Common Fears About Starting Therapy (and Why They’re Completely Normal)

The decision to start therapy is a big step.

It is common for people to feel anxious about what it means or how it might go. Some worry about whether it will help, some about the level of commitment or financial investment, and others about whether they will be judged. This is perfectly normal. Like entering any kind of unknown space, a degree of anxiety about what will happen is normal. It is not a sign that something is wrong, but a sign that something matters enough to make you feel slightly unsettled.   

To speak to those of you who might be feeling anxious, I have listed some of the most common worries people bring and added a few reflections of my own.

1- Will I be judged?

The most common concern is that people will be judged for either attending therapy or for sharing specific bits of information. There could be a worry that attending therapy means they are weak and unable to cope (which could be tied to gender and culture), or that what they share will be evidence of being “mad” or “crazy”.

These concerns make a lot of sense when we remember that we grow up in societies that encourage conformity in terms of how we think, feel and behave. This is what we call the “norm”. The fear of judgement keeps us “in check” with how society expects us to be.

When we are afraid of judgement, shame starts to flood our minds. Therapy can be a space where judgement is suspended long enough for shame to be explored rather than obeyed.  

The question I leave you with is – who made you feel like the world was a judgemental place?

2- Is my problem serious enough?

Another idea that pops up sometimes is that there is a hierarchy of problems, some of which reach the threshold of “serious enough” and others do not. The world gets set up as a division between “those with real problems” and “the moaners who are actually fine”.

This concern usually has two layers: one shaped by early experiences, and another that speaks to deeper anxieties about being emotionally overwhelmed.

In the first case, it can mirror key messages people received in their early years. Perhaps the family had a ‘stiff upper lip’ kind of attitude, meaning vulnerability gets denied, or someone in the family was very unwell leaving others feeling like their needs were not as important.

The other side is that beneath a concern about whether or not a problem is serious enough could lie an anxiety about getting in touch with those vulnerable parts of the self in the first place. This might speak to a fear about getting overwhelmed or having a breakdown, for example.

The question I leave you with is – who didn’t take you seriously when you were most vulnerable? How do you relate to your vulnerability?

3- How can talking help with my real-life problems?

This is a common question that gets posed, particularly when the therapy isn’t a ‘problem-solving’ kind of therapy like Cognitive-Behavioural Therapy (see my blog post about different therapies). It’s a fair enough question.

Therapy isn’t just one thing. Some seek tools and guidance; others want to understand themselves more deeply. Clarifying what you are looking for helps you choose which therapy might be right for you.

In Psychodynamic work, the goal isn’t to provide ready-made solutions, but to strengthen your capacity to think and feel about real-life issues. It’s about making sense of your inner experiences so that you can meet external challenges with more courage and confidence.

The question I leave you with is – what do you want out of a therapist? Who is it that you are looking for?

4- What if I can’t commit to weekly sessions?

Life is unpredictable. Schedules change and new responsibilities emerge. However, difficulties with commitment can sometimes reflect deeper patterns in the mind. They can speak to fears about depending on someone (particularly if depending on people has not come easily), or fears of being ‘trapped’ by the consistency and expectation of attending weekly.

In cases where problems with commitment seep into other areas of life, therapy can help to understand why it has become a challenge so that you can make changes that positively impact other relationships.

5- Will what I say remain confidential?

It isn't uncommon for people to be concerned about confidentiality, given that what they discuss often concerns private or intimate details about their lives.

Therapy is a confidential process, however, I attend regular supervision in which I discuss the work anonymously. No private details are shared in this environment, and it serves as a way of reviewing the work so that I can ensure that my attempts at helping you are sound.

The only times I may have to break confidentiality are if I believe you or someone else is at risk of harm, or if required by law. Those boundaries exist to protect you and to ensure the work can proceed safely.

6- Fear of change

Perhaps less commonly acknowledged is that for many, change is terrifying.

As human beings, we are creatures of habit. Even though we might be suffering in some ways, the suffering becomes familiar. No one naturally disrupts familiarity for the unfamiliar, even if that familiarity is a source of suffering.   

The question I leave you with is – what would change alter in your life that you may not want to alter?

If you recognise yourself in any of these worries, you’re not alone. The very feelings that make it hard to begin therapy are often the ones therapy can help you work through. In that sense, hesitation isn’t a barrier – it’s already part of the work.