Starting therapy and feeling nervous? Put down the notebook.
Your urge to over-prepare isn't helping. Show up messy.
You may have seen the meme of the woman who makes a PowerPoint presentation of her trauma for a new therapist. I laugh every time I see it because - like all good comedy - it says something true. Starting with a new therapist is a daunting process.
Even after you’ve done a phone consultation, a new therapist is still a stranger. You hope therapy will help with the anxiety and overwhelm you’re struggling with, but not knowing what to expect from those first sessions just adds to the pile of worries.
Starting any relationship requires vulnerability and risk. Therapy above all is a relationship: the same rules apply here. It’s normal to feel nervous at starting. But something important led you here and diving in is the only way through.
Where Should We Begin?
Unlike the meme, you do not need to download your entire history to a new therapist. The relevant parts of your past will unfold naturally as they relate to the present: knowing your family tree before I really know you doesn’t speed things along. I’m a fan of context, always.
So, we will start with where you are. This is true for the first session as well as the fiftieth. Name that you’re nervous. Acknowledge that you aren’t sure this will work or that you feel overwhelmed at starting something new. If that feels too personal or difficult, then you might start with how you’ve been feeling. Why are you seeking therapy right now?
I like to start with what I know from you from our phone consultation. It might sound like: “You mentioned going back to school while working and taking care of your mom who is aging. That sounds like a lot to manage! Tell me about how that works.”
From there, we can go in any direction that makes sense to you: you might want to talk about going back to school and what you’re hoping will happen as a result. Or maybe your relationship with your mom is weighing on you and we start unpacking that part of your life. Or maybe you’re overwhelmed and anxious about holding all this and we talk about that.
Because here’s the truth: it doesn’t actually matter *where* we start because all of it leads back to you and the life you want to build for yourself. Anywhere we start, we will find your patterns, your hopes, your fears. So start wherever and we will find our way through to what’s important and worthy of your attention.
Take a breath with me.
I often sense this immense pressure in people to utilize therapy *just right.* To arrive with a five-year plan, to receive homework tailored to their goals, to hit metrics in a few weeks. And yes goals and progress and growth are all important, but let me be honest with you: that pressure you’re feeling? It’s at least 60% of the reason you are so overwhelmed with life.
If you feel pressure out there, you will feel pressure in therapy. Our patterns follow us like obedient dogs into the therapy room. And that’s where the magic happens. Together, we can name that pressure, get our hands on it, get curious. Figure out what it’s telling you that’s real and important. Let go of what it says that is just bullshit.
When you’ve been white knuckling it for months or years or decades, it isn’t reasonable to ask yourself to settle into a new therapy relationship, figure out your goals, and move forward in a few hours. Instead, we need to take a breath together. You need to feel yourself land, in this life, in this body. Before we embark on something new.
The first few sessions are like I’m meeting you after you have been thrown overboard and are treading water. The immediate priority is to get you out of the water. You need to be able to breathe again. After that, we need to talk about how you found yourself in the middle of the ocean in the first place.
This is how therapy work evolves. We will address your burnout, your worry, your lack of focus. We will meet you where you are, drenched on the shoreline. Then we will peel back the layers - how did you find yourself in this space for so long? how long have you actually been holding your breath? and what does a life look like when you aren’t bracing for impact?
Because this *is* your life. you’re living it. And if we are meeting, then something about it just isn’t working for you. And I want so badly for you to have a rich, full life that works for you. That feels magical as fuck.
It’s So Good to Meet You
Above all else, the first session is about building a relationship. An important relationship that will contain you on your worst week, invite you to look at that relationship you really don’t want to look at, and challenge you to understand yourself and your life differently.
So yes, your therapist wants to know what you’re struggling with and to understand your goals and dreams, but ultimately, your new therapist wants to get to know you.
New relationships all start somewhere. Work relationships begin with an interview. Friends and partners begin with a date. Therapy relationships begin with a first session. It is an opportunity to be the person you really want to be. If you’ve struggled to be honest when it’s hard to be, this relationship might be the first time you try saying what’s real. Maybe you use humor to deflect and therapy can be the space you try saying the vulnerable thing and letting it live in the room, undeflected. Or maybe you’ll finally stop rushing to over-explain and tolerate the vulnerability of someone trying to understand you.
Therapy is often the place we try new ways of being, new ways of relating. You might not even know what you want to change and that’s okay too! Often as I get to know someone, I see their little tells - the self-conscious laughter, the self-criticism that functions as “you can’t hurt me, I already know I suck,” the minimizing their experience so no one else can. And I point that out over and over again so you can learn a new way of being. One that is more aligned and true.
You will likely never know your therapist’s story and life, but you will, over time, have a deep relationship and know how they show up with you. That starts with the first session. Show up as you are and – as clichéd as it is – trust the process.
You’re Ready for This
It’s often intimidating meeting someone new and sharing yourself. However, the first therapy session doesn’t have to be completely overwhelming. If you hear nothing else, hear this: be present in your therapy session. Be present with the nervousness. Be present with the newness and unknown. Tolerate the uncertainty for a beat longer than you’d like to. You don’t need to rush to the next phase.
You are coming to therapy because something is missing or not working in your life. The part of you that wants to share the PowerPoint presentation just wants the hard part to be over so you can get on with the business of living. But this *is* the living: the messiness, the uncertainty, the slow building of something important. So set down the presentation, take a breath with me, and let’s build that magical life.