What To Expect From Your First Therapy Session

In normal times I would start this piece with a rundown on what to expect when you’re walking into your therapist’s office for the first time, but given it’s COVID-times, this is both a rundown of my experience going to therapy in-person for the first time and what I’ve learned about doing virtual therapy for the first time.

The biggest caveat I want to introduce early on is that I started therapy over six years ago. It’s been a while since I had a first session with a therapist, but I can still remember the nerves I felt while sitting in the waiting room. I was the first person I knew who was going to therapy as an adult and the only other point of reference I had was a horrible experience I’d sat through when I was 11 years old and coping with my mom’s death.

From conversations with friends and strangers, I’ve learned that the two biggest hurdles to actually starting therapy at the beginning are finding a therapist and actually getting to the first appointment.

Finding a therapist

This post will focus mostly on the experience of going to your first session, but if you’re still in the process of looking for a therapist I pulled together this doc with a spreadsheet that may help. I wrote it pre-COVID, so my only added considerations would be to still prioritize someone who is physically close to where you live/are staying but who also is offering virtual sessions through quarantine. The last thing you want is to hit it off with someone who you may want to eventually see in person, but wouldn’t be able to.

My first therapy session

I was days into having turned 21 years old the first time I went to therapy. I was still on Medicaid and my therapist pulled shifts in the local clinic that served my low-income neighborhood. I didn’t get much choice when I was set up with an appointment, since she was the only therapist available in the clinic. She was also incredibly booked given she only practiced there about two times a week. A lot of the variables that I encourage others to factor in when searching for a therapist, I know can be impossibilities for others. I didn’t have the privilege to be picky because I was locked in with whatever mental health help Medicaid could afford me. All this being said, I lucked out. I completely lucked out.

My therapist is a wonderful, Latina who beyond being so intelligent is the most empathetic and generous human I’ve ever met. On Day 1 though, my biggest thought was simply that she wasn’t scary. When I walked into the back room of the clinic with its full-general doctor setup and the desk and two chairs we used as our therapy corner, I didn’t know what to expect. My only other interaction with therapy was when I was a kid and the children’s therapist pushed and prodded too early into my grief about whether or not I was idolizing my dead mom. It ruined me for therapy for over a decade.

Stepping into my new therapist’s presence made me feel immediately respected. I think too often we’re encouraged to have our first therapy session be one of major epiphanies and one where we’re completely understood from day 1. I personally think that’s the wrong way to approach therapy. It takes way more than one session to start feeling seen in therapy, mostly because there’s a good chance you haven’t even really been seeing yourself yet. Teaching someone else a language you’re only still learning takes time.

What I think should be a nonnegotiable during your first session is to feel respected and like your therapist is curious about who you are and why you’re there.

RESPECT

The need for respect in any relationship doesn’t suddenly disappear when you’re getting to know your therapist and they are getting to know you. You’re both figuring out whether this will work and how to best speak to each other. Respect is the first step to being able to fully trust that relationship with your most protected secrets. During your first session, gauging whether you feel respected or whether you respect the manner in which your new therapist handled those few minutes together will help you determine whether you feel good enough to go to the next session you all put on the calendar.

Curiosity

I think this is the hardest part about first therapy sessions that maybe doesn’t get talked about enough. Someone is suddenly incredibly curious about where you are in life, the hard parts that you’re coping with, the good parts that made you who you are, or simply why you’re sitting across from them. During my first session my therapist’s curiosity felt both so needed and so intrusive. I’d never talked openly about pretty much anything I was telling her. Whether it was my feelings about how I was coping with being my grandmother’s caregiver or what life being a caregiver and full-time student was like, I’d never talked about it because no one ever asked. It takes time to get used to that level of curiosity and interest in your life. It’s okay to feel uncomfortable with it on your first session or during your 500th. I’m years into therapy and if we’re talking about something that’s new for us to talk about — whether it be something new that actually just happened or revisiting something from my childhood that I’m just bringing up — it still takes me time to get used to the follow-up questions my therapist delivers. Sometimes I have the answer and sometimes I don’t.

You don’t have all the answers

I read in a book once that while you may walk into therapy for a specific reason it won’t be the only reason to actually come up. You being there is a conglomeration of so many different factors. Giving yourself grace to hold that you may know some things but not all the things will take the pressure off of you needing to find the “right” answer any time you’re asked a question or chasing a train of thought. Just last week my response to my therapist was, “I don’t know, I don’t actually think I’d thought of that at all until right now.” Therapy isn’t about arriving with answers, it’s essentially your training ground for learning how to best find answers that make sense for you.

More than one “date” will be needed

Therapy is like dating. Therapy is so much like dating that you will have to go on more than one date with that same person to figure out if you’re a fit. You may have to go on a date with many different people to figure out what you’re even looking for. Your first therapy session will rarely be where you figure out if you’ve met the right therapist. Respect, curiosity, and space for learning will all be essential to get you to session 2, but they won’t be the only things you consider when deciding to keep coming back after say session 5. Like getting to know anyone, you need to feel comfortable, trustworthy, but also trusted and encouraged. You’ll want to gauge if it’s actually helping you cope with what you’ve walked in with, while understanding that “helping you cope” and “taking all the bad away” are not synonomous. Therapy is not a instant cure-all for all that is troubling you in your life. It’s a slow build that takes time because it’s about you developing a better toolkit to manage your life, your therapist is your partner and trainer in that journey. After many sessions, the question that will keep you coming back to them is if you can answer wholeheartedly that you feel like no matter how slow you are actually learning how to human better thanks to them.

I’d love to hear if you’ve started therapy during COVID or if you’d add anything else to this list of what to expect during your first session.