“Will I be judged? Is talking about my feelings really going to help?”

Understanding the Nerves: Is It Normal to Feel Anxious?

You’re about to press the buzzer and you notice your finger shaking.  You then become aware of your heart rate that’s thundering in your ears, and your accelerated breathing. You take a deep breath and slowly let it out trying to regain some form of composure whilst asking yourself “Am I nervous?  What is causing me to feel this nervous?  Is this normal?”

For many of you, walking into the unknown can be very nerve-wracking, whether it’s your first ever therapy session or if you’ve seen several therapists before.

Psst… Let me tell you a secret… I also get a little bit nervous when having my first session with a new therapist!  (Yes, I feel it’s very important for therapists to have therapy and have an understanding of that first-hand experience of what it might be like sitting in your seat!).  

Common Concerns: What Am I Getting Into?

I remember going for my first-ever session and being incredibly cynical about what to expect.  “How is talking about my feelings actually going to help me?  Will the therapist judge me?  Other people have it much worse than me, am I just wasting the therapist’s time?  Am I wasting my own time and money?  What if they can’t actually help me or I end up feeling worse?”

I had tied myself up in knots by the time I sat in front of her and felt incredibly grumpy and resentful at being there, and we sat in silence for those first few moments.

Me: “I don’t need help, I’m fine!”

Therapist: “I wonder why you’re questioning your decision to be here now?”

Me: “I guess I’m a little bit scared of where this process will take me, can I trust you…?”

The Structure of a Therapy Session: Beginning, Middle, and End

Each session has the same structure, a beginning, middle and ending.  Some of these sessions will be led by you (the client) and some will be more directed by me (the therapist).

1. The Beginning: Contracting and Building Trust

In the first session ‘us professionals’ call this part the contracting stage.  You will have already received an information pack via the portal you signed up through and now we have an opportunity to discuss any queries or concerns you may have regarding the contract, therapy itself or me as your therapist.

When you meet a therapist (me) for the first time, powerful emotions can be brought up for you.  I might remind you of someone from your past or present and depending on your relationship with that person (we call this transference) its definitely worth exploring these strong emotions further.

You may also be harbouring feelings of mistrust towards me or think of me as ‘the better other’ and secretly hope that I can fix you.  Hate to say this, but its not my job to tell you what to do.  However, I can help you find these answers within yourself (cringe, I know! But it’s true!).

Next, I will guide you through a series of questions so I can get a better understanding of where you are right now with any current mental health symptoms.  This also helps you reflect on how you’ve been feeling over the last fortnight and may jog your memory.

Talking of memory, some clients find it useful to write a list of things they would like to discuss, or you can just wing it in the moment and go with what’s happening for you there and then, totally up to you!

2. The Middle: Delving into Your Story

Creating a Genogram: This visual tool maps out your family and significant relationships, helping identify patterns and unresolved issues.

This is where we get to the nitty gritty!

I’m a big fan of doing ‘Geno-grams”.  These are similar in structure to a family tree but it also includes friends, exes and any significant others who have an impact on your emotional wellbeing, from the past or present tense.  This really helps me get an understanding of how you relate to other people, spot any unresolved issues, possible trauma (the spectrum for this is huge), grief and loss that may be current or still unprocessed from your past. It ends up looking like a complete mess with lots of lines and scribbles, luckily for you, I will understand it and be making mental notes on what needs focusing on throughout your therapeutic treatment.

We will still be sussing each other out during this stage too, and my hope is that you will start to feel more comfortable as the session goes on.  I will check in with you regularly and adapt myself accordingly depending on your needs at that moment.  I want you to feel safe enough in this space to fully express yourself, be it crying, swearing, punching a pillow or even just sitting in silence for a bit!  

3. The End: Reflection and Goal Setting

Towards the end of the session and will make sure there is an opportunity for you to reflect back on how the session has been for you.

I will summarise all the main discussion points and together we will come up with a plan.

This will include:

• Goal setting- what you want to achieve from working with me.
• Homework (I can hear you groaning!). This is really important because it will encourage you to put into practice anything discussed during the session or reflect further on points made.  Most of the work on yourself occurs between sessions.
• Grounding- ways to self-soothe and change unhealthy habits for better healthier ones.  Intense emotions will be brought up during your sessions and the week between each session may feel like a roller coaster, some weeks you’ll feel up and others you’ll feel extremely low.  It’s all part of the process and geared towards becoming a more authentic version of yourself.
• Therapeutic plan- by the end of the first session we will both have a clearer idea of what’s needed going forwards.  Short- or long-term therapy.  This is not binding though, you will always be in control of how many sessions you have whether it’s weekly, bi-weekly etc depending on your financial circumstances.  I will plan the sessions accordingly.

Embracing Change: The Journey Ahead

My hope for you is that the safety of my therapy room will enable you to implement change where you feel it’s needed and that I can guide and encourage you in a non-judgmental manner.  I will always be transparent with my thoughts, feelings and behaviour and this will assist in building the foundations of trust between us and help you leap into the unknown.

Your therapist will ensure you feel comfortable and safe throughout the session, adapting the conversation based on your emotional state.

Conclusion: Taking the First Step

While the thought of your first session may be intimidating, it’s an opportunity for growth and understanding. Trust the process and allow yourself to be vulnerable. By doing so, you’ll pave the way for a more authentic version of yourself.