Katie Dalebout’s Pivot: Showing Up for Therapy

Transitions are universal and inevitable, regardless of age we’re constantly evolving. And while change can, at times, feel messy and uncomfortable, it’s through these metamorphosis that we learn success. All of my greatest lessons have come as a result of a pivot after a failure. These pivotal movements have made fertile ground for growth. Through the exploration of these transitions and changes it is my hope that fullest readers will feel less alone in knowing that others are going through the same trials and celebrations. As I move through my Saturn return and the tail end of my 20’s I find myself mining for life’s gems and sharing the lessons I’ve learned (and still continue to learn) through personal essays, lists, and interviews.

Enjoy my monthly column, Pivot for the fullest.

My heart stopped as I saw her across the hot bar at Whole Foods. We made eye-contact and I started shaking as she pretended she didn’t know me. This was the person who knew my secrets. I’d been more honest with her than anyone, yet she ignored me. 

Little did I know that therapists traditionally don’t say hi to their patients in the wild unless the patient initiates it. I eventually said hi and we had one of the most awkward exchanges of my life which we later discussed in her office the following week — exploring why it made me so anxious. 

Where I grew up I didn’t know anyone in therapy. I barely knew what it was other than what I saw on my TV. The movie Prime which I weirdly watched enough to memorize made it look insanely cozy and the only psychiatrist I knew of was Mr. Seaver from Growing Pains.

A gift of my eating disorder was that it landed me in a therapist’s office rather young. This gave  me the self-awareness of my neurosis and a language for weird things I thought only I dealt with. It made me feel less alone. Although young, I wasn’t quite young enough to have my therapy paid for by my parents, and it sadly wasn’t covered by insurance. This meant that by bearing the entire financial burden of my therapy I was more apt to show up fully and do all the inner work I was paying for. 

Therapy has allowed me to see myself from a neutral observer’s perspective. I’ve had multiple therapists with various specialities — but the throughline is that I felt safe enough to show up as my most unfiltered, authentic, tender, and vulnerable self. I felt comfortable enough to remove all the masks I normally wore in the world.

I’ve laughed in therapy and used an entire box of tissues while crying. I’ve brought a boyfriend in for couples therapy and even sat on the shrink’s couch with my mom. It’s not a magic salve, it didn’t cure all my issues, but I do believe that years of self-inquire have had a cumulative positive effect on my mental health, and therefore my life. Some sessions feel like a massage for my mind while others feel like I’ve opened pandora’s box on an emotion I’d been avoiding and wished I’d never opened up — but, ultimately, that’s where the biggest growth comes from. 

That awkward run-in with my first therapist was almost a decade ago and since then I’ve spent hundreds of hours and thousands of dollars on talk therapy. And with that investment of time and money you better believe I want to make sure I’m getting the most of it. 

I asked six therapists how they suggest getting the most out of their sessions: 

“Don’t overthink a therapy session (there must be a pun in here somewhere). It isn’t a business meeting or an interview for a job. Avoid a “checklist mindset.” The most valuable insights come from unexpected and unscripted twists and turns in conversation. If you have specific questions in mind, you can put them on a note card so you don’t forget, but I don’t think you need to take notes while you’re in the session. It might detract from the interaction. It’s better to engage with your therapist and be fully present. Therapy is more about the process and less about productivity.” 

Samantha Boardman, MD, Department of Medicine, Weill Cornell Medical College

“Before launching into whatever is at the top of your mind, take at least five minutes (hopefully under the guidance of your therapist) to sit quietly and notice your breath, heart rate, physical sensations, and thoughts. Starting from that point will avoid the use of the appointment to “catch up” and will begin from a deeper, more contemplative place. Later that day jot down the major themes and reactions you took from the session. When clients commit to these practices they heal more rapidly and make the changes they want to see in their lives.” 

Lisa Spiegel, MA, Licenced Mental Health Counselor

“It’s about being open to transformation without being attached to the outcome. Make your appointments at a time that suits your schedule, always with time afterwards to reflect on the session and practice self-care. When coming to a session, be prepared to show up, not for your therapist, but for yourself. Take notes before and after your session with questions or reflections. The work is really done outside of the session, when you are faced with real-life triggers and situations. Know your tools, practice your tools, and commit to doing the work. If you don’t prioritize making space in your daily or weekly life to “do the work” then the magic of the session can be lost and your path to healing may be drawn out longer than expected. Never come into therapy thinking it will be a cure-all. It is a marathon and if you’re thinking you will sprint to the finish and achieve your goal in one session, then your need for immediacy is something to definitely bring to the table.” 

Dr. Carlen Costa, Sexologist, OCSWSSW Psychotherapist

“Think about the outcomes you want in the session and be clear and focused about what you want. After the session, give yourself a task to follow up on. Take that one thing and put it into action.”

Dr. Rachel Hott, MMT, PhD

“Allow yourself to be seen. Sometimes clients will self-censor in therapy, fearful of judgement from their therapist. This can block your own growth, as well as feelings of self-love, trust, and safety that come from sharing openly and being accepted exactly as you are.” 

Brooke Novick, Licensed Marriage and Family Therapist 

Katie Dalebout is a writer, host, and founder of Let [a podcast] Out, a workshop that helps people DIY podcast. Since 2013, she has interviewed nearly 300 people on her long-form podcast, Let It Out. Her first book, Let It Out: A Journey Through Journaling is a collection of personal essays and journaling prompts that was published in 2016. She now writes about her feelings monthly in her Let It Out Letter. Katie, her feelings, and all of her plants live together in Manhattan.

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