How does your T start the session?

The woman sometimes mutters hello when I walk in - sometimes nothing. Then silence for 5-10 minutes until my anxiety goes down enough for me to talk.

My T just looks at me expectantly.

My T always comes to the waiting room looking absolutely serious. I think he wants me to set the pace of the meeting. He follows me to his room, I sit and look at him, and to break the ice try to say something a little entertaining and its comfortably casual from there on.

Mine says:

"Hey, you handsome devil you! Have I told you that you are my most brilliant client? You are the reason I am glad I have become a therapist. In fact, you make me want to be a better therapist." Then wipes away a tear while I nod smugly.

Oh, oops, I just realized you said what the therapist says not what you would like her to say. She just says hi, how are you today? (Booooooring.)

p.s. Yeah that last comment there is a reworking of a line from as Good As It Gets.

Oh, my freaking god, I had a T who used that line and I hated it, too, for pretty much the same reason. I had enough problems feeling self-conscious about what I had to say not being worthwhile, etc., and this made it worse.

I've always had a hard time beginning. My current T usually asks me how I've been or where I'd like to start. If I'm really having trouble, she might bring up a topic like homework I'd agreed to try or something we'd discussed previously. I don't love it, but it's better than any of than "how do you want to use this time" or just being completely silent. I'm not sure if anything would make it easy for me, really.

For the first couple years, my T would remain silent and let me speak first. She might exchange a glance with me, essentially saying "I know it's hard for you to get started." The next year she would say "hi" and very occasionally make some small comment. When it was getting close to termination, she was much more prompting and said things like "how are you feeling?" "what would you like to talk about today?" "what's on your mind?" or she would ask me a particular question.

A handshake and "Well how are things going today?"

Then unless I jump right into something we usually have a social chat for a moment, maybe not social, not the right word. But I general conversation before we get into my deep crap from inside. Last week one day he started by telling me about a sale at the outlet for the kind of shoes I like. Stuff like that.

He doesn't say anything when he gets me from the waiting room (I'm the only one in there usually), then we sit down in his office and he waits for me to talk. I feel bad that I don't say much "hi, how are you" type stuff - I usually feel awkward & just dive into something on my mind.

She picks me up from the waiting room, says hi, small talk until we get to the office . Sit down, she will say , what when on since we last met? Spend 5 ten min on that, then get to the core of session ect....

My t says hello and asks how I've been. I dictate where the conversation session goes. Works well. Doesn't start awkward once asked how I'm feeling I kinda dive in. I would feel pressure to with that kind of opening.

Mine asks how my week has been and how I am. My default answer is "fine", which is kinda silly because if I really were fine I wouldn't need to be there I guess. If I have a hard time coming up with something, she'll ask about my home situation, etc.

We say hello anf then I sit down and he waits for me to start. If Im silent he asks me what I am thinking about.

Hello, would like add that this formula comes from "Executive coaching", which is a way to help managers with their goals, mainly. It seems your T considers you have some goals and therapy time have to be invested where you will in order to achieve them. Greetings.

Mine always asks what do I remember of the last session. I think its related to my dissociation and my auditory processing disorder.

Mine is clent-centred, which I think means following the client, not the other way round. So, she also sits and waits for me to start, but I think it's because she wants to make sure we're going to talk about what I need to talk, not her. Mind you, it makes me uncomfortable anyway, but I'm working on it

Mine says hi as she comes to get me. Small talk as we sit down and get settled. She used to ask "how are you" and I would say "fine" or "ok" and she would give me the look because I was being so vague.
Lately she's changed to "so, what's going on". One time I couldn't decide where to start so I said "just sitting here". LOL

Small talk as we walk down the hall to her office. She'll check in and see how I've been doing since the last office visit. Med/physical health discussion and any adjustments there if needed, then psychotherapy stuff

We usually make a bit of small talk, then he says "Is there anything you'd like to be sure to cover today?" And we either talk about that, or he asks a question about my email or something we talked about the prior week.

Mine says 'first, put the ****ing cash on the table. Now, back off, and sit where I can see your hands. And don't even think about cuddling the cat. What the ****s up this week?'

Actually, she normally says 'how ARE you?' And I say 'fine' and she sighs....

A T I know (not my T) told me that 'fine' stands for: F***ed up, Insecure, Neurotic and Emotional.

Haha, yep that's me!

My old CBT t always started out by asking if I needed to use the bathroom

My T tried the silent treatment for the end of a session a few months ago (after a chat about how difficult I find it to speak in there). I left feeling dreadful. At the beginning of the following session he told me straight off that he had felt as though he had been incredibly cruel and apologised. During the week I had created an image (just a pencil sketch) of HOW he had made me feel, I could tell that it made him uncomfortable and we shared a little moment.

I was lucky in that in reflecting on my horrible experience it strengthened the theraputic relationship. Express how it makes YOU feel to your T, especially if you feel it's unhelpful or worse, harmful to your theraputic journey.

Good luck

Because of the unusual way me and T do things we have a kind of ritual beginning each session.


1 Before collecting me from the waiting room T puts a chair cushion on the floor and his reading glasses within reach.


2 He comes to the top of the stairs and summons me, then walks to his room (leaving me to follow behind which always narks me a little).


3 Whilst he closes the door, I sit next to his cushion, take off my shoes and get out my teddy.


4 He sits next to me, (sometimes we lean on one another) then I hand him my folder of thoughts / dreams and any imagery (paintings or sculptures etc.) from the week.


5 Then I wait for the first question. Usually something like 'how did you find last week?' or 'tell me about this picture...'


This has all developed across over a year of sessions and conscious negotiations regarding how we are and how we do things. I am only just coming to realise how unusual a lot of this is and am very grateful to have a T willing to try things most T's wouldn't even think about.

Mine comes and gets me and her office is literally right next to the waiting room, so I just go in. We talk about the week and how much I am a perfectionist in school and don't need to beat myself up for a low A. Sometimes we go straight into meditation and meditate for 10-20 minutes. After that I either show her a drawing, my diary entries for the week, or she will ask me what I want to talk about. I just started actually bringing up things I need to talk about instead of saying "I don't know", but before she would help guide me into something, or we would continue small talk and from it, I'll accidentally say something and she'll push more from it. At the end we hug and exchange thank yous.

One thing I find odd is that whenever I ask my T how she is, she answers me but doesn't ask me how I am.