What happens in your first therapy session with a psychologist?

Sometimes it’s a really difficult thing to book an appointment and come to therapy.

So difficult, in fact, that some people resolve never to do it.

For others, it’s something that they put off, day after day and month after month; sometimes the waiting time can go on for years.

It’s not comfortable asking your mind to talk about things that you worry about or deeply fear, or perhaps feel humiliated or upset about.

Possibly you may resolve never to go to a therapy session.

If you feel that way – why not try this (go to course).

If you’ve ever wondered what a fly on the wall might hear in a therapy session, then read on (not that I’ll tell you what the fly actually hears).

This article will give you an idea of what happens in a therapy session – and that might help you feel a bit better about booking one.

What you can do

If you’re coming to a therapy session and you’ve gotten past the first hurdle (actually making the appointment) there are things you can do that will make it a more fruitful and useful experience.

You might like to take some notes the preceding week of the problems and things that bother you and any questions you have about your thoughts, feelings and behaviours.

These ideas help keep the session on track, although I will ask you lots of questions so we can unearth what’s important.

Remember, we’re on an exploration journey, so there is nothing that is right or wrong, just experiences that we need to think about, put together, and investigate, so we can understand.

I love the magic of brains. The human brain assembles, analyses and interprets information at lightning speed and in a plethora of ways that we often cannot explain.

However, we’ll use what research tells us about thinking, feeling and behaviour to help you figure out your mind, so you can get the absolute best out of it.

When you arrive, take a deep breath and try to open up your mind.

The theories and ideas I like to work with

I have strong attachments to a number of theoretical principles that I keep in mind all the time I’m working with you.

Here are the important ones:

• Learn and understand how YOUR brain works. Your brain is the only one that processes and makes sense of information your way. You are unique.

When you know about brain function and how different parts of your brain behave, you will understand why you often do the things that you do.

You will no longer be surprised when you notice thoughts and feelings that don’t make sense or struggle with behaviours since you’ll have meaningful skills, tool and tactics you can use.

• Your brain is capable of change. You are capable of being different – completely different if you wish to be.

Although it’s easy to say and believe that brains can change, actually doing it is difficult.

That’s because most of us instinctively resist change.

We’re often stuck and powerfully anchored into who we think we are, so change is not always appealing.

• Your fear, anxiety, stress and loneliness will be very different if you use self-compassion.

The more you resist these feelings - fighting them, fearing them, fixing them, criticizing and belittling them – the more you’ll notice they persist.

When you change your response to a caring or soothing comment or movement, you are using self-compassion.

Self-compassion is the antidote for automatic thinking that critically puts you down all the time and reminds you that you aren’t ‘good enough’.

• Your brain wants to make sense of your world. It never stops thinking and problem-solving and making meaning.

That’s because your brain is always searching for coherence and cohesiveness.

Brains love integration – between your thoughts and feelings, between the past, present and the future, between what you think and what you do.

Part of your task is to develop this integration – for example, between who you are and how you behave, between what you believe and what you do, and between what you think and how you feel.

• You are not your thoughts. You are not your feelings.

You may believe you are what you think and feel.

Sometimes you may not believe that you are what you think and feel.

You are yourself. And your brain produces thoughts, and feelings.

Since you can notice these thoughts and feelings, then you are obviously not them.

Well then, you might ask, who am I? (I’m glad you asked).

• Who are you? To answer to this question, you’ll have to explore further.

To go deeper into your thinking, dreams, memories, passions, values and visions.

Finding your purpose means you can begin to build a meaningful and fulfilling life.

You’ll also find the calm and still mind you search for.

What I will do

I’ll introduce myself and make sure you know who I am and how I work.

I’ll ask you about previous therapy experiences – simply because these may colour how you feel about therapy. You may have had some wonderful or awful experiences with therapy – so it’s helpful to know how it feels for you.

If you haven’t been to therapy before – you may find the beginning of the session a little unsettling. I’ll try make you feel relaxed 

I’ll quickly go over the ethics and some guidelines you need to know about therapy, and I’ll reassure you about confidentiality.

I’ll ask you if you would like me to talk about the concepts and ideas that underlie the therapy we are doing. This is particularly helpful if you don’t know much about therapy, as you’ll get some idea of how we tackle issues and what you can expect to get of out the process.

Many people prefer to get started instead of hearing about these ideas. If that’s what you prefer to do, we’ll skip the explanations for later.

We will spend most of the time in the first session doing an assessment of what is happening for you. We’ll talk about the problems you face, what you think is happening and how it affects your thinking, feelings and behaviour. I’ll ask you lots of questions, because there are factors that are important for me to know.

If you are feeling overwhelmed or a facing a crisis of some sort, its important to talk about this, as we will try to leave some time to give you some strategies that will help you alleviate any distress.

We’ll leave some time at the end of the session, to talk about what we both think about what is happening and I may give you an exercise or a strategy you can use to get started on making changes.

Sometimes I’ll do a breathing exercise with you or demonstrate mindfulness techniques you can use.

What we do together

Together we assemble all the information and ideas you have and combine them with the theories and experience I have, and we try to make sense of what’s going on for you.

It’s a creative process which means we work together – exploring different ideas and interpretations. It’s a bit like working with a whole big box of jigsaw pieces and looking for missing bits so we can begin to understand the whole picture.

Sometimes we have to do some experiments (thinking and behaviour ones) to find out what is really happening inside your head.

In the end you will know so much more then I ever will about you, that I need you to work with me to understand what is really happening in your brain.

At the end of the first session, I’ll give you two assessment questionnaires that you can take home and complete at home. They are detailed, thought-provoking and may take some time.

When you do these out of session, you will free up the second session for us to start working, rather than continuing with assessment.

We may talk about the theoretical ideas that underlie problems you are experiencing.

You may have medical labels and diagnoses that you use to describe your problems, but I’ll most likely to take a problem-solution approach to whatever is happening for you.

You are starting on path that will change your understanding of who you are forever.