First therapy session? Here are common questions answered


After college, when I lived alone for the first time, I decided to try therapy. Everything around me was new, and all unexplored territory made me feel small and uncomfortable. But I was also a 23-year-old girl who wanted to talk about dating, and my therapist, a reference from a family friend, just seemed to want to mock it based on my perception of our first appointment. I left feeling frustrated, bored and despised. And I never came back.

But, here's the thing: It's not how therapy normally looks – at least it should not be like that. Nor are you lying on a couch, holding a box of tissues, staring into space, as they ask you incessantly, "How does that make you feel?" Since the notion of therapy is often confusing and misleading, it is time to set the record straight. Here, the psychotherapist Lori Gottlieb – whose new book, Maybe you should talk to someone., follows your journey as a therapist who also goes to therapy – answers all your questions, how to find the right therapist for what to expect from the first session and how to know if it is "working".

You asked, she replied: Find your tip sheet from the Therapy 101 tip sheet.

Thumbnail for what you can really expect from a therapy session, directly from a practical therapist
Photo: Getty Images / FatCamera

1. How do I start finding a therapist myself?

To get started, scan Psychology Today to get a sense of a particular therapist, know your areas of expertise, and your overall vibration, Gottlieb says. Mouth-to-mouth also helps, and you can ask a friend's therapist for a referral to someone who is less close to home. "I had many clients who came to me and said," My friend is looking for a therapist, can you recommend someone? ", She says. "And I absolutely do."

2. Are there any clear signs that my therapist is the One?

Think of therapy as dating: when you meet someone, your feelings will become clearer. You just have to give it time. "In the first two sessions, I can clearly see what this person is doing relationally, but I probably will not mention that," says Gottlieb. "I'm trying to make sure they feel comfortable and when I feel ready to help them, they'll be ready to welcome you."

After a few sessions, Gottlieb recommends that you ask some questions to check-in: "How do you feel in the room with this person? Do you feel that this person catches you? Do you feel like this person is understanding you, listening to you? "And if the answer is a resounding no, say," If you're not clicking, do not assume it's like all therapy, "she says. "Talk to your therapist about this. Is not strange! Sometimes you find that there is something you can solve. And sometimes you find out that hey, it's not the right fit. "

3. Should I see a therapist or psychiatrist?

It depends on what you are looking for. Therapists can not prescribe medications and psychiatrists can. But the two of them usually work together. "If I feel like someone can benefit from medication, I'll refer them to a psychiatrist," Gottlieb says. "From there, the psychiatrist and I joined that patient. It does not matter what you get. Either way, you'll get to the right place. "

4. Should I come prepared with questions or an opening conversation for my first session?

No do not worry. Just chill. "Most people are a little anxious to get in and meet a new person. A first session looks very different from the other sessions, "says Gottlieb, who uses her first interactive meeting as a forum to find out why a patient came to her.

"I guide them in a way that gives me that information," she explains. "I'll say," Tell me about what brought you here today. I'll have lots of questions about this, and we'll have a talk. "Of course, this may be different depending on the specific person you see. So again, if it does not seem like an adjustment, express your concern, try to find common ground, and if it does not work, be prepared to walk.

5. Why do therapists always seem to be fiercely writing notes?

In fact, this is more a fair thing in the movies. Therapists do not usually make notes on the IRL because this is a distraction. "What's happening in the room is so relational, and it's hard to be relational when you're recording what's going on," says Gottlieb. "Sometimes people take notes at a first meeting, so they remember all the information. But after that, we usually do not write.

The copious annotation is more a fair thing in the movies. Therapists do not usually make notes on the IRL because this is a distraction. -Lori Gottlieb, therapist and author

She will, however, scribble a note if she does not want to interrupt a client with her own thoughts. "I'm writing something because I do not want to forget it and I want to go back to it."

6. Is my therapist judging me?

If they are doing the job properly, they definitely are not. "Often, I do not agree with what you're saying, but I'm not judging," Gottlieb says. "If everything you're saying is working for you, there's no reason for you to be in my office. But I have a point of view. " That said, the sense of shame patients sometimes feel about a therapist is a projection of their own insecurities. "They are imagining that I am doing this because it is similar to an experience where they opened up to someone else and were tried," she says. "Another possibility is for them to judge."

7. Will my therapist tell me how to fix my life?

Sorry, but they do not give advice; it's more about helping you find your own conclusions. "It's not that we're holding back from you, but we do not know what the right answer is for you, "says Gottlieb, offering an example of marital conflict. "Could someone say," Should I stay at my wedding? " Well, if it was me, I'd leave. But perhaps I had not entered that marriage in the first place.

Instead, the role of a therapist is to help a client in a particular problem. "In life, there is no" right or wrong "answer in quotation marks," she says. "It is," What is the choice that will make their lives run more smoothly? "

8. Can not I talk to my friends about what I'm going through?

You can – and should – but keep in mind that they may have a certain bias. Friends can say whatever it takes for you to feel better or retain your honest opinions so you do not get angry. "We all want to be good friends and we do not want our friends to feel unsupported," says Gottlieb. "It's not that we're not going to call our friends, but in the therapy room, a therapist can do it in a very skillful way. A way that, if you were a friend of this person, would not be the same way. "

9. When will I see the results?

This changes from person to person and depends in large part on what you really want those results to be. "The goal is" Do I want to make a decision on whether to stay with that person? "That's very specific, or is it," I want to stop feeling useless? ", Asks Gottlieb." That's another thing, it's not like one day, you will not feel useless, you're going to wake up like this. 50% better after a while. But people do not always get up to 100%.

10. How do I know when I can take a step back from therapy?

Simply put, when you can talk about it with your therapist. "If they did not talk about it, maybe they're afraid that if they find out they're not ready," Gottlieb says.

"Our goal is to get you out [therapy]. It's a terrible business model. We want to help you, and part of this is to help manage what you're experiencing and then be able to manage it on your own. "-Gottlieb

But therapists are not here to fool you into seeing them weekly. "Our goal is to get you out," he adds. "It's a terrible business model. We want to help you, and part of this is to help you manage what you are experiencing and then be able to manage it on your own. "

Again, think of dating therapy. "There's a difference between whether you went on a virtual date or whether you sat in a room with someone," says Gottlieb, who meets with customers in person and via Skype. "It's not so much what you see, but how you feel. When someone is crying or telling a really intense story and you are sitting in the protected space of this room where there are no distractions, it seems so different from sitting anywhere with your laptop. Something happens with the energy in the room that simply can not happen on Skype. "

12. Is it therapy for all?

Surprisingly, no. "I do not think everyone should try it," says Gottlieb. "But I think what therapy can do is help you understand yourself and your place in the world. We all have blind spots and most of us have ways of shooting ourselves on our feet without realizing it. Sometimes these forms are small and do not seem to impair the day to day functioning. But sometimes they do. Therapy helps us understand how we relate to the world and therefore how we relate to ourselves. "

Check out how effective mental health promotion strategies are, and therapists themselves depend on them. Also, see how to find a positive therapist for LGTB +.


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