Finally, you’re off the waitlist and it’s time for your first therapy appointment. You walk into the office (or log in to Zoom). T-minus 60 minutes until you’re totally transformed: anxiety gone, depression a thing of the past, and burnout cured. At least that’s what you’re expecting to happen. But halfway into your appointment, you’re so over hearing, “Tell me more,” or “That’s quite an experience.” Your (not-so-cheap) therapist sounds a lot like AI, and you wonder: Am I wasting my time?
It makes sense why guys are turning to AI for their mental health fix. Some of my patients admit that they prefer to “talk it out” with Chat GPT; it’s not pricey and the algorithm that serves up phrases like “good job with that” feels weirdly validating (more about that in a bit). Other guys are quitting therapy altogether. They choose to get their emotional support from a traditional human friend. It’s normal for the first few sessions to feel pretty useless. Before you bail on therapy, here’s what you should know.
Therapy Is a Relationship
That’s right, like any other relationship—a friend, romantic partner, or colleague in the office—you and your therapist need to get to know each other. Sometimes that happens more quickly than others. One of the most common mistakes is quitting therapy because you don’t feel comfortable right away.
Usually, the first few sessions utilize a technique called “supportive psychotherapy.” It’s when your therapist encourages you through difficult times, with phrases like, “You’re doing a great job,” and makes statements like, “That must have been tough for you—talk to me about what you were feeling.” As therapists, we do this to prompt our patients to take the session in any direction they think is meaningful. Doing this can help us understand the important areas we will need to focus our future conversations on. Your therapist will want to know what makes you tick, what you are passionate about, and what your treatment goals are. It might feel more awkward than a date or an appointment with your barber. This happens because you’re not there to impress anyone but to show the “real you” right from the start.
READ MORE: Why Men Need to Train for Balance in the Age of Burnout
During the first few appointments, therapists often tell you a little about themselves, like if they enjoy running marathons, to help make opening up a little easier. Other times, therapists take more of an observational approach and don’t disclose much personal information at all. If this makes you uncomfortable, it’s ok to ask your therapist general questions like “How long have you been practicing,” or “Where are you from?” This helps the conversation feel more interactive, not a monologue.
Therapy Takes Time to Work
Think of your first therapy session like the first day of class when you were a kid. It can be exciting, scary, and fun—all in the same day. If you leave your first appointment feeling like you just wasted an hour, I recommend giving it a least a month or two before quitting. The time spent in the “getting to know you” phase can vary. It depends on how often your sessions are scheduled and how quickly you establish therapeutic alliance. This means feeling comfortable “peeling back” your emotional layers in a sincere and transparent way. Research shows that after you have a good therapeutic alliance, therapy may even work better.
READ MORE: “I Didn’t Think I’d Make It”—Men Who Survived by Speaking Out
That’s when your therapist may pivot toward more specialized therapies. These include cognitive behavioral therapy (CBT) for depression and anxiety, or cognitive processing therapy (CPT) for trauma. These techniques can be very effective. However, they take time to work. CBT can take anywhere from a few sessions to several months to start working. CPT usually consists of weekly sessions for 12 weeks to treat post-traumatic stress disorder (PTSD). If you’re interested in Freudian psychoanalysis, you’re likely diving deeply into how childhood experiences shape how you navigate the world today. Buckle up, because some studies indicate the average length of treatment is between 3 and 7 years. Therapy is a journey of self-discovery, and the first few sessions are usually only the beginning.
Therapy Is Hard
Let me begin by saying that I personally “get” how hard therapy can be. A few years ago, I went to therapy—not as a psychiatrist, but as a patient. At that time, I was going through a divorce and experiencing some intense panic attacks. My therapist was great (and extremely patient). She even humored me on those rare occasions when I’d interrupt her advice to quip, “I already understand CBT, that’s not going to work.” Then one day, during our third or fourth session, I found myself crying so unconsolably that I could barely get a word out. It was like every emotion I had experienced—good or bad—for almost the past decade was pouring over a broken dam as I sat there bemused by what was happening to me while my tears flooded her couch.
READ MORE: Depression Symptoms for Men, According to Therapists
Therapy has a way of doing this to you. For some guys—including me—opening up about real feelings, perhaps things you’ve never shared with anyone else, can be embarrassing and make you feel like you shouldn’t go back. Being on the “other side,” I had seen this take place in my own patients enough times. Even though I didn’t want to go back to therapy, I knew I needed to return. After that good cry, when I returned to therapy the following week, my therapist wanted to talk about what happened the week before. The fact that she seemed comfortable, helped me feel more comfortable about sharing my feelings. Eventually, I began to leave therapy feeling like a weight was lifted—and that’s when I knew that therapy was working for me.
Therapy is not easy, and it is definitely not a quick fix. The first few sessions can feel slow or even pointless, but they are laying the foundation for real change. If you feel stuck, tell your therapist what you want to work on more directly. It is your time after all. And remember, not every therapist is the right fit. If it does not click, that is okay.
What matters is that you keep showing up. Whether it is stress, anxiety, trauma, or just needing someone to talk to, therapy can help you move forward. And if you are not sure where to start in South Africa, organisations like SADAG (South African Depression and Anxiety Group) and Lifeline offer affordable options and helplines that can guide you. Sometimes the strongest thing a man can do is ask for help and keep asking until it works.
This article by Gregory Scott Brown MD was published on Men’s Health US – additional reporting and products added by the Men’s Health SA team.
