As the 50-year-old therapist I am today, I sometimes reflect on the 15-year-old adolescent I was when I first went to therapy. 

I remember feeling angry that I had to be there, and as if everyone thought there was something so wrong with me that I required this endlessly embarrassing and annoying weekly interaction with a well-meaning but overbearing stranger who wore altogether too much lipstick. 

I genuinely thought the problem was everybody else—forgivable, I suppose, given my tender years—but also a terrible state of mind to be in if one is actually in need of help. 

I was like a wounded wild animal howling in a corner, unable to understand that the scary men in khaki jackets were there to save my life. My thinking was, if everyone could just leave me alone, I’d be fine. 

It might surprise you to know that many bona fide adults enter therapy with that exact same attitude. Sure, they are a little more subtle in their resistance. They share some, but not all of their story, candy coating the stuff that they think reflects badly on them—the parts they are ashamed of. They defend their hidden shame with diversion, projection, evasiveness, even humor. 

It makes sense—it’s tough to take out all our ugly and spread it on a table like so many pieces of a messy, old puzzle and have some stranger go over it with a fine-tooth comb. 

“Oh!” we are afraid our therapist might say, “How could you not see that this piece goes here? And that this piece is from the wrong puzzle altogether? No wonder this picture doesn’t make sense…you’re obviously not very good at puzzles, are you?” 

We have psychological defenses for the same reason porcupines have quills—we need a go-to strategy for when things feel scary. Sometimes, we’re so disconnected from our emotions (another psychological defense) that we don’t even know we’re feeling scared. Instead, we misinterpret our fear as anger, resentment, numbness, or even exhaustion. 

If you don’t believe me, I’ll direct you to one of my favorite quotes and an idea that drives my entire therapeutic philosophy. 

“There are only two emotions: love and fear. All positive emotions come from love, all negative emotions from fear. From love flows happiness, contentment, peace, and joy. From fear comes anger, hate, anxiety, and guilt. It’s true that there are only two primary emotions, love and fear. But it’s more accurate to say that there is only love or fear, for we cannot feel these two emotions together, at exactly the same time. They’re opposites. If 

we’re in fear, we are not in a place of love. When we’re in a place of love, we cannot be in a place of fear.” ~ Elisabeth Kubler Ross 

Therapy is scary because we have to lay down our quills and let someone, who we may or may not trust, see our tender bellies. 

This leads me to the first inroad to successful therapy: courage. It takes courage to admit that we are in over our heads and that some of the tools we’ve used to manage our lives or relationships have been lacking, to say the least. And it also takes courage to believe that someone else might have better ideas than we do. (That’s the part I really grapple with, being the apparent ego maniac that I am.) Furthermore, it takes courage to keep admitting these things week after week, while we slowly develop the wherewithal to begin to think and behave differently. 

The flip side of courage—which isn’t often talked about, but that is the second most indispensable ingredient to getting ourselves great therapy—is humility. 

We think of courage as the staunch conviction that propels us onto battlefields despite terrifying odds, but it is also a willingness to concede that, perhaps, we’ve chosen the wrong battle in the first place. Such an admission can undoubtedly take a (temporary) toll on our sense of personal power and righteousness, but in the long run, it’s better to feel humbled than to continue to fight wars that do not serve us. 

So, here we are, in therapy and fighting every fiber of our being not to snap up our quills and defend our un-ironic idea of who we are, when we discover the real challenge of personal growth, which is discipline, or the willingness to be courageous and humble over 

and over again until something really shifts. Ugh! I never said it was going to be easy! 

I’m not talking about a few sessions either. We must commit to this process for as long as it takes (and we will know when things are moving because it will hurt and feel hopeful and maddening and maybe boring all at the same time) and sometimes, it can take years. That’s right. Years. 

Something I often say to clients is that it took you “x” number of years to land in my office, so don’t be surprised if it takes you “x” number of years to get back out. As I read that back, it seems awfully grim, and yet, inevitably, it is the truth. 

As we begin to accept that we are perhaps a little more—for lack of a better word— f*cked up than we might have imagined, we tend to go through a phase where we’re really mean to ourselves about it. “How could I not have seen these obvious stupid things I do?” “How is there even one person left in the world who loves or respects me?” “Is there even one person left in the world who loves or respects me?!” “What if I never turn this around and I just have to sit with the knowledge that I suck?” 

Well, that brings us to the final word of the day, and the way to not just get—but survive—great therapy, and that is compassion. The thing we need to remember is that we all have work to do and if we’re honestly trying to do that work, we can cut ourselves a break. 

The goal is never perfection (because perfection doesn’t exist)—it is just to do better, to think more clearly, and to connect with kindness in any way we can—especially kindness to ourselves. 

I recall that being a pretty radical concept to me back in the day. I really believed that the only way for me to improve myself was to submit to a constant internal beat down so I could whip myself into shape. I’ve since learned that a beating never equals a bettering and that gentleness toward ourselves and others is a lot more efficient when it comes to making real changes. 

So—courage, humility, discipline, compassion. The foundation upon which anyone can rebuild their lives through therapy. Perhaps it goes without saying that these four ideas are also the foundation upon which to build a rich and purpose-driven life filled with dynamic, satisfying relationships. 

Employ these tactics ruthlessly to become the person you were truly meant to be.