The majority of my clients, when I ask how they’ve been feeling in the run-up to their first session, have told me that they’ve been dreading it. They almost didn’t come, they nearly turned back just before it started, they spent the week before trying to decide whether to cancel. So if you’ve booked yourself a therapy session and have become increasingly filled with dread; you’re very normal.
Seeking and booking therapy is a massive hurdle. Whether you’re still thinking about it, or you’re booked in and are awaiting your first session, it’s really important to acknowledge that this is a big step, so give credit where it’s due.
Therapy is rarely a case of having a couple of sessions and feeling all better. This expectation can be detrimental to our mental health because if we’re not feeling totally different/better in a couple of weeks, we can feel like we’ve somehow failed therapy. This is, of course, impossible. But it’s a very real feeling if we haven’t adjusted our expectation of how therapy works. Of course, depending on the reasons we’ve booked therapy, and on what type of therapy we choose (for example, CBT and coaching often run shorter term, often 6 week courses), the number of sessions we want will vary. It’s a good idea to have a think about what the expectation of the therapy is, and it might be really useful to actually discuss this with our therapist in the first appointment.
Reflection and list-making
I’ve seen a lot of advice given about preparing for your session in this practical way of list making and note-taking.
It might be useful to spend a little bit of time reflecting on our mental health. You could try journaling, noting down any triggers, making a list of things that have been working for you, things that have not been working, how you’ve been sleeping etc. This makes some people feel reassured that they’ll have things to say, and it can make us feel like we’re getting a bit of a head start on the process. Which it might!
However, know that this is also not necessary… The onus is not on you to do any of this preparation whatsoever! It’s just that it makes some people feel more calm and in control. Sometimes we’re reluctant to engage in therapy because we’re not sure if our reasons really warrant professional help… You deserve to take up that space no matter what. We might not be exactly sure why we’re going to therapy, and we just want a space to explore or reflect and need a non-judgemental sounding board. You don’t need a list of ailments, triggers or “issues”. If you’re anything like me, you’d rather go in there with no idea where you’ll start.
Always keep in mind that this is your therapy - you do it however you want. This is not an interview: you’re not there to impress anyone. The therapist's job is to be free from judgement, to listen authentically, and to tailor your therapy to you. Don’t forget that!
How will you get to your appointment?
Sometimes the unknown of a journey/route/mode of transport can add to our anxiety; especially if it involves public transport and any changes or stops we need to make. So planning the journey out beforehand can really ease nerves about this and it helps us to feel like we’re taking a bit of control over the situation. It might be a good idea to familiarise yourself with the actual journey too, so that we feel as comfortable as possible just before the appointment. If we do the journey once or twice, we can see the outside of the building or plan where to park if we’re driving (parking is always a massive stressor for me), it can help to alleviate the feeling of it all being such a big unknown.
Hopefully your therapist will discuss this with you before the session ends. The first therapy session can be really draining. Often the anxiety that we’ve felt during the run-up to the session can leave us feeling exhausted. When I was first in therapy I used to arrange my appointments so that I had nothing else to do afterwards - then I’d take a long route home and make sure I came home to a calm environment where I could just lie on the sofa if I needed to. Most of this zapped feeling was a hangover from being a bit wired or nervous before the session, and my brain needed to just rest.
Some people experience a different type of wipeout, where their brain is suddenly buzzing, full of thoughts and feelings and that can feel exciting, overwhelming or just completely unwelcome if we’re quite drained too. If this is the case for you, something like journaling might help, or going for a walk.
Some people just nip to their therapist during their lunch break and are totally able to go back to work afterwards. You might be like this! Or you might be more like me, and need at least a half an hour journey home/time afterwards to process the session. It’s a good idea to allow some time after your first session, just in case, to process. It can be quite emotional just because you’ve done it - it might have taken you such a long time to get to that point, so much dread and doubt that you’ll actually go through with it. And now it’s done and you’re out and everything’s ok. Be really nice to yourself, it’s a delicate time and however you feel is completely valid and normal.