What Are the Barriers to Starting Therapy?

20th February 2022
 minute read

Table of contents

Starting therapy for the first time is a big step and feeling worried about it is natural. Let’s look at some of the barriers to seeing a therapist for the first time…

From getting to know yourself better to dealing with past experiences to making sense of our increasingly confusing world, therapy can have life changing benefits. 

Yet despite this, many people feel uncertain or uneasy about taking that first step into seeing a therapist, for all sorts of natural and understandable reasons. If this is the case for you then it can be useful to examine these fears, so that they will no longer be a barrier to getting support.


So if you’ve been thinking about therapy for a while but it feels like something is holding you back, then here are a few key reasons for why that might be…


‘I don’t know what to expect’ 


If you’ve never had therapy before then the idea of stepping into a therapist’s office for the first time (or even logging onto an online session) can feel daunting. What will happen exactly? Will you be asked lots of probing questions? Be pushed to reveal too much, too soon? Will you know what to say? Or will it just be one long awkward silence? 


When we do something new in life, feelings of uncertainty and anxiety are completely normal. That’s why it can be really usual to demystify the experience ahead of time, for instance, by taking a look at our post on 4 things to expect from your first therapy appointment. 


It’s also worth remembering that although different therapists have different approaches and styles, most first sessions are mainly about information gathering. Your therapist will want to get a feel for why you are there, find out a few key things about you and also explain their process, as well as go over any practical considerations like scheduling and payments. The appointment will probably last around 50 minutes (although again, this can vary).


It is unlikely that your therapist will do a ‘deep dive’ with you in this first session, meaning you won’t be pressured to open up before you are ready. Mainly your first meeting will be a chance for you both to get a feel for each other so that you can decide if you want to go forward with that particular therapist.


And remember, it is totally fine to ‘shop around’ until you find the right person for you — you aren’t obligated to keep seeing someone after a first appointment. It is also fine to book a one-off session (Single-Session Therapy) as a way to start thinking about what you might need — and also to get a better understanding of what it’s like to talk with a therapist.


‘I’m worried that I’m not “worthy” of therapy’


It is quite common to think that our own particular issues are somehow not ‘serious’ or ‘important’ enough to need therapy (sometimes because we have lived with them for so long). You might also feel that you don’t want to ‘burden’ a therapist for this very same reason.


Yet if you are feeling this way then it’s important to consider a few key things. Firstly, we tend to underestimate our own pain, issues and problems — sometimes because we were given the message in childhood that our needs didn’t matter. But just because you have learned to minimise or bury your struggles, doesn’t mean you are not as worthy of support for them as anyone else. 


Secondly, if an issue in your life is causing you pain, anger or confusion (or holding you back from your goals, or affecting your relationships), then it matters. And you absolutely deserve the chance to talk to someone about it. Finally, therapists talk to all sorts of people about all sorts of issues. They know that if you are struggling with something, then that’s reason enough to seek support for it. 


But maybe, at some level, you are holding back from therapy because you feel that you don’t ‘deserve’ to be happy? If so, this in itself is a really good reason to talk to someone. Together you can get to the root of this belief and work towards replacing it with a more helpful one. But try not to let it stop you from seeking support in the first place.


‘I’m worried that therapy won’t work for me’


Therapy isn’t a magic cure for anything — but it can help a lot. In fact, psychotherapy has been estimated to be effective for around 80% of people (based on hundreds of different trials), making it a powerful method of support and healing. What’s more, new techniques are being developed all the time to deal with deeper traumas.


However, sometimes people are resistant to therapy as they just don’t believe it will help them. Beliefs might include ‘I am unhelpable’, ‘My issues are bigger than anyone else’s’ or ‘I am uniquely broken’. But again, the presence of these thoughts is a good reason in itself to seek support.


Also, if you don’t believe that therapy will help you because you have had negative experiences in the past, then that’s completely understandable. However, those negative experiences are something you could talk through with a new therapist, so that they can offer you reassurance.


It’s also worth bearing in mind there are many different types and styles of therapy. So even if you didn’t find an approach that was right for you in the past, that doesn’t mean you should give up. In fact, you might want to find out more about the different kinds of therapies available, as well exploring our guide to the different types of mental health professional as the type of professional you see can make a big difference too. 



Finally, if you didn’t quite ‘click’ with therapy before, then it might just have not been the right time. The past doesn’t equal the future, so maybe now could be the right time for you?


‘I’m worried that there’s a stigma around therapy’


These days, therapy is widely seen as a positive and responsible wellbeing choice - actually a sign of strength rather than weakness. People enter into it for a huge range of reasons, from developing better assertiveness skills to dealing with grief to processing difficult past experiences. 


For this reason, different therapeutic approaches have been developed to match different needs — for instance, some methods focus on your responses to present circumstances, others on exploring your childhood and others on releasing trauma. And while a big myth about therapy is that it’s all about ‘blaming your parents’, this isn’t the case. That’s because a key focus of therapy is empowering you to move forward in life, not getting trapped in a spiral of blame or recrimination. 


That said, some people can still feel ashamed at the idea of seeing a therapist for many different reasons. These can include coming from a culture or religious group where therapy is frowned upon, or being part of an older generation that grew up thinking that it was somehow ‘embarrassing’. That said, there can also be barriers to younger people seeking therapy as well. Research by MTA therapist Dr. Keziban Salaheddin found that these include disliking talking about emotions, feeling that problems aren’t serious enough or fearing what will happen if you seek help. In some cases, younger people can feel more comfortable with live chat or text therapy instead. 


According to Dr. Salaheddin, ‘Taking the first step to starting therapy can be very daunting for many people. Concerns about being judged, feelings of shame and difficulty putting words to your emotional distress, are really common barriers to getting support.’ Yet while it’s normal to experience barriers, we shouldn’t actually let it stop us from seeing a therapist, not when it could benefit us. In her words, ‘If you've noticed something holding you back from starting therapy, please remember that you don't need to struggle alone.’


Men are another group who can struggle with the idea of getting support, sometimes because they see it as ‘weak’. They might also feel uneasy about discussing their emotions with a stranger — especially if they have been socialised since childhood to hide those emotions and ‘be strong’. In fact, according to the American Psychological Association: ‘Dozens of studies and surveys over the past several decades have shown that men of all ages and ethnicities are less likely than women to seek help for all sorts of problems — including depression, substance abuse and stressful life events — even though they encounter those problems at the same or greater rates as women.’ 


An added issue is that men might not even recognise mental health problems in themselves, which is why it’s important to pay attention to any signs of stress, anxiety or low mood.These could include physical indicators such as loss of appetite, sleeplessness or a reduced sex drive. And with an estimated one in eight men in England having a mental health issue, learning to look out for these signs — and seeking support for them — is vital. So if you are a man struggling with the idea of reaching out for help, remember that you are far from alone. This very insightful Metro article explores some of the reasons why men can be reluctant to see a therapist. 


These are all valid reasons for feeling concerned about what therapy might ‘say’ about you. However, most of us wouldn’t feel ashamed about going to see a doctor if we were unwell, or going to the gym to maintain our physical fitness. In the same way, therapy can be a really helpful way to manage any mental health issues, as well as maintain wellbeing during challenging times (such as the pandemic or a personal loss).


Therapy can help us to develop stronger resilience, manage our moods, set better boundaries, have healthier connections with others and feel more confident in pursuing our goals. It can also help us to unearth any secret self-sabotaging behaviours that might be holding us back from our dreams and goals. These are all crucial life skills. 


And if you do feel worried about opening up to a therapist, then this is something that you could chat about in your initial appointment. They will then be able to reassure you about your concerns and take the sessions at a pace that works for you.


‘I’m worried that my therapist will judge me’


‘Will they think badly of me?’ is one of the biggest fears that people can have about their therapist. After all, aren’t we often our own worst critic, judging ourselves for things that we can forgive more easily in others?


Added to this, we live in a society where image is highly emphasised and where we’re often pressured to show our ‘best self’. For these reasons, it can be hard to reveal our more vulnerable side. We might feel really afraid of a therapist finding out about our weaknesses and perceived ‘flaws’, for instance, seeing us as ‘selfish’, ‘angry’ or even ‘immoral’. It doesn’t always come naturally to show these parts of ourselves to another person, or to talk about our deeper and darker thoughts, emotions and fears.


Added to this, if you grew up in a family where your feelings weren’t validated, or where you weren’t soothed when you felt sad, or were shamed when you showed anger, then the idea of opening up can feel particularly challenging. And if you felt criticised by a parent or caregiver, or grew up in a strictly religious family, then being judged could be a very deep fear for you. When you start working with a therapist they are unknown to you — you don’t know their personality or how they think. So it’s understandable that you might fill in the gaps with information from your own beliefs and past experiences. In fact, this is often a core part of the therapy journey. 


Thankfully, a good therapist will understand all of these barriers and fears. Their role is not to judge but to understand — and to help you to understand yourself better as a result. Also, they know that therapy and trust building are both a process, so they won’t expect you to open up about everything straight away. In fact, the idea behind therapy is that it should offer an ‘emotionally corrective experience’. This just means that you can experience what it’s like when someone truly listens to you and accepts you; takes your feelings and concerns seriously, and has your best interests at heart. This ‘unconditional positive regard’ is at the heart of all therapies and it is experiencing this — and learning to accept it from another person — that can be the most healing thing of all (especially if you lacked it growing up).


‘I’m worried about the feelings that therapy might bring up’


Sometimes we can bury difficult emotions that we don’t want to talk about, or show to others, or even feel within ourselves. Sadly, burying these emotions can sometimes cause the most harm to our wellbeing. Yet despite this, we might just want those feelings to stay buried as they could seem much too painful to face.


For instance, if you went through a bereavement in the past but didn’t fully grieve it, then you might be afraid that therapy will bring up that sadness and loss. Or if you are dealing with addictive behaviours, then shame might be an emotion that’s just too overwhelming to confront. Some people are also afraid of losing control and ‘embarrassing’ themselves in front of a therapist, for instance by crying, expressing anger or by being upset by something that seems ‘trivial’. And if you have abuse or trauma in your past then you might fear reliving those memories in a session. You might also be afraid of the consequences of acknowledging certain feelings — for instance, if anger at a parent starts coming to the surface then what will that mean for your relationship with them?


The truth is that all good therapy will help you connect with difficult emotions eventually, but a therapist is also trained to guide you through those feelings safely and at a pace that feels manageable for you. In fact, a core part of their role is to create a containing space to access those emotions, no matter how big, messy or painful they might seem. And by processing difficult feelings under the guidance of a therapist, you can finally let go of them and move forward with your life. 


‘I’m worried that therapy just isn’t realistic for me’


Sometimes, practical worries around therapy can stop us from getting the support that they need. One common fear is not being able to maintain regular appointments with a therapist, for all sorts of reasons.


Life barriers to attending therapy can include living in a rural area without a car, having a disability, having a medical condition, being a new or breastfeeding mum; dealing with anxiety, panic attacks or agoraphobia; having a busy or changeable work schedule, being an at-home carer or having to social distance. People in controlling, coercive or abusive relationships might also struggle to see a therapist privately and safely. 


That is why online therapy can be a great solution, as you can talk to someone from the comfort of your sofa, car or even a quiet room at work. And if you prefer sending texts to talking on video, then live chat therapy is an increasingly popular option (especially with younger people).


Finally, money can sometimes be a barrier to finding support. Yet if it’s at all possible, you might want to consider redirecting money spent on non-essentials towards a ‘therapy budget’ for a while. You could see this as a valuable investment in yourself that might pay off in huge ways in your future. Alternatively, you could consider booking a Single-Session Therapy (SST) appointment, which can be really helpful if there is a specific issue or block that you need to focus on. Essentially, SST is a dynamic form of support where you and your therapist will make a concrete plan for a particular issue over the course of one appointment. You will usually leave with a set of steps to implement and in some cases, resources like workbooks to complete in your own time. 


But if neither of these options is possible for you financially, then you could still seek an NHS referral from your GP; search for charities and organisations that offer free counselling, or try to find a therapist who offers sliding scale fees. And if there are limited resources in your local area then you could also look into online services. 


There are lots of reasons why you might feel uncertain about starting therapy and all of them are completely valid. Yet sometimes, the best starting point is to schedule an initial chat with a therapist, just to get a feel for things. And if you’re not sure where to begin, then our blog post on finding the right therapist for you could be a really good starting point.


And remember, while that first step into therapy can be the hardest, it can also be a huge relief when you finally do it. So why not take it today?


Ready to try therapy? Connect with a world-class MTA therapist for an introductory appointment, including in-person, video or live chat options.

What Are the Barriers to Starting Therapy?
Clinical Director
Lumo Health team
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