First time talking to a therapist? Here’s what to say

Whether you’ve never been to therapy or are getting to know a new therapist, your first therapy appointment can be overwhelming. This is especially scary for people who consider themselves shy, introverted, defensive, or aren’t used to opening up and sharing their innermost thoughts and feelings with others. According to Miami-based therapist Maria Sosa, MFT, feeling anxious is normal and completely okay. To put your mind at ease, Sosa notes that therapists are trained to deal with all types of people, including those who don’t feel comfortable in their presence at first. “Their job is to work with your anxiety, your fear, your discomfort — you can name it,” she says. “Therapeutic is a place where you can be yourself.”

A useful technique to alleviate some of that anxiety during the first session is to have a script that guides you through what to say the first time you talk to the therapist. Before you start the conversation, however, Sosa encourages you to take a deep breath. “Practicing shorter inhalations and deeper exhalations signals our nervous system to relax, which will slowly work to neutralize our stress response,” she says. “From this low-stress state, we can move on.” Once you’ve calmed down your system, you can start working through the six topics below to get the most out of your first talk with a therapist (or any medical professional for that matter).

1. Let them know how you’re feeling

Sosa says it’s entirely possible to let your therapist know what’s going to happen to you at the beginning or at any point in the session. You could say something like:

“This is my first time going to therapy and I’m nervous. I just wanted to share that and let go of what I’m carrying.”

Sosa reminds us that the therapy is confidential (with some exceptions, the therapist will discuss it with you). “Let that free you and allow you to speak freely,” she said.

2. Share your expectations

Your first therapy appointment is also the best time to share your expectations about what you will cover and get from therapy. “We all create stories in our heads about what our first session will be like,” says Sosa. “Sometimes these expectations are realistic, sometimes they aren’t. Instead of waiting and possibly being disappointed at the end, discuss it with your therapist.”

So what exactly are you talking about here? Sosa suggests something like:

“This is what I imagine therapy looks like…” or “In my first session, I thought this would happen…” You can also say, “Here are some of the results I expected…Is this realistic?”

3. Focus on what is concrete and tangible

Usually, Sosa says, it’s hard to get straight to the point of sharing your deep feelings, but you don’t have to do so on the first session. You can move at your own pace if you don’t feel comfortable sharing everything at once. “Be patient with yourself and your process,” she adds.

Instead, Sosa suggests starting by sharing your goals and observations, and suggests here’s one way to start that conversation:

“I’ve noticed that this is happening now and this is how I want it to look different.”

According to Sosa, “telling your therapist specifically what you’re going through and how you want things to change provides a great platform and starting point for further exploration.”

4. Edit your therapist if needed

If the therapist doesn’t understand something, Sosa recommends letting them know as they will likely be happy to take your feedback and redirect the conversation. “It can feel intimidating, but it’s a great place to practice assertiveness,” she says.

Sosa saying this can be like saying: “Actually, not really, it’s more like this…”

5. Ask for clarification

Also, if at any point during your first therapy session (or really any therapy session), the therapist shares some insight or asks a question you don’t understand. Very well, Sosa recommends asking for clarification. You can reply with:

“What do you mean?” or “Can you ask that question another way?”

6. Advocate for yourself

Ultimately, we’re our biggest advocates for mental health, so don’t be afraid to do so, even during your first therapy appointment. “Although the role of the therapist is to lead and guide, you are also the one in charge of the session,” says Sosa. If something feels too much or too soon, Sosa says, hit the brake and say:

“I’m not ready to talk about that yet. I want to discuss it last. Can we get back to that?”

Advocating for yourself also means ending the therapeutic relationship, even after the first session, if you don’t feel any connection with that particular therapist. “Therapeutic is like dating, sometimes clients/therapists don’t fit together,” says Sosa. “Don’t be discouraged; keep looking; there are plenty of therapists at sea.”


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