Have I ever said how much I wish I didn’t need therapy? I look forward to my annual pap more the therapy. Not because I don’t like my therapist – actually, I think she’s brilliant. But because it is so gut wrenchingly difficult to give words to some of your feelings and thought you wish you didn’t have.

That’s why I loved the pointers for surviving therapy that author Sue Atkinson offers in her insightful book “Climbing Out of Depression.” The following excerpt is used with permission of her publisher Jeremy P. Tarcher/Penguin Books.

Going into therapy is not an easy option. Some think it should be on the life events list for high stress. If it were, it would be pretty near the top! There is no doubt that therapy is though, but if we an survive, it could be the most helpful thing that we could ever do to escape depression. (No promises, of course). 

Here are my rules for survival.

1. It takes enormous courage, so tell the therapist if you are terrified.
2. Expect it to get very much worse before it gets better.
3. Even if after ten agonizing sessions you still think that the therapist hates your guts, it may be worth going on, but tell him or her.
4. If the therapist is clearly an insensitive idiot [I’ve had a few of those], get out quickly.
5. If the therapist tries to make connections between things that have been said, trying to get at what is underneath the words, and these connections make absolutely no sense whatsoever to you, it’s important to say so. If the therapist’s reaction is then to search further, or try another approach, that’s a good sign. If, on the other hand, the explanations sound like irrelevant garbage and you say so and you get put in your place and made to feel small, that may be a signal that the therapist needs therapy as much as you do! Rapid retreat could be called for if this persists, but it is crucial to explore it first with the therapist; it could well be a key issue.
6. Don’t just give up. Explore all problems thoroughly.
7. It might be that, if things go badly, we have unrealistic expectations. Explore this with the therapist.
8. If most of what is said is jargon, it is a good idea to say so. If the response is a real attempt at communication, go on. But if it is one that makes everything all your fault and “shows clearly that blah blah blah gobbledygook gobbledygook, don’t you think so, Sue?” I don’t know what to suggest. I never really figured that one out.
9. All therapy is painful. It’s not a good idea to give it up for that reason. However, it can be a good thing to stop if life gets so overwhelming that your survival is in doubt. There is a right time for things. We need to be ready to face things. There are also some therapeutic approaches that may not be right for you at that time. It’s okay to say you can’t cope with it right now.

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