How do you start your session?

Small talk? Silence?

My sessions are 45 minutes, less for the time she takes to come get me. So I always feel time-crunched and worried about how little time we had.

I almost never start with small talk, weather, how are you things. I usually will break the ice talking about a dream, or some thought I had. When I threw away my razors, I blurted that out before I had even sat down.

She rarely starts the conversation. It's usually silent until I open my mouth. If I wait long enough, sometimes she'll ask how I am, which is a silly question because it shows on my face and in my body, and I'll never say anything besides "fine".

T usually starts -- "So how are you?" Or, "How was your week?" Last time she started with, "Before we start, I just wanted to ask. I noticed you left that phone message at 4 in the morning. What was going on?"

T always starts. After a 3 wk interval she would say, well, how have you been? One time I lost it and said, wow, you really cut to the chase don't you?! She looked taken aback and I said that it was embarassing to always always always answer that with a list of failures or bad news. If I could truthfully say "fine", would I be coming there?

Since then she has rephrased it a bit, it's more like, well, how are you doing? regardless of the fact that she has JUST gone to the waiting room to get me and one more time I have looked up at her as if I don't know what she wants.

My T usually says "how are you" and I always answer with a "fine" until she started repeating me each session i said it, then I got annoyed and said OKAY. I mean I dont know how I am supposed to answer that. I can lie and say GREAT im GREAT! which i know she knows is not the truth, or I can just start listing all of the negative things..so I say fine which is in neutral territory.

Or she will ask, "what's been going on" sometimes I have an answer for her, but most times I don't. I once told her I don't know what you want me to come in and start saying/talking about. She said anything you want OK that doesnt help me...I need more structure than that...I usually wait for her to start asking me questions.

He would start with, "How are you?" or "What have you been thinking about?" I would then ask him how he was before we started.

My t usually says, "How are things going?" And most of the time she asks, "Before we get started, is there anything specific you want to make sure we cover today?"

My T usually asks me how I am, or sometimes I beat her to it and ask first how she is, and then she asks me in return. This last session was after my trip to see my family, so the first question T asked was, "How was it? How did it go?" But she rarely steers the session in a direction with any pointed questions at the beginning like that, she leaves it completely up to me to bring up the first topic.

I guess it depends. If I've been having a rough time, T will ask "How do you feel today?" or maybe just "How are you?" Sometimes I blurt something out if I've been dying to tell him something or sometimes we sit in silence. Those are my least favorite beginnings. He is so good at silent and I am not. Then it gets into a discussion of how I interpret the silence, erghhhhh

Oh the beginning of sessions! How I hate them. We mostly just stare in silence at each other. Well, not stare because I make little eye contact. Then I will stare about the room for a bit, and shift nervously. Then I will semi-laugh at myself because I NEVER know how to begin! Sometimes if she knows I am really struggling, she will ask how the week has been, or if I had any dreams. Sometimes if there has been a break, or she knew I went away, she'll ask how that went.

Mostly though, it is silent until I start.

I usually start by asking T how he is....and then he asks me how I'm doing. I usually respond with "I don't know" or I'll delve into a feeling - I'm anxious, I'm tired, I have a migraine, etc. and things go from there...

One time, I said I was doing fabulous...and he was surprised and said, "Really?"....I said, "No"....and he asked if I was just being polite. I said yes...and he said something along the lines of this not being the place....LOL.

With my last T we would start by me sitting down and waiting for her to say, "so how was the week?" or "so how are you?" It would depend... usually I would say "fine, how are you?" Sometimes the entire session would be small talk about her son or about her cats. She always kew when I wasn't going to be talking about myself and that was okay... sometimes wouldn't even charge me for those sessions.

I just started with a new T... today was my 2nd session and she said "so, Gravyyy, how was your Christmas?" We'll see what she says next week, but at least for this week its a general how are you type thing.

T can usually tell exactly how I'm feeling by my face and body language, she's gone so far as to actually say "You look awfull, what's going on?"

But it's usually How are you doing? or if I've been away, she'll ask how the trip went. We usually do small talk for about 3 min about her research or her lecturing, with me asking her how her trip went as she travels a lot to give training to other T's.

--splitimage

lol it's actually pretty humorus, me and T both take a potty break before we begin our session, then start with small talk and work our way up to the more serious things. T usually makes an observation on how tightly I"m holding my little stuffed ox too..

Great thread! For me, I try to ask T how he is doing - because I really want to know. But usually I start rambling before he can even get comfy in his seat! I tend to do a lot of talking when I am nervous. And I change subjects very quickly too. Poor T can't get a word in edgewise with a greased spoon! So I have been trying to slow down and take a few deep breaths before we start. When I do that, he says stuff like "So you have had an very interesting week!" -- referencing my billions of emails to him between sessions. ((( blush ))) . But trauma work is hard and thankfully he allows for the contact at this time.

My session usually is on a Monday. So I usually open up with Did you have a good weekend? or Do anything fun over the weekend? And he'll ask me the same. I don't have a difficult time with the small talk. I have a problem getting to the stuff that I need to work on. The stuff that matters. He knows that and will somehow manage to steer the conversation so that I will open up.

At the beginning of a session, he sits down across from me and looks at me expectantly, and very openly. Sometimes he will just stare into my eyes, waiting. It is up to me to start. Sometimes I will throw out a first line to him, "well, blah blah blah," and he will respond encouragingly, saying something like, "I'm all ears." This little encouragement to keep talking helps me continue.

Sometimes if I don't say anything for a long while, he might say, "whatcha thinking?", but not all the time. Sometimes he will "listen" to my silence very closely and offer an observation, "you feel sad today," or "I feel your sadness" or "you seem upset," but not usually.

There are times when we do small talk to start off, but it took us a couple of years to get to that point. In the first years, I had so many pressing issues, I couldn't devote time to small talk. Now the sessions are a little more relaxed and I like being able to spend a few minutes on small talk, if I want. It helps us bond and rediscover each other, which is sometimes really important, as my sessions are less frequent now (every 2-3 weeks), and I can be feeling shy when I come in after so long. I have told him before about feeling shy--he seemed charmed and said, "let's sit in that shyness," and so we did. Almost immediately I began feeling upset and sad and started crying. This thing had come up that was very upsetting to me, and I hadn't even known it, so we worked on that for the session, and it was really a good hour. I guess I like to keep that little story in mind, because sometimes giving myself space for something to "come up" can be a really good approach. Sometimes I might not know what I need to talk about until I am in his office, we are silent, and he looks at me with warmth and acceptance. It opens doors.

Another typical pattern is that I have a "lesser" topic to talk about and something "bigger" or more important too. I start with the lesser topic to break the ice, reestablish our connection, and get the ball rolling. Then I will move to the more important topic. It's like the "A" and "B" plots in a TV show, LOL. This a common pattern that works well for me.

I like thinking of the little routines we have established. It's kind of like the familiar habits of an old married couple, LOL. I think each of his clients must do it somewhat differently, so if T does nothing to start off, it gives each client a chance to establish their own routines and make the therapy "theirs." Plus, it saves T from having to remember how each person wants to start off if he doesn't have to do it.

My t is very specific about the questions he asks at the beginning of a session. He asks specifically about my sleep patterns, eating patterns, depression level, suicidal thoughts. We go from whatever shows up there.

I remember I used to feel SO awkward at the beginning of a session!!! Now I usually feel really happy to see T. And he seems happy to see me. So, if I am in a good place, we sit and smile at each other for a minute.

If I'm in a bad place, I'll usually lay on the couch...and I think he'll either ask me how I'm doing, or I'll just start talking about how I feel. I think I usually just start talking.

I am REALLY ANTSY a lot of the time when I get there. So I do a LOT of jumping up and turning the lights on/off, getting the blanket, trying out a different seat, getting something off of his desk to hold. T just sits there patiently and waits for me to settle down. I would actually like to be able to walk in and sit down and start, but I just can't. Yet.

SO! First we smile at each other for a while, OR I lay under the blanket, then I run around the room rearranging things, then we do therapy.

I am also restless at the beginning. I curl up on the couch in three or four different positions, zip and unzip whatever sweater or hoodie I am wearing, pull my sleeves up and down, over my hands and not. Sometimes we do some small talk, and then I take a great big sigh, and I'm silent for a moment: then I begin.

I am trying to get through this faster lately as it takes ten minutes some days, and I hate 'wasting' time in T. Though I suppose feeling comfortable with someone else that close, physically and intimately, is part of my work in T.

It's interesting how much the beginning of our sessions mirror each other, skeksi!

I do hate how it feels like it "wastes" time. There are days occasionally where I can just sit down and start talking, but they are rare.

I wonder what it all means? Why does it take us so long to settle down? I guess for me, running all over T's office and sitting/laying all over the couch (I also sit or lay 4 or 5 different ways in different spots before we can start) and turning the lights on and off is a BIG way to keep things from getting intimate. Because once we start, it's so intimate.

Maybe I will try to get through it faster too. It does waste a bunch of time...I can't imagine not being able to do it though...

I deal with the anxiety I feel at the beginning of session by making sure that my stuff (and I usually have a bunch of it) is in the exact right place. The more anxious I am the longer I take at getting it organized. After that my T usually waits for me to start. Even once when I came in and said that I didn't have anything on my mind to talk about (and really was hoping she would come up with something-but didn't say this) she said that was okay and we just waited until I had something to say. My old T would ask what I was thinking about if it took me a long time to start talking. But in a very gentle way.

Maybe it's not an effort to avoid the intimacy, maybe it's an effort to initiate it? T's gaze is intense, and being seen and heard is challenging when your whole life you've been invisible. It's scary and I think the restlessness is an attempt to cope with that anxiety. I hope someday I will be able to turn to T and say, "I'm anxious, because this is a lot of attention on me!" instead of just fidgeting. You know, using my words

It is really hard to switch from my daily "I'm fine! I'm great, I am a happy happy person!" mode to "I have been abused and I have PTSD and I am scared 90% of the time" mode. I wonder if as I begin to accept who I am and what problems I have, the transition will be easier because I will be more genuine in my daily life?

(((((((( skeksi )))))))) "It is really hard to switch from my daily "I'm fine! I'm great, I am a happy happy person!" mode to "I have been abused and I have PTSD and I am scared 90% of the time" mode. " (((((((( skeksi ))))))))