I’ve been working on myself a lot recently and realized that I can’t do this alone anymore (or rely on Internet strangers to talk about my issues). I feel like I finally have the strength to ask for help in the real world. I’ve just never done this before.

That’s awesome! Be sure to acknowledge your own effort and reflect on the progress you’ve made, especially whenever you’re feeling stuck or frustrated about the things you feel still need work.

What’s it like? Is it warm and fuzzy, or cold and analytical? (Does it feel like someone is providing care and comfort, or is it more like an emotionally detached scientist meticulously studying you and scribbling down notes while mumbling “Hmm, I see, I see” while you yap at them?)

Maybe yes, or maybe no, or maybe some or all or none of the above. As others have noted, therapists can come to their work with a variety of different backgrounds, potentially trained in a variety of different methods and philosophies, with different ideas about the how and the why and the nature of the patient-therapist relationship. They also come with their own personalities, which influences all of this. A good therapist will do their best to make the interaction something that works for you. Even so, as others have mentioned, sometimes it can take time to find a good fit. The first time I saw a therapist, I felt like it just wasn’t clicking, they weren’t understanding me, and we weren’t getting anywhere, even after a few months of weekly sessions. So I stopped going and languished for a while. Eventually I decided to give it another try, and found someone who really helped me make progress with my anxiety. Much as you couldn’t get along with just anybody as a roommate, or not just anybody could be your best friend, or not just any shoe will fit your foot, so too can not just any anybody be a good therapist for you. So, don’t get discouraged if the first therapist you meet doesn’t seem like a good fit - it happens sometimes.

Do you start to see results right away, or are things slow at first?

Something like treating a specific phobia (e.g. spiders or elevators) often sees noticeable results faster than treating complex trauma from years-long childhood abuse. It just depends. It depends what you need help with, what you’re willing and able to tolerate, and the methods used, but generally progress is slow to get started. Expect the first session or two to be pretty much just the therapist getting to know you, what your concerns are, and where you’re already at with the work you’ve done yourself. Also, working through trauma and anxiety and big feelings is really hard sometimes, so expect there to be difficult points where you feel like you’re not making any progress, or sessions that make you feel emotionally drained. But, if you feel like something isn’t working, or it’s causing you too much distress, or any other concern, then don’t fret or hesitate to say so. Any half decent therapist will listen to your concerns and do their best to help address them.

How much stuff is recorded in a database that other systems can look up?

It depends what you mean by “other systems”? Some electronic medical records systems are accessible across an organization, and rarely in between organizations who use the same software, but even then it should only ever be accessed by someone who is involved in your care/treatment. And even then, psychotherapy notes typically have an extra layer of privacy and legal protection. Nothing is automatically getting sent to like a government database, if that’s what you’re concerned about (at least, not in the USA - but I assume/hope it’s similar in most places?). If you use insurance, they’ll have to give the insurer certain details like a diagnosis code and length of sessions, but nothing more detailed than that.

I wish you well! It has been a bumpy road sometimes, but going to therapy has significantly improved my life.