What it’s like to begin therapy
If you are new to therapy, and even if you aren’t, the first steps into it can feel like a real step into the unknown, and that can be scary and confusing, For this blog I want to say something about what you can expect from our first few sessions together .
In the very first session, whether we are meeting in person or online, I will begin by explaining the working agreement between us. The agreement is there to explain clearly what you can expect from me as your therapist, and to establish the boundaries of the relationship. For example, almost everything we talk about in a session is confidential. However, there are exceptions. For example if you are at risk of harming yourself, then that is information that I might need to share with your GP or with my supervisor. However, ideally, if we came to this point in a session, I would remind you of this, so any sharing of information would not happen without your agreement. Beyond establishing the boundaries, however, this first session is a chance for you, as a client, to get a sense of whether I am the right therapist for you. Whatever form the therapy is taking, feeling confident that you have an effective working alliance with your therapist is fundamental.
In the first few sessions I am likely to be asking more questions that I would in later sessions. This is because I want to understand as clearly as possible what has brought you into therapy, and what you are hoping to get out of the experience. For example, it is helpful for me to understand your family relationships, what kind of childhood you had, as well more basic elements about your wellbeing, such as how well you are sleeping, or whether there are times when you feel particularly anxious. Perhaps you have a clear idea about what you want from therapy, and this will naturally be the focus of the work. Sometimes the focus is less obvious, perhaps you have a vague sense that something is not quite right and this demands attention. In this case it will take a bit longer for the focus to emerge, and requires a little patience from us both.
After a few sessions it may be that the balance shifts away from me asking the questions towards you bringing in what you want to explore. One of the fundamental principles of talking therapy is that by the act of organizing our thoughts and feelings, finding words for them, and then sharing those words with another person, we are doing the work of challenging stuck ideas about who we are, and opening channels for change and growth to emerge. At this stage of the work, the questions I ask might be more an invitation to reflection or to go deeper, rather than straightforward information gathering.
One final thought: you might be wondering if there is anything you can do between sessions to help the process. Perhaps unhelpfully, I don’t have a straightforward answer to this. For some people the one hour a week in therapy is something of an oasis in which it is possible, and encouraged, to slow down and to reflect. What is precious about therapy is its separateness from routine, so we want to keep those boundaries firmly in place. For others, reflecting on what emerges in a session during the week between sessions is helpful. This could take the form of journaling, keeping a dream diary, or just taking a bit of time to check in with yourself about how you are feeling. There is a lot more for to say about this, but I will save it for a blog entry of its own. Thank you for reading.