The Most Surprising Things About Starting Therapy

What do you imagine will happen when you first start therapy? And what if the reality is nothing like you expected?

At Televero Health, we’ve heard countless versions of “I didn’t expect that” from people starting therapy. “I thought my therapist would tell me what to do.” “I didn’t realize I’d feel worse before feeling better.” “I was surprised therapy didn’t focus more on my past.” “I didn’t expect to talk about my body so much.” These surprises aren’t signs that therapy isn’t working — they’re normal reactions to experiencing something that often differs significantly from how it’s portrayed in media or discussed in casual conversation.

Maybe you’re considering therapy and wondering what it’s really like beyond the stereotypes. Or perhaps you’ve started and found yourself surprised by aspects no one mentioned. Either way, understanding the common surprises can help navigate the early stages of therapy with more realistic expectations and less unnecessary confusion.

Here are some of the most surprising things about starting therapy — the realities that often differ from expectations.

Surprise #1: Good Therapists Rarely Give Direct Advice

One of the most common expectations is that therapists will function as advice-givers — professional problem-solvers who listen to your situation and then tell you exactly what to do. This expectation often leads to surprise when therapists instead ask questions, offer reflections, or explore options without dictating specific actions.

Why this happens:

Effective therapy focuses on developing your own capacity for discernment rather than creating dependence on the therapist’s judgment
External advice, even when well-informed, often doesn’t account for your unique values, context, and needs
Learning to trust your own wisdom is typically more sustainable than following someone else’s directions
The process of exploring options often reveals important insights that direct advice would bypass

This doesn’t mean therapists never offer perspectives or suggestions. But they typically do so in ways that support your agency and judgment rather than replacing it.

As one client put it: “I was frustrated at first that my therapist wouldn’t just tell me what to do about my relationship. But as we explored it, I realized I actually knew what was right for me — I just needed help clearing away all the noise to hear myself.”

Surprise #2: You Might Feel Worse Before You Feel Better

Many people enter therapy expecting a steady improvement in how they feel — like a medication that gradually alleviates symptoms. They’re often surprised to find that therapy sometimes temporarily increases discomfort, especially in the early stages.

Why this happens:

Bringing attention to difficult patterns or feelings can intensify awareness of them before change occurs
Speaking about challenges can temporarily activate the emotions associated with them
Questioning habitual coping mechanisms can create vulnerability before new approaches are established
The process of change itself can feel disorienting, even when it’s ultimately beneficial

This temporary increase in discomfort doesn’t mean therapy isn’t working. It often indicates that real engagement with important issues has begun. The key is distinguishing between productive discomfort that leads to growth and unproductive distress that indicates a problem with the therapeutic approach or relationship.

Most people find that this initial intensification gives way to genuine relief as therapy progresses, but the path rarely follows a simple upward trajectory.

Surprise #3: Therapy Isn’t Always About Your Past

Popular depictions of therapy often focus heavily on exploring childhood and uncovering past traumas. While some therapeutic approaches do emphasize historical understanding, many people are surprised to find therapy focusing significantly on present patterns, current relationships, and future possibilities.

Why this happens:

Different therapeutic approaches vary in how much they emphasize past exploration
Current difficulties often provide the most immediate access to patterns that need attention
Creating change in the present doesn’t always require extensive historical exploration
The relationship between past and present isn’t always direct or literal

This doesn’t mean the past is irrelevant. But its role in therapy is often more complex and variable than pop culture depictions suggest. Sometimes understanding historical patterns is essential; other times, focusing primarily on current experience creates more effective change.

As one therapist explained: “We’re always working with the past, but sometimes indirectly. The patterns formed in early relationships show up in the room between us, giving us the opportunity to address them experientially rather than just talking about them.”

Surprise #4: Therapy Involves Your Body, Not Just Your Mind

The term “talk therapy” can create the expectation that therapy is exclusively a verbal, cognitive process. Many people are surprised when therapists ask about physical sensations, notice bodily responses, or incorporate awareness of breathing, tension, or movement into the therapeutic process.

Why this happens:

Mind and body aren’t separate systems — emotions, thoughts, and physical experiences are deeply interconnected
The body often holds and expresses what hasn’t yet been verbally articulated
Nervous system regulation is a key component of emotional wellbeing
Sustainable change typically requires integration at both cognitive and somatic levels

This bodily dimension doesn’t mean therapy becomes physically intrusive. It simply means that awareness of physical experience is recognized as an important aspect of holistic therapeutic work.

One client described their surprise this way: “I thought we’d just be talking about my thoughts and feelings. I didn’t expect so many questions about tension in my shoulders, changes in my breathing, or sensations in my chest. But those bodily cues often led to the most important insights.”

Surprise #5: The Therapeutic Relationship Itself Is a Powerful Agent of Change

Many people enter therapy focusing exclusively on the content they want to discuss or the techniques the therapist might use. They’re often surprised to discover that the relationship itself — the quality of connection between client and therapist — plays a crucial role in the therapeutic process.

Why this happens:

Many emotional and relational patterns formed in relationships can only be effectively addressed within relationship
The experience of being genuinely seen and heard often creates change even before specific issues are “solved”
The therapeutic relationship provides a context where new ways of relating can be experienced and practiced
Trust within the therapeutic relationship creates safety for exploring vulnerable material

This relational dimension doesn’t mean therapy becomes primarily about the relationship with the therapist. It means that the quality of that relationship creates the context in which other therapeutic work becomes possible.

Research consistently shows that across different therapeutic approaches, the quality of the therapeutic relationship is one of the strongest predictors of positive outcomes.

Surprise #6: You’ll Probably Do Most of the Talking

Despite the stereotype of the silent therapist who only says “And how does that make you feel?”, many people are still surprised by how much they end up talking in therapy compared to the therapist. They sometimes worry they’re “doing it wrong” or that the therapist isn’t providing enough input.

Why this happens:

Therapy creates rare space focused entirely on your experience, unlike most conversations which involve turn-taking
The process of articulating thoughts and feelings aloud often creates clarity and insight independently of the therapist’s response
Therapists are trained to use silence productively, allowing important material to emerge rather than filling space
The therapeutic value often comes more from your own exploration than from the therapist’s pronouncements

This doesn’t mean therapists never speak or that they don’t provide meaningful responses. But the balance of talking time typically differs significantly from ordinary conversation, with the client speaking considerably more than the therapist in most sessions.

As one therapist explained: “People sometimes apologize for ‘talking too much,’ not realizing that their speaking is the work. My job isn’t to match their talking time but to create space for what needs expression and to respond in ways that deepen the exploration.”

Surprise #7: Progress Rarely Happens in a Straight Line

Many people enter therapy expecting steady, linear improvement — each session building directly on the last in a clear progression toward resolution. They’re often surprised by the non-linear nature of therapeutic change, with its cycles of progress, plateaus, and sometimes temporary setbacks.

Why this happens:

Different aspects of growth often happen at different rates, creating an uneven overall experience
New awareness sometimes precedes the capacity for change, creating periods where things feel worse before they get better
Life circumstances continue to fluctuate during therapy, affecting the pace and focus of therapeutic work
Deep patterns typically change through cycles of practice, integration, and refinement rather than immediate transformation

This non-linear nature doesn’t indicate failure or lack of progress. It reflects the complex reality of human change, which rarely follows the neat, orderly progression we might prefer.

Understanding this pattern can help reduce unnecessary discouragement during plateaus or temporary setbacks, recognizing them as normal parts of the growth process rather than signs that therapy isn’t working.

Surprise #8: You’ll Likely Play an Active Role Between Sessions

Many people imagine therapy as something that happens exclusively during scheduled sessions, with little connection to life between appointments. They’re sometimes surprised to discover that effective therapy often involves active engagement between sessions — noticing patterns, practicing new skills, reflecting on insights, or completing specific exercises.

Why this happens:

The goal of therapy is change in daily life, not just insights during sessions
New patterns and skills require practice to become established
Awareness that begins in sessions needs to extend to everyday situations
The limited time in formal therapy is most effective when supplemented by ongoing integration

This between-session dimension doesn’t mean therapy becomes homework-heavy or burdensome. It simply means that the boundaries between “therapy time” and “regular life” are more permeable than often expected, with each informing and enhancing the other.

As one client described it: “I thought therapy would be like a doctor’s appointment — go in, get treatment, leave and forget about it until next time. Instead, I found myself noticing things during the week that I wanted to bring back to sessions, and trying out new approaches we’d discussed. Therapy became less of an event and more of an ongoing process.”

Surprise #9: Finding the Right Therapist Matters More Than the “Right” Approach

People researching therapy often focus heavily on different therapeutic approaches — CBT, psychodynamic, EMDR, etc. — trying to determine which is “best” for their situation. Many are surprised to discover that the fit with the specific therapist often matters more than the particular approach they practice.

Why this happens:

Research consistently shows that the therapeutic relationship is one of the strongest predictors of positive outcomes
Most experienced therapists integrate elements from multiple approaches rather than rigidly adhering to a single method
Different therapists practicing the “same” approach can create vastly different therapeutic experiences
Personal factors like communication style, worldview alignment, and relational dynamics significantly impact therapeutic effectiveness

This doesn’t mean therapeutic approaches are irrelevant. Different methods do have different strengths and emphases. But these differences often matter less than finding a therapist with whom you can develop trust, feel understood, and engage in meaningful work.

Understanding this reality can help shift the focus from an abstract search for the perfect approach to the more practical question of finding a therapist with whom you can develop a productive working relationship.

Surprise #10: Therapy Often Raises More Questions Before Providing Answers

Many people enter therapy seeking clear answers and solutions to specific problems. They’re sometimes surprised to find therapy initially expanding their questions and complexities rather than immediately narrowing them toward resolution.

Why this happens:

Sustainable solutions often require deeper understanding of the questions themselves
What initially appears as the “problem” is frequently a symptom of broader patterns that need exploration
Premature answers can shut down important exploration before full understanding develops
Complex human situations rarely have simple, singular solutions

This expansion of questions doesn’t mean therapy never provides answers or resolution. It means that the path to meaningful answers often involves a phase of increased complexity and deeper questioning before clarity emerges.

As one therapist explained: “People sometimes get frustrated when I respond to their questions with more questions. But I’ve found that the questions people bring initially are rarely the ones that, when answered, create the change they’re seeking. We need to find the questions beneath the questions.”

The surprises of starting therapy aren’t flaws or problems to be fixed. They’re natural aspects of a process that’s inherently more complex, relational, and multidimensional than common depictions suggest. Understanding these potential surprises can help navigate the early stages of therapy with more realistic expectations and less unnecessary confusion or disappointment.

This doesn’t mean everyone’s experience will include all these surprises. Different therapeutic approaches, individual therapists, and unique client circumstances create significant variation. But awareness of these common experiences can help distinguish between normal aspects of the therapeutic process and genuine concerns that might indicate a need for adjustment.

Ready to discover what will surprise you about therapy? Start here.