What actually happens in a therapy session, who speaks first, how does it end - There are so many questions when you haven't done something before. I've been a client and a therapist, so am going to explore this topic from my personal experience in both angles today.
As a client
I sat in my car for about 10 minuets before my first session, I was early - I always am. I was so nervous, what do I say, what if I don't like her, what if she doesn't like me. I went in and sat down, and really struggled with what to say first. Lets be honest you are quite unlikely to start divulging trade secrets within the first 5 mins of meeting someone. I didn't even really think I needed formal therapy, but as part of my own training it was a requirement. I sat nervously on the couch and after she introduced herself and went over the service she provided, I then started a verbal waterfall of stuff that seems mundane. Mainly as a way of filling the gaps, I hated silence - it took me many years to find out why and become comfortable with it. That first session I don't remember much of substance being said, when I looked lost on what to say next she gently moved me along, with a question or reflection. Sometimes we sat in silence until I made the next move. It felt like a game in a way, who's turn was it to go and what would they do? I never felt pressured into talking about anything in particular, she let me lead the way, every time. I was talking about something particularly annoying to me and I pointed out I hated someone's judgemental attitude, earlier in the session I talked about how I felt I was a judgemental person. She brought those together for me, she didn't scold me she simply asked (I am paraphrasing her here) if I felt like I see something in that person because I feel like I do it and it annoys me. That was my first big breakthrough with her, Yes...yes I think I did - was I annoyed with this person because I see how I must look and that's actually how I felt about myself?? After this I opened up more, because I started to get to know her and trusted her words. Those sessions changed my life in so many ways, I only did 10 but that was enough to be the catalyst to how I shape my life every day. I took those reflections, that she helped me find, and made something of them. Turns out I did need therapy, and that woman changed my life in a lot of ways. But it was me, I made the changes I needed to make - did she help, yes I couldn't of done it without her. It feels like, to me, winning an Oscar and thanking the casting director for the opportunity.
As a therapist
My first session as a therapist was more nerve wracking than my first as a client, all the same questions came back, what If they don't like me, what if I don't like them, who is going to speak first? Over time, with experience these thoughts stopped and it became a wonderful flow I got into. But what are the practicalities of a session, you may ask? Well I do go onto most sessions with a rough idea of what is going to happen, if we know each other well than you may have spoken to me about a number of issues and I can confidently ask you questions, however it would be foolish to think I know it all. A session may go a completely opposite way to the last one, something may have happened and you need to figure it out urgently, priorities change and with it so do your goals for the session. Logistically of course they are mainly the same, they last 50 mins, about 10 mins towards the end I will let you know we have 10 mins left so we can start to wrap up safely. How those sessions go though, what you want to talk about and how you want to deal with them are totally up to you. We will probably start with a how have you been since the last time we met and go from there, if we don't know each other I will ask about your reasons for coming to a session today. I wont pry into topics because I'm nosy and want to know, I wont force you down one path or another. Sometimes I can see you don't know where to go next, and that's when I step in to help, either sitting with you in silence or prompting you. Silence can be hard to deal with, sitting in it may bring up something for you. I may challenge a belief or though pattern you have - to help you see where, what, why, when. I may connect some dots that you left me 30 mins ago, or even a few sessions ago and ask you about them. I'm aiming to provoke thought, not direct it, but to help you harness it and see what power you can gain from it. Sometimes I can see you need more direction from me, then I may try different therapeutic techniques like cognitive behaviour therapy, psychotherapy or solution focused brief therapy. I wont sit and explain every move, I will gently move into an area I feel you maybe headed. Sometimes I will teach you something, a coping skill or a strategy to deal with anxiety in the moment. My goal isn't to make you dependant on me, it's to help you be dependant on yourself. So that when we don't work together anymore, you can still go back to those things we discussed, those strategies and utilise them. When we finish our work, I do shut the virtual door but I leave the window open.
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