[Rapunzel]

What do you open with, or how do you start your sessions, especially that works and gets you off on the right foot to have a good session? I keep messing up right at the beginning, and then I end up feeling picked on for the whole time, because after I get tired of the staring match, I blurt out what I have done wrong over the last week or two, and how I am repeating the same old patterns that I still haven't changed.

A typical session starts with the dreaded "How are you?" question. I hate that question, because most people ask that just to be polite, and they couldn't care less, so I just automatically say "OK" without thinking about it. Of course T knows that, and won't settle for the automatic reply, but I generally don't know the real answer to that question and I am afraid of getting it wrong (because my family of origin always corrected me if I ever said I was not fine, and maybe because T doesn't let me just say fine). Once (actually several times) I told her that I don't like that question. So she asked what question I would prefer, and if multiple choice would be easier. I said that multiple choice would be great, and she came up with a few options for questions. I wish that I could have remembered all of them. One was "progress that you have made," and another one was "confessions you would like to make." Out of those two, progress seems to be a much better choice, as confessions lead to being in hot water fast.

Particularly, do you have any ideas for starting a session if you don't feel like you made progress since the last time, or may even be backsliding? That's when it is hardest.

[MissCharlotte]

((Rapunzel))

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typical session starts with the dreaded "How are you?" question. I hate that question, because most people ask that just to be polite, and they couldn't care less, so I just automatically say "OK

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I have had a discussion with T about just this topic--he says ok means a lot of things. I said to him, "well ok in this instance means I'm not dead."

As far as starting sessions, I don't know how you can plan ahead. it just seems that you start where you are in the moment. But, maybe you can talk about the concept of progress and why it feels to you that you need to look at your lack of progress first rather than any positive feelings you are having? In other words, begin by having a discussion about why you can't begin on a positive note? It sounds like this frustration merits a conversation all of its own.

I have been trying not to look at my therapy on a scale of good vs. bad. I don't think of it as a linear model of progress. Rather, I try to think of it as a holding environment, surrounding me as I heal. Each week, each discussion, valuable in and of itself.

Good luck and take gentle care.

[ECHOES]

"Begin wherever you are" is what my T said to me about how we would begin our first session after our initial meeting.

I used to really worry about where to start and what I'd talk about, but letting go of that and just going and saying whatever comes to mind is how I do it now. It works well and leads to all kinds of interesting topics.

Sometimes I just say I don't know where to begin.

Sometimes I say I'm really feeling a lot of shame that day.

Sometimes I say what my overall mood has been that week.

.. and we go from there.

You might want to start with saying that beginning the sessions is so hard for you...

Also, you can say you don't want to talk about something any more at that time and change direction. Also, when you are feeling picked on, tell her that you are feeling that at the moment.

If you think you're 'backsliding' you could just open with that statement and go from there.

It's taken me a while to learn to relax and do this. It can feel like I'm stating the obvious or that I'm talking about something trivial, but it is all important. If it is on your mind, then it is important and can be talked about.


ECHOES

She usually asks "What's going on?", though she knows a lot already because we email a lot between sessions. I usually say "a lot". She says "What do you want to talk about today?" I say "Life..." She usually replies "Good topic, what about life?" And it falls apart from there. I have a lot of racing thoughts, a lot of topics, but I can't focus. Usually then she pulls out all the emails since the last session and we go over them.

[lauren_helene]

It's a mixed bag about how my sessions start. Sometimes he will say 'how are you feeling' or 'how are you' or like the other day he made a funny comment about something political on his t.v. in the waiting room.

We joke around sometimes about politics but very lightly. The only opening remark that I don't like is 'so what do you want to focus on today'. It makes me feel like I shouldn't be there or something.

[MissCharlotte]

After reading others posts, I had another thought on this topic.

My T never begins the session. He never speaks first, with two exceptions, one is when he is going on vacation. He will say " I will be here for two more tuesdays and then I'll be away..." [or something like that] He always gets that out there asap. The other is when we have some scheduling to do and he might just bring that up first.

But after that it goes silent until I begin somehow. But I always begin, never he. He doesn't ask how are you or anything like that.

Hmmm, maybe the difference between CBT and analytical/dynamic therapy?

[bipolar_bear]

I hated that question too and said OK all the time. It was just what I was taught to say and is automatic. I started to journal throughout the week and after she reads them we usually start out with something that I have written about. It feels safer for me to put something in writing than to say it right now so it is a good starting point. Once the subject is broached sometimes I can talk about it in greater detail.

I have a hard time when I am feeling picked on too. I don't react well and tend to withdraw. I do think that to be able to tell her would be the best thing but it is so hard.

BB

With a snide remark, LOL. Yesterday I sit down and he goes, "Do you mind if I run upstairs to just grab a box of tissues?" When he returned I said, "What, do you plan on crying or something?"

A lot of the sessions start with him saying, "What's been going on?" And I always come back with the information-rich answer of "nothing."

Do you record your dreams? I don't know if you and your therapist to dream work but that's always a good way to start off a session; talking about a dream you had.

Other cool things to do are: go through some psych books (I usually go through McWilliams or Yalom) and find a passage or a particular line that really pertains to you or to the current status of your therapeutic relationship. Bring that in, read it to your T, and talk about what it means to you. You can even do the same with song lyrics, a poem, etc. Stepping outside of the box to find different outlets of expression can be very helpful, particularly in getting a session started. One time T and I started off a session by him asking me what I would do if he and I were in the painting that was hanging on the wall (it's a painting of a picnic scene), and he walked away from me. Then he asked what I would do if he came back. And we went from there.

Sometimes my T starts by saying, "What shouldn't we talk about today?"

[WinterRose]

What shouldn't we talk about? That's a really interesting way to start!

We start with chit-chat. Last time I started as we walked through the door by mentioning that it was weird seeing her without her glasses. (She just had cataract surgery and whatever they do to correct your vision too while she was at it.) Then she usually asks what I want to talk about. The chit-chat helps warm me up and then I don't feel like it's a cold start jumping into the hard stuff. I have to work my way up to that.

[Irine]

you know, when i was on therapy, during the week i would have something..you know, htings happen. and when i felt like i woudl sit down and write my thoguhts. my feelings. like a diary, but just what you think/feel right now.

what you ae ready to show your T. and then i would come to her and already have something to start with.

it doesn`t ahe to be like htis ALWAYS so that it limmits you..but it can help.

[Christina86]

My T usually asks me how I am... and I evade the question pretty much. Somehow he manages to convince me to talk. Otherwise it's a very akward silence since he won't ask me anything else or really say anything...

[January]

(((((((( Rap ))))))))))

I write down a list of things I want to discuss with t. That way everything I need to discuss is covered.

I don't know what to suggest about helping after a mad meeting, but I imagine the list would help there, too.

Hugs,

Jan

[Rapunzel]

I've got a huge list, and I keep adding to it, but I can never decide which thing to talk about, and we'll never get through the entire list. I make new lists that are current, but still never get to more than usually one item if that much.

Today it worked out, but ended up starting out with me being late because I had to go find a new oil cap for my car before driving that far (I noticed that it was missing when I checked the oil before leaving). I started with apologizing for being late, and trying to take responsibility for waiting until the last minute to make sure the car was ready to go, so in essence I started with what I did wrong, again. T helped me see that I could have presented it the other way, emphasizing that I had a problem and I dealt with it, and called to keep her updated on what was going on and that I would be late. Apparently I am much more comfortable with scathing criticism than I am with praise of any kind. It is hard to acknowledge that I ever do anything right.

[sunrise]

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Rapunzel said:
What do you open with, or how do you start your sessions, especially that works and gets you off on the right foot to have a good session? Particularly, do you have any ideas for starting a session if you don't feel like you made progress since the last time, or may even be backsliding?

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My sessions are not usually about reporting on progress I've made. I never actually thought that would be something I would want to focus on in my sessions, and T has never said to me, "I want to hear what progress you've made since last time." We actually rarely refer back to a past session. Each session stands alone. Sometimes T will ask me how I am or sometimes "how goes the journey?" But often times he just sits there and doesn't say anything, just looks at me expectantly, waiting for me to start. He has always let me pick the topic for each session, and this extends even to having me be the first one to speak. Other times he will sit across from me, smile with his eyes, and say "therapist at your service."

I just start with what is most important that I talk to him about that day. What is my most pressing concern? What do I want to work on? I only get the guy once a week for 50 minutes and I pay his full fee myself with no insurance, so I am darn well going to make use of his time and get the maximum benefit that I can. Sometimes it helps me if before the session, I can identify the most important thing I need help with from him or that I want to explore with him. Then at least I know how to start out. There have been times I did this exercise by myself before a session (complete the sentence), "if I could say only one thing to my therapist, I would say ________." And I try to think in as few words as possible what that one thing would be. Somehow, having to be concise helps me get to the heart of what I need him for that week. I don't do this everytime, but it has helped me.

Sometimes what I want to talk about is too difficult to broach, and leading off with a dream can be easier, because the dream deals with the topic I want to broach but in a more indirect way that will get us there without the impossibility of my having to pose it directly.

There are other times when I don't know what we will talk about, and I just let the moment lead me. Sometimes an emotion will overtake me, such as sadness, and we will just sit in the sadness together, and maybe not say much, and that is OK. Once I was so excited I was just bouncing off the walls and could not settle down and focus on anything. T said maybe what I most needed was to come see him and share my excitement and bounce off the walls and not focus on anything. I liked having his permission to just be what I was at the moment instead of trying to conform to this idea I had in my head of how therapy should go. All these ways of starting have resulted in some really good sessions.

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One was "progress that you have made," and another one was "confessions you would like to make." Out of those two, progress seems to be a much better choice, as confessions lead to being in hot water fast.

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Why does confessions lead to hot water? Are you keeping a lot of secrets that you are not yet ready to share with your T? If so, maybe you just need to give it more time. I actually think, given a certain degree of closeness between you and your T, the confessions angle could be kind of productive!

[Rapunzel]

I'm really not keeping secrets from her, but usually confessions consist of admitting to something that I know better than doing by now, and there is no justification for having done it anyway. Starting with " tangled with the rose bush, on purpose, again - aren't these scratches lovely?" just is not going to be well-received. Same with procrastinating things I needed to do and not having time to eat or sleep and living on caffeine. I know what I'm doing, and if I confess to running myself into the ground, when I know better, the confrontation is going to be pretty uncomfortable, and we've already been there a million times so there's no point. It can be productive sometimes, but usually not the best use of the time. Sometimes I do feel compelled to tell her, just to be honest, and lately I get confronted on why I chose to mention that, when I know where that's going to lead and I know that I don't like it much.