Are Stigma and Nerves Getting in the Way of Starting Therapy? You are Not Alone

You are starting to take the steps… You may be exploring the idea of therapy, noticing that you are feeling a little nervous, and admitting that you aren’t entirely sure. Maybe it is social stigma & beliefs about therapy that you’ve absorbed over time, or perhaps you’re just flat-out nervous to talk with a stranger about your experiences. You are not alone! In fact, your concerns are pretty common, and there is hope in overcoming your hesitations.

Begin by learning more about social stigmas, how a lack of information contributes to negative beliefs about therapy, and how to break down your barriers to reaching out. By starting to understand & normalize these feelings more, you can shed your fears and start living the life you want.

What is stigma?

We hear the word “stigma” used often in conversation – especially in the contexts of physical and mental health – but what does it mean, and how can it affect us? Stigma is a negative social belief that a group of people may have about a specific characteristic of a person. According to the American Psychological Association, a stigma “implies social disapproval” about a perceived “mental, physical, or social deficiency.”

Stigmas are often pervasive in a society and are a sign of more considerable misunderstanding surrounding a social characteristic, including mental health concerns, poverty, disability status, etc. Stigma may interfere with a person’s ability to access care, feel comfortable in their community, have positive self-esteem, or attain new opportunities in the workplace.

Why is there a stigma about therapy specifically, and how can it affect people?

Stigma can affect many different people in many different ways. For example, sociocultural factors such as gender identity, race & ethnicity, religious beliefs, and socioeconomic status can limit people’s abilities to seek care & community in times of hardship comfortably.

When it comes to mental health, many social beliefs about emotions, help-seeking, and “weakness” interfere with our abilities to cope. In many cultures, displays of emotions are frowned upon, and asking for help to cope with challenges is seen as a weakness. In fact, some surveys suggest that nearly half of Americans believe so. However, it is important to remember that all emotions are a universal experience, and to show vulnerability is often a sign of social strength & resilience when practiced in a supportive community.

Often, stigmatizing language, lack of education, messages from media, and internalized beliefs about “self-reliance” may contribute to more significant misunderstandings about therapy. Additionally, concerns about institutionalized stigma & discrimination may create barriers to accessibility &

quality care. Self-stigma may also cause someone to label themselves as “unacceptable because of having a mental health concern” due to internalized beliefs about the perceived “imperfection” of emotional challenges.

Many people notice that internalized stigmas may cause procrastination behaviors, relationship concerns, feelings of isolation, behavioral outbursts, and feelings of loneliness as a result of conflicting emotions about starting therapy. You may also experience increased anxiety or mood concerns due to feelings of shame, which may manifest as self-doubt, low self-esteem, negative self-talk, increased feelings of hopelessness, or other symptoms. By continuing to educate yourself (and others!) on the effects of stigma in your community, you can begin to overcome socialized beliefs and take a step toward your personal growth & healing.

What are other myths that may make someone nervous about starting therapy?

Whether you have concerns about resources, privacy, commitment, or discomfort, a person may be nervous about starting therapy for many reasons.

  • Privacy – Some individuals may have concerns about the safety & confidentiality of their information and matters discussed in therapy. Therapists and other health care providers are bound by confidentiality protocols, meaning they will not share sensitive information without your knowledge & consent. Your therapist will also discuss what this means in your first session to ensure your comfort & understanding.
  • Discomfort – It is uncomfortable to talk about ourselves. Talking about our emotions is even more uncomfortable – much less with a stranger! These thoughts are okay and quite common for people when starting therapy. However, therapy is the space to be uncomfortable and to talk about that discomfort openly and safely. You may also fear revisiting specific painful emotions or experiences from your past. You are encouraged to take these moments in your own time and should never feel pressured to rush into triggering memories until you are ready.
  • Commitment – You may question what being in therapy even means… How long am I supposed to be in therapy? Do I have to go every week? Do I have to stay with one therapist forever? Know that you are certainly not committed to one therapist – or even weekly sessions – forever! While there is no specific time frame or set commitment for therapy, you are encouraged to express your concerns & questions with your provider throughout your time together.
  • Finding a Therapist – “Dating” therapists can be an additional time commitment and emotional hurdle for many. To minimize any long-term time investment in your search, be thorough in your research, take advantage of consultation calls, and ask thoughtful questions to ensure you feel comfortable & confident in the provider you’ve chosen. Therapy is not “one size fits all,” you want to seek a provider who understands your unique needs & perspective for the strongest fit.
  • Doubts About Your Needs – You may ask yourself if you “even need therapy.” It is a myth (often due to stigma) that a person needs to “hit rock bottom” to begin therapy. These beliefs are far from the truth. In fact, the many faces of therapy clients likely look like many people you know personally – regardless of gender, race, sexuality, nationality, career, age, socioeconomic status, etc. Often, people seek therapy to seek coping skills for emotional distress, to process everyday stressors such as work or finances, to supplement health concerns, to resolve interpersonal conflicts, to develop skills, and to seek help for adjusting to changes in life circumstances such as moves, relationship changes, job searches, etc. These people are far from “failures” and are viewed as resourceful by peers for addressing their concerns with a helping professional.
  • Fear of Judgment – Due to the pervasive nature of stigmas, many people may fear that their social circle or even health providers may interfere with their desire to talk with someone. It is important to understand that you are not a diagnosis and that having emotional concerns does not make you any less worthy of happiness and support.
  • Resources—For many people, it may be a privilege to prioritize their mental health. Whether time, insurance coverage, or affordability concerns are obstacles, it is essential to take advantage of the available resources and seek flexibility in your community.


How can I overcome social stigma & other nerves about therapy?

Despite stigma about mental health concerns, the CDC has noted a consistent increase in mental health treatment across all adult populations in the past five years. This increase can be attributed to many changes, including social efforts to destigmatize mental healthcare and individual efforts to understand emotional & behavioral concerns.

  • Find people who are talking about mental health. There are many opportunities to find people normalizing therapy via social media, news platforms, books, podcasts, television shows, movies, and more. Research continues to demonstrate that conversation significantly reduces stigma.
  • Prioritize the relationships that make you feel most safe. You do not have to share your concerns or experiences with anyone with whom you feel uncomfortable and are encouraged to seek support from the people who validate your feelings and affirm your values most.
  • Seek out success stories and research the benefits of therapy. Learn more about others’ experiences with therapy – including what inspired & benefited them – and understand various ways of approaching mental health challenges.
  • Research support groups, show compassion for others who are struggling, and find other opportunities for community in mental health spaces. Hold yourself & others accountable when you notice stigmatizing language or beliefs coming up.
  • Continue educating yourself about what therapy can look like for you and how it works. A more objective approach to mental health may ease concerns about emotions or doubts about efficacy.
  • Challenge yourself! Take the step, one step at a time. Therapy does not have to be rushed, and it shouldn’t be. It can feel scary & overwhelming, and yet, “for anxiety to get better, you must go through the anxiety in the short-term.”

Seek an open, supportive, and validating therapist. Ask questions and discuss your hesitations with your provider. You have now found a safe, confidential space to express any and all of your concerns—the easiest one just might be talking about the nerves.

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