotten less frequent. In a recent session, she got out a clipboard and prepared to take notes as I told her about my family’s intergenerational trauma. It made me feel like she was really listening and engaged.

I’ve been more assertive with her recently, if only in small ways. One time, on the way into her office, she asked me how I was, and I said, “I’ve been better.” She said, “That’s good,” misunderstanding how I meant it. I was using it in the negative way, like “I’ve been better at other times in my life than I am now,” but she took it as “I’ve been better recently.” I hate correcting people, so my impulse was to just go along with it, but instead I clarified.

I’m still not confident enough to tell her directly when something she’s doing isn’t helping me much, but I’ve learned to recognize and communicate when something is working especially well. I come out of therapy feeling best when we address old, deep pain or a current acute crisis. Even if I’m seriously chronically frustrated about something (like housing, employment, or my career as an artist), spinning those wheels doesn’t make me feel better. I’m learning that on days when I come into the office feeling pretty good, the best thing for me is to pick a situation that hurt me long ago and discuss it with my therapist. Even when I can self-validate, it’s still healing to have someone else acknowledge violations that everyone in my life wanted to ignore when they occured.

I’ve come to trust my therapist more to respect my privacy with regard to my art life. Some of my trust developed through familiarity, and some developed because I didn’t want to bother to obscure identifying details about things like my performances and employment. My therapist has enough information about me to easily find my pen name and everything that’s associated with it, but I trust her to respect my boundaries. I still haven’t shown her any of my writing, though, because I don’t think she needs to read it to understand me.

As for the things she gets wrong about transness or disability, I’ve decided to only correct and educate her if she needs to understand better in order to support me. As important as it is to educate people about social justice, she’s paid to help me, not the other way around. If I can brush off her mistakes and still get the support I need, that’s what I do.

As much as I’ve struggled with some aspects of navigating therapy, I like my therapist and look forward to our sessions. Therapy fulfills my lifelong fantasy of having an older adult who cares what happens to me and is a reliable presence in my life. I know she’s paid for that, but that doesn’t negate it, and she also shows me that she cares through specific compliments and, once, coming into the office on a day she usually takes off because that was all my schedule would allow for. She also offers me a hug at the end of each session, which I appreciate as a reliable and predictable way of receiving touch. Knowing that whatever happens to me, there will be someone waiting to hear about it and give me a hug helps me get through tough times.

While I still value and need support from my friends and communities, I feel better about not needing to ask quite as much of them since I started therapy. I think therapy has also helped to ease my overall desperation, which is a relief.

It’s work and a process of growth to get what I want out of therapy, but I’m gradually working towards knowing what I want and asking for it. As I come to understand and assert myself, my therapist is becoming the supportive presence that I’ve longed for all my life.


(I’m still struggling to integrate class dynamics and privilege smoothly in my writing. I’m happy and privileged that my mom and her insurance are able to pay for me to see the therapist I want to see, even though my mom’s financial and other abuse kept me from accessing therapy for most of my life. I suspect she finally became willing to pay for therapy because I’m too old for the government to take me away from her and because she knows it would be financially difficult for me to cut ties with her.)

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