Beginning therapy – the first appointment

Alice Ayres reflects on her first session with her therapist. 

How did I feel back then?

When I’m looking back at a difficult period of my life from a position of relative stability, I tend to minimise how bad things really felt for me back then. I think this is a fairly common thing. I think to myself, “Oh, I was just being silly, things weren’t that bad. It was just a bad patch. I shouldn’t have bothered anybody about it. Oh well, there I go again, being over-emotional!” And of course, if I’m feeling good, I naturally don’t really want to revisit the bad times. However, in a highly uncharacteristic moment of foresight, I made notes after my first session reflecting on my experience. I would really recommend doing this. If you have a written record, you can’t play things down later. You have to confront how you felt at that moment. Which is one reason why I’ve been cheerfully avoiding that particular file on my laptop ever since, but I’ve dug it out now.

Reading it back, I realise that I had forgotten many things about that first appointment. For instance, how vulnerable I felt going in, emotionally and physically. It was a miserable February morning and I had a terrible cold. From my account, I can see that I felt a rapport with my therapist from the first. There was a comment that he made that made me feel properly heard for the first time in ages. That was important and made me feel that I could trust him.

One thing I don’t recommend is to go into your first session all fired up to “get your money’s worth” (whatever that meant to my teeming brain) try to explain absolutely everything that’s ever happened to you and collapse into floods of uncontrollable tears after five minutes. My therapist gently brought me back at this point and calmed me down before I became too overwhelmed, and we filled out a standard form for his records. At that moment, I couldn’t begin to imagine how I was going to work on what I needed to get through, but I knew my full name, I knew where I lived, I knew where I worked, and that proved to be a good place to start.

I told my therapist that the things troubling me felt like an enormous ball of tangled wool. I had no idea which end to pull on to try to disentangle it. Some bits of the wool, if pulled, might get the whole thing more hopelessly tangled still, others might come away and turn out to be dead ends, leaving the main knot untouched. (I’m pleased with this analogy. Can you tell?)

At the end of the appointment, I felt tentatively hopeful. I’d made a connection with my therapist and we had made a plan for how we would focus our future sessions and help me tackle the tangled ball of wool.

So here’s my handy step-by-step guide to suggestions if you are preparing for a first appointment with a therapist:

1. Plan your route. Know exactly how long it’ll take to get there, look the location up on Google Street View, arrive an hour early and sit in a coffee shop with a book, if you’re like me and are super-paranoid about public transport.
2. Don’t rush things. Allow yourself time and space to speak about what you need to speak about, and remember to breathe. I found this one out the hard way, so you may not have to.
3. First impressions are important – how do you feel about the therapist? Do you feel comfortable in their company? Do you think that you could establish a rapport with him or her over time?
4. Make notes and reflect after the session. What are your thoughts? How do you feel at the end of the appointment?

What have I missed? Is there anything else that might have helped you before your first appointment with a therapist?

Alice Ayres

The writer of this blog is not a current or past client of any therapist presently or formerly practising at Brighton & Hove Psychotherapy. Alice Ayres is a pseudonym.

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