Real Men Don't Write Blogs

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Your First Therapy Session

Humorous advice for people seeking psychotherapy for the first time

Whenever I tell people I'm a psychologist, they often assume I'm a clinician, but I'm not. I have never practiced psychotherapy. This is certainly not to say I don't know anything about therapy. I was in therapy before I could walk.
Of course, I'm kidding. They don't do therapy with pre-toddlers, or at least they didn't when I was growing up. But I did have my first session when I was in my teens -- back in the ‘50s, when this was not common -- and I have sought therapeutic counseling on and off ever since. So, as a public service, I would like to tell my readers who have never been in therapy - all three of you - what a first appointment is like.
But first, to assuage your curiosity, I can tell you that my first session was for a specific problem: I was having trouble studying effectively. After giving me several tests, including the classic Rorschach -- where every inkblot reminded me of roadkill, namely the stray cats who were constantly getting run over in our Brooklyn neighborhood -- the therapist concluded that I had a "mental block" about studying.
For this my parents paid good money; and none of us realized at the time that he had provided no information whatsoever. Of course, I had a mental block about studying. His conclusion was at the same order of insight as if you go to a therapist because you are checking to see if your door is locked five times before leaving the house and the therapist says, "You have a compulsion about checking door locks."
But that's enough about me. There you are, having never gone to a therapist before, and you're about to have your first session. Relax. The most important thing to remember before you get to the therapist's office is that all those worries you have - I'll sound silly, I'm neurotic, I look weird, I'm obsessed with herring salad - are all concerns that your therapist has heard before (well, maybe not the herring one, but he or she will act like even that is the most normal thing in the world - at least at your first appointment).
I cannot stress this too much: The therapist's office is the one place where you really don't have to worry about how weird you sound. Remember, this is someone who has decided, for reasons few of us can understand, that she would like to spend her life dealing with nut jobs. If you come in sounding too normal, she'll be bored.

To help you prepare, here are the answers to some FAQs people commonly have when they think about going to a therapist for the very first time in their lives.

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Disclaimer: Keep in mind that I'm just having fun here, though some therapists may wince if it hits a little too close to home.

Should I dress up? Jacket and tie? One of my best outfits?
Sure, if you want to get into a whole discussion of why you felt it was important to put on your best clothes to see a psychotherapist.

What will be the first thing my therapist will ask me?
Do you have health insurance?

Is it normal to feel uncomfortable at a first therapy session?
As far as I'm concerned, it's normal to feel uncomfortable any time.

Will I be expected to reveal my innermost secrets at the first session?
No, but it will make your therapist's day if you provide at least one juicy little tidbit.

I wouldn't want anyone to know what I'm saying to my therapist. Will everything I say be kept in strictest confidence?
Aside from the fact that your therapist will have to tell your insurance company things you wouldn't want anyone to know and that she will probably be unable to resist telling her partner about your bizarre sexual fantasies, the answer is yes.

Will the therapist secretly be evaluating and judging me? Is there a chance that he will criticize me or laugh at me?
Yes to both questions. Your therapist is only human after all, and if you are total basket case, what do you expect from him? He's not made of stone.

Will I need meds?
Yes. Maybe not right away, but eventually, everyone goes on meds.

What happens if I can tell very quickly that this isn't the therapist for me? What's the best way to make my exit?
Above all, get to the end of the session before you announce your intentions. So all you have to do is hang in there for the 45 or 50 minutes. It won't go longer. No matter what you have to say, your therapist will never, under any circumstances, let the session go even seconds beyond your allotted time.
So, as soon as he says, "I'm sorry, but our time is up for today," just get up and say, "No, our time is up, for good." If you try to leave before the session is over, your therapist will probably say something like "So what do you think it is about your life that makes you unhappy with me?" Or perhaps "Do you always quit things so early? Maybe that's part of your problem."
And you could be hooked for years.

Mark Sherman, Ph.D., is a psychologist and humor writer.

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