What you can actually expect from a therapy session, straight from a no-nonsense therapist – Well+Good

What you can actually expect from a therapy session, straight from a no-nonsense therapist – Well+Good


After college, when I was living on my own for the first time, I decided to try therapy. Everything around me was new, and all the uncharted territory led me to feel small and uncomfortable. But I was also a 23-year-old who wanted to talk about dating, and my therapist, a referral from a family friend, seemed to only wanted to poke fun at that based on my perception our first appointment. I left feeling frustrated, annoyed, and belittled. And I never went back. But, here’s the thing: That’s not what therapy typically looks like—it shouldn’t anyway, at least. It’s also not you lying on a sofa, clutching a box of tissues, staring up into space while being incessantly asked, “How does that make you feel?” Since the notion of therapy is often fraught with confusion and misconceptions, it’s time to set the record straight. Here, psychotherapist Lori Gottlieb—whose new book, Maybe You Should Talk To Someone, follows her journey as a therapist who also goes to therapy—answers all your Therapy 101 burning questions, from how to find the right therapist to what to expect from that first session and how to know if it’s “working.” You asked, she answered: Find your Therapy 101 cheat sheet cheat sheet. Photo: Getty Images/FatCamera 1. How do I even begin to find a therapist? To start, scan Psychology Today to get a sense of a given therapist, learn what their areas of specialty are, and also their general vibe, says Gottlieb. Word of mouth helps too, and you can ask a friend’s therapist for a referral to someone who hits less close to home. “I’ve had so many clients come to me and say, ‘My friend is looking for a therapist, can you recommend someone?” she says. “And I absolutely do.” 2. Are there clear signs my therapist is The One? Think of therapy like dating: Once you get to know someone, your feelings will become more clear. You just have to give it time. “In the very first two sessions, I might see very clearly what this person is doing relationally, but I probably won’t mention it,” says Gottlieb. “I’m trying to make sure they feel comfortable, so that when I do feel ready to help them, they’re ready to receive it.” After a few sessions, Gottlieb recommends asking yourself a few questions to check in: “How do you feel in the room with this person? Do you feel like this person gets you? Do you feel like this person is understanding you, hearing you?” And if the answer is a resounding no, speak up: “If you aren’t clicking, don’t assume that’s what all therapy is like,” she says. “Talk to your therapist about it. It’s not awkward! Sometimes, you find out there’s something you guys can address. And, sometimes, you find out that, hey, it’s just not the right fit.” 3. Should I see a therapist or a psychiatrist? That depends on what you’re looking for. Therapists cannot prescribe medicine and psychiatrists can. But, the two often work together. “If I feel like somebody might benefit from medication, I will refer them to a psychiatrist,” says Gottlieb. “From there, the psychiatrist and I team up together with that patient. It’s doesn’t matter which you start with. Either way, you’ll get to the right place.” 4. Should I come prepared with questions or a conversation starter for my first session? No, don’t sweat it. Just relax. “Most people are a little anxious about coming in and meeting a new person. A first session feels very different from other sessions,” says Gottlieb, who uses her initial interactive meeting as a forum to suss out why a patient came to her. “I guide them in a way that will give me that information,” she explains. “I’ll say, ‘Tell me about what brought you here today.’ I’ll have a lot of questions about that, and we’ll have a conversation.” Of course, this might go differently depending on the specific person you see. So, again, if it doesn’t feel like a fit, voice your concern, try to find common ground, and if it doesn’t work out, be prepared to walk. 5. Why does it always seem like therapists are ferociously jotting down notes? Actually, that’s more so a just-in-the-movies thing. Therapists don’t often take notes IRL because it’s distracting. “What’s happening in the room is so relational, and it’s hard to be relational when you’re recording what’s happening,” Gottlieb says. “Sometimes, people will take notes in a first meeting, so they remember all the information. But after that, we don’t generally write.” Copious note-taking is more so a just-in-the-movies thing. Therapists don’t often take notes IRL because it’s distracting. —Lori Gottlieb, therapist and author She will, however, scribble a note if she doesn’t want to interrupt a client with her own thoughts. “I’m writing something down because I don’t want to forget it and I want to come back to it.” 6. Is my therapist judging me? If they’re doing their job right, they most definitely are not. “Often, I don’t agree with what you’re saying, but I’m not judging,” says Gottlieb. “If everything you’re saying is working for you, there’s no reason for you to be sitting in my office. But I do have a point of view.” That said, the feeling of shame patients sometimes feel from a therapist is a projection of their own insecurities. “They’re imagining I’m doing that because it feels similar to an experience where they’ve opened up to somebody else and have been judged,” she says. “Another possibility is that they judge themselves.” 7. Will my therapist tell me how to fix my life? Sorry, but they don’t dole out advice; it’s more about helping you find your own conclusions. “It’s not that we’re withholding the answer from you, but that we don’t know what the right answer is for you,” says Gottlieb, offering an example of marital strife. “Somebody might say, ‘Should I stay in my marriage?’ Well,
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