Andra Brosh, Ph.D.,
Clinical Psychologist providing honest and relevant advice on getting the most out of therapy.

Therapy Notes

What To Expect From Your First Appointment

Most people feel their first therapy appointment “flies by”. You have so much to unload, and to share with your therapist and the session is over before you know it. Most therapists will let you talk more in the first session to learn about you, and to give you the opportunity to express whatever is on your mind. However, the session should not only be about you talking and leaving without any feedback.  A good therapist will leave space to give impressions and some kind of potential treatment plan going forward. You should also get some reflection and insight on what you have shared.

The first appointment can feel awkward and uncomfortable. You may not know where to begin, or what to say. While most therapy doesn’t require any agenda, many clients find it helpful to have some specific things prepared in advance. Your therapist will most likely invite you to just begin wherever you want, without much direction. If you know to expect this, it won’t be quite so weird when you are in it.

Your reaction to the first session after you leave will completely depend on your unique situation. Some people feel like they basically vomited all over the floor leaving their therapist with a big “mess” to clean up. This can lead to feelings of shame or embarrassment because of disclosing so much so soon. Other therapy clients feel relieved and immediately experience themselves as feeling lighter. Leaving the first appointment feeling confused, overwhelmed, uncertain and even remorseful is normal. Just remember that you really can’t know if it’s a good fit, or the right therapy for you by going just once. Of course, sometimes it’s really obvious that you will never feel comfortable with that therapist. More often than not, it’s just a matter of giving it time.

If you feel like you don’t want to go back, it’s your choice but I would encourage you to go anyway. The second and third sessions are more telling, and you may uncover some things you didn’t anticipate. The drop out rate is very high with therapy, and this has more to do with a lack of understanding about the process than the positive outcome of the therapeutic process.

Your Therapist As Healing Tool: The Importance of the Therapeutic Relationship

What many people don’t realize is that the relationships we sustain in our lives are the key to a fulfilling and satisfying existence. We are “wired” to be relational beings, and to connect with others. This means that we actually “need” each other to thrive and grow, and to feel a sense of safety in the world. Knowing this, it’s no wonder that we feel devastated, disoriented and completely thrown off kilter when our relationships falter and fail.

This also explains why we so often feel chronically disappointed and dissatisfied in our personal relationships. Relational needs start when we are young, and if those normal developmental needs are not met adequately, we can spend the rest of our lives trying to get from others what we didn’t get as children. This is probably the main driving factor behind most love relationships; an unconscious hope that our partner will finally provide what has been missing.

This is where therapy comes in. The therapeutic relationship within the framework of most psychodynamic therapy is what heals the pain of the past. Most of our “problems” surface within the interpersonal realm of relating. This is what we often refer to as “triggers” or someone pushing our buttons. Things get activated within a relationship that probably would never surface if we spent all our time alone. The beauty of the therapeutic relationship is that it creates a safe and healing forum in which relational issues can surface or become activated. Once brought to awareness, these relationship dynamics can be played out. Needs from the past can either be met, or grieved, depending on each person’s personal experiences.

Most people don’t realize the power of the therapeutic relationship, and become frustrated only to leave therapy prematurely. This can take time, and it usually isn’t discussed, but trusting the process and being patient will serve you well.

Using Online Dating Tips To Find A Good Therapist

With todays crazy world of internet marketing and social networking, finding a good therapist is not unlike online dating. The amount of options can be overwhelming, and you need to dig through thousands of potential people to find “the one”. As a seeker of therapy you are probably in a similar situation to someone seeking love in that you exist somewhere on the spectrum of eagerness and desperation. Eagerness can lead to hasty decisions and desperation can similarly land you in a “good enough” relationship with a therapist.

If you’ve exhausted your options, and haven’t been referred or “fixed up” with a good therapist, here are some quick tips to make your search more productive and efficient.

1.     Just like with online dating, many people look for a therapist who is visually attractive before anything else. While you will have to look at this person from where you sit on the couch, looks are not the best criteria for finding a good therapist. So instead of focusing on the profile pictures, train your eye to look at more important things like years of experience, or specialties and training.

2.     When looking for a “soulmate”, many people make the mistake of focusing on things that might not be important in the grand scheme of a long term relationship. With a therapist, things like fee, geographical location, and office policies are not as important as this person’s characteristics. Your therapist’s way of being in the room is what will allow you to heal and maintain a good therapeutic relationship. These things would be more along the lines of warmth, reliability, empathy and eye contact.

3.     Similar to online dating, it’s not helpful to make judgment calls solely based on what the person is like on paper. You can’t possibly know if you will like someone unless you meet them in person. Go for several “first sessions” with a few different therapists to see how you feel in the room. It usually takes at least 3 visits to know if it’s a good fit.

4.     A common mistake with online dating is the tendency to focus on what the other person has as opposed to what you need. In looking for a therapist, you must identify what you are needing from this person to find a good fit. Are you needing immediate relief from panic attacks? Or maybe you are looking for a solid, healing relationship that can develop over time. Knowing what you want will help you narrow your choices down based on certain criteria of the therapist.

5.     Doing your homework before going on a first date makes everything go more smoothly. Do the same with your therapist search by digging as deep into the clinician’s credentials and training as possible. The more information you have, the more secure you will feel in making a good decision about who you want to begin working with. Don’t be afraid to ask direct questions, and to really get to know who will be treating you.

The therapeutic relationship can be one of the most important relational experiences of your life. Taking the time to do it right, and not rushing through the process will ensure that you find the right fit for you and your needs.

A loving heart is the truest wisdom. Charles Dickens
In true dialogue, both sides are willing to change. Thich Nhat Hanh
Looking for peace is like looking for a turtle with a mustache: You won’t be able to find it. But when your heart is ready, peace will come looking for you. Ajahn Chah
The people we are in relationship with are always a mirror, reflecting our own beliefs, and simultaneously we are mirrors, reflecting their beliefs. So… relationship is one of the most powerful tools for growth….If we look honestly at our relationships, we can see so much about how we have created them. Shakti Gawain ~

ETCETERA theme by Hrrrthrrr