How Do You Start Your First Therapy Session?

So you’ve found a great therapist you feel good about working with and scheduled an appointment. Now what? Starting therapy can feel like both a relief and an overwhelming task. When you’re at a point where you seek professional help, there’s probably a lot going on you want to talk about, and it can feel vulnerable or awkward to dive right in with your biggest issue with someone you just met. So where do you start?

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Here’s a helpful way to think about choosing discussion topics in therapy: if you’ve ever had a professional massage, you know that sometimes a massage is light, relaxing, but ultimately not helpful if it doesn’t get in and work out some knots in your muscles. Sometimes you get a massage that feels like your muscles are being pummeled relentlessly, and you can’t wait for it to be over. And sometimes you get a massage that is just right: mostly relaxing, with occasional moments of discomfort you need to breathe through as knots are worked out.
 
Most of the time, therapy should feel like this last example: mostly good with some moments of discomfort as certain knots are teased out. If there’s no discomfort, there’s no progress, but if there’s continual discomfort, you’ll get overwhelmed, shut down, and want to stop therapy.
 
As you approach your first session, it can be helpful to think about the various issues and topics you want to discuss and rank them accordingly: is this a “lighter” topic, or a topic that will feel really intense and scary to discuss? If it’s the latter, consider giving a brief introduction to it, but telling your therapist you’d like to work up to processing it as you get to know each other. Then find another topic that feels light or medium pressure. You’ll still get therapeutic benefit, but won’t be spooked off of therapy.
 
Even though the therapeutic relationship is structured and offers the protections of confidentiality, it can still take some time to build up trust. And it should! It’s okay to take your time and work up to discussing scarier topics. Make sure your relationship and communication with your therapist is strong before getting super vulnerable. No therapist expects you to bare it all right away.

​If you're ready to start therapy, schedule a free consultation today.