So many clients tell me that they're unsure what to expect from the consultation, or that they worried about it beforehand, that I thought it might be helpful to open the door on what happens. Whether you're considering therapy for the first time, or you’ve experienced counselling or psychotherapy before, it's natural to feel a mix of emotions – from ambivalence, through apprehension and even fear, to hope and excitement. I can’t predict exactly what will happen in the initial consultation, or in the first few sessions, but I can give you an idea of what you could expect.
Embracing the unknown?
Embarking on therapy is a courageous step towards taking control of your mental well-being. It's normal to have concerns about what therapy may entail. You might wonder what the sessions will entail, and what you'll uncover about yourself. You might fear that the therapy will unfold in a way that is outside your control, or that you will be overwhelmed by emotions that you’ve kept tightly packed away for a long time.
Creating safety is never more important that at the beginning of therapy. Without a feeling of safeness, a sense of trust, and the knowledge that you are not being judged, therapy cannot begin, or help. So that is where I focus at the outset of therapy; working to create safe space for you to explore your thoughts and feelings, and building the therapeutic relationship.
Yes, alongside coming up against feelings and behaviours you know all too well, it is likely that you will encounter the unknown. But there is no expectation that you will embrace this. We can accept that it is likely to be difficult and possibly overwhelming, as much as it might be ultimately transformational. So rather than building an expectation of embrace, we can simply accept (and even hope) that you will encounter the unknown, and we will work together to process that, and equip you with the tools and resources to navigate it.
The initial session
Your initial consultation might well feel daunting: you are meeting someone you don’t know, and preparing to talk about things that are hard for you. That is why we allow a little more time for this first meeting, and why I aim to support you to take it at your pace, and to express yourself freely yet with care. We do not have to cover everything; this is not your one chance to set out what you need to say. I may be curious about something you say and ask more. I may prompt you to share something about a particular topic, and I do have some questions that I need to ask, to ensure I have the information I need to assess whether my service can support you. But overall, this meeting is your space to share what you’d like to, and for you to gain a sense of what it would be like to work with me.
The relationship really is the most important determiner of the success of treatment (many research studies have shown this). So it can be helpful to think of the initial consultation in this light: how do I feel in the presence of this person? Can I imagine sitting in a room with them each week for a period of time? Do I want to get to know them, and do I want them to know me? Of course, relationships take time to build. But many of us have an immediate sense of a person, and how we feel when we are with them. I invite you to listen to this, to and trust your innate knowing.
It could be hard work
This warning applies to the whole of the therapeutic process. While there will be positive progress and change, and hopefully moments of joy, laughter and true connection, there will also be sessions that feel hard.
It can be useful to bear this in mind ahead of the first meeting. Although I will pace the session, and perhaps encourage you to slow down or not share everything all at once, you might nevertheless feel exhausted after the consultation. You might feel like you have done a work-out or had a late night. The physical exhaustion you might feel may be confusing or alarming; after all, you’ve just been sitting and talking. But you’ve also been giving space to upsetting emotions and psychological difficulties. These are held in our bodies. So our bodies feel tired! Even experiencing my support, my curiosity and my responses demands your energy and attention. And, like going to the gym, while you know it will benefit you in the long run, at first it feels exhausting.
It could offer a sense of relief, like a weight lifted.
Not everyone feels the physical impact of a first session like this. Many people leave their consultation feeling lighter, seeing the world more brightly. They experience bodily the sensation of having shared the burden they have been carrying on their own for so long. They might feel buoyed, encouraged and lifted by new insight or awareness, which often comes from this very first meeting. They might feel energised and ready to begin.
And for some it takes longer to know how it feels. Some continue to come to this knowing during the first few sessions. There is no right or wrong. Everyone is different, and everyone’s experience is valid and to be discovered. The one thing we can know, is that experience will evolve and change. Our first meeting, could be seen as creating the safe space or the frame within which that can happen.
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