Most of us do not feel completely at ease sharing our strongest feelings, most intimate fears and worst regrets even with those closest to us. It makes us feel vulnerable, raw and exposed. We wonder if unloading our worries on someone else would seem inappropriate. All these reservations we have, hold us back from speaking up – And that’s when a therapist can play the perfect role!
I’m a Psychologist, and I meet people from different walks of life, trying to deal with problems and emotions of varying magnitudes. First sessions of therapy are usually filled with silences, fidgeting, fleeting eye contact and nervously telling me they aren’t sure of what they’re supposed to say. Some need just a few nudges before they feel comfortable to vent or express themselves, while others take a couple of sessions to settle in. But once they’ve developed faith in me, along with a surety that I won’t push them too hard down uncomfortable paths, they tend to come prepared to tell me about their experiences, in their next few sessions.
Even after deciding to seek professional help, your fear of being judged may linger for a while. It’s reasonable to feel unnerved and antsy in your first session of therapy, but giving yourself some time to develop comfort with your therapist, will help your alliance.
Here\’s what your first session of therapy is likely to be like:
- Environment and Location:
Let me tell you straight up, it’s usually not like the movies. It’s unlikely that there will be a couch for you to lie down on, while your therapist asks you ‘how you feel’ at that moment. Therapist’s clinics are likely to have you sit across from one another at a table, but it may not feel as “clinical” as a visit to a doctor. Occasionally, you may sit on comfortable chairs across one another, without any barriers in between. A skillful therapist will try to put you at ease from the get-go, sometimes by intentionally ignoring your overt nervousness, and at other times by verbally comforting and reassuring you. A pleasingly decorated clinic that exudes warmth is always an advantage and will help you feel comfortable and at ease.
- Understanding your background:
To be able to holistically comprehend your situation and difficulties, your therapist needs to know about your background. Basic introductions will be exchanged, and details including your education, occupation, work environment, family structure and dynamics, social circle, and your support system will be understood by the therapist. At times, specific questions may be asked to elicit important information, while later the therapist may allow you to steer the conversation in the direction you like. Here too, your therapist may ask for clarifications and specifics.
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- History and symptoms:
Eliciting specific symptomatic complaints from you will help your therapist understand your level of distress at the time of your first therapy session. For instance, you may be crying more often, you may feel sad or dejected a lot of the time, you may not feel like meeting friends, and maybe avoiding social events. These are what we call ‘symptoms’. They are usually patterns of thoughts and behaviour that seem to have changed lately, or over time, and are not typical of your personality. Expressing these openly will help your therapist reach a diagnosis, if there is one, as well as help them prioritize and broadly structure your forthcoming therapy sessions.
Your therapist is likely to understand whether you require medication at this stage, or may ask you to undergo some psychological assessments to gain further insights into your situation.
Your therapist will also want to obtain an understanding of your personal history to comprehend what may have led you to seek help. Understanding if there was a certain stressful event that took place just prior to your health deteriorating (also called a ‘precipitating event’), will indicate to your therapist how to approach therapy with you.
Details of any past diagnosis or treatment of a psychiatric illness are important, as well as that of your family members. An understanding of physical ailments you may be suffering from also provides vital information to your therapist.
This detailed evaluation will help your therapist form a holistic picture of your situation.
- Some initial advice and take back from your session:
Remember that for therapy to help you, applying practices you’ve learned and employing new techniques of analysis, is a must. This is one part of the work you need to do on yourself. Your therapist is likely to leave you with some basic insights into your noticeably faulty patterns in your first session and may make some suggestions. They may be simple ideas like changing your daily routine, maintaining better sleep-wake cycles, incorporating exercise into your day, and teaching you some techniques to relax your mind and body. These are simple stress management techniques that all of us should be adept at, but tend to ignore.
Your first therapy session is likely to last 45 minutes to an hour. It tends to conclude with a confirmation of your understanding of the strategies discussed and a scheduling of your next appointment.
Remember that starting small but staying consistent with your practice will ensure that you make steady progress through therapy. It will also allow your therapist to introduce more advanced therapeutic techniques to you once you’ve mastered some basic skills. A few sessions in, your therapist will delve deeper into your past experiences and the subtle reasoning behind some of your life choices.