2nd Session

Hi all -

I'm brand new here, and have spent several hours this weekend reading the posts. There is some very helpful information here.

I had my very first session with a T last week. She seemed really nice, asked what I guess are pretty standard get to know you questions, she let me talk, but didnt probe into serious stuff.

I am going to meet with her again on Wed. I really hope it works out so that I dont have to go through the process of looking for someone else. Also, it's quite expensive and I will not be using insurance so I want to make sure that I get the most out of each session. If I sat there silent the whole time I think I would leave feeling like I wasted a bunch of money! So I'm nervous about this second meeting, will she have more questions for me, can she pick something to talk about based on what she wants to know, or how do I even begin to know where to start?

Also, since I dont have experience with therapists, besides that gut feeling how will I know that I should stick with her?

Thanks for reading.

Hey there. Empirical studies seem to be showing that the most important predictor of therapy helping is a good relationship / fit between client and therapist. You said that she 'seemed really nice' and so that sounds like the start of a good theraputic relationship to me :-) That being said, I've heard from somewhere or other that you should give it 6 sessions before really deciding whether you want to work with a particular person or not. Sometimes you don't like them particularly initially, but come to fit better over time, or sometimes the converse seems to be the case. I do think that it sounds promising, though.

Did you tell her about the things you want to work on?
What theoretical orientation is she?

Different answers to those can mean that therapy progresses in different ways, you see. It might be that your therapist will be very focused in on the goals that you stated, or it might be that your therapist will continue to let you talk about whatever you want to talk about and so they will get to know you over time and develop some ideas of what is problematic in your life.

Whether she will have questions for you or not also depends on her theoretical orientation. Some therapists are very focused and directive. They want to provide you with information / education that will enable you to make some progress with your symptoms. Others are much more into 'mmm hmm, i see... please go on' and they simply observe you and get to know you over time in what you choose to disclose to them.

Thanks so much for your response, it's very helpful. I am hopeful that she will be "the one", but will give it time. I'm just being impatient because I would hate to start over with someone new.

She apparently practices psychodynamics. We talked in general about my family, relationships etc. I just want to deal with unresolved family stuff (dont we all have that?!)

It's just with so much stuff that I've never talked about - how do you even know where to begin or what is the most logical thing to talk about first?

If you would hate to start over with someone new then maybe that is because you really like her and would really like to work with her :-) If you felt generally positive about the first session then I guess that means things are going great. I have to admit (though this might be more specific to my pathology) I'm much more likely to be left thinking 'I'm really not sure about working with this person' than being left feeling positive about the way things have gone. If you feel generally good about it then I would say that it is indeed likely that you are a good match :-)

Therapy doesn't have to be logical. If your therapist is psychodynamically oriented it is likely that she will be quite interested in hearing whatever is on your mind. Different psychodynamic therapists have different ideas as to how interactive they would optimally be. Some are fairly interactive (in the sense of asking questions and structuring the session with talking about different things). Some are happy to be interactive if the person is having trouble talking, but would like to move to something a little more 'free associative' where the client talks more and the therapist doesn't say a great deal. Some refuse to be interactive and they will happily sit in silence until the client thinks of something to say.

Does she have a couch in her office or just chairs? (That is a fairly good indicator).

In a way... It doesn't matter so much what in particular you talk about. What happens... Is that you talk about whatever whatever over time and your therapist starts to see patterns in the way you interpret other peoples intentions, the things that seem to be holding you back etc etc etc.

The idea of free association (which, admittedly isn't something that ALL psychodynamic therapists use) is that you should say whatever comes to mind without censoring your thoughts. Without censoring them because you think they are irrelevant to your problems or without censoring them because you are embarrassed about them or whatever. Most people can't do free association very well. They find that they censor what comes to mind for a variety of reasons. Part of the psychoanalytic process is to figure out what prevents you from saying what comes to mind. The reasons why you don't say what comes to your head. Because you worry that your therapist will think you are stupid or silly or will condemn you. And why would you think that? Maybe because your parents weren't very sympathetic to you telling them what was on your mind etc etc etc.

This is just one psychoanalytic technique, however. The fact that she listened to you and wasn't very directive makes me think that she might be wanting you to just continue on talking to her, though.

How is this supposed to help????? Our early experiences with our parents and siblings and the like are very influential in the way that we relate to people currently in our life. Your therapist will probably be trying to access those patterns... And trying to show you what some of these patterns are and the reason why that pattern is there (because of past stuff). The notion is that once you become aware of the pattern and aware of alternative ways of relating to people... All within the safety of the theraputic relationship... We find the courage to interact differently in our present relationships outside therapy.

But that being said... I guess a logical place to start would be... To talk about some of the problems that led you to seek therapy in the first place and then kind of see where you end up...

Hey survivin, welcome to psychcentral. I hear you about the silence and wasting money; I did that for lots of years!

That's the one thing I would tell myself if I had to do it all again, to talk anyway; I didn't figure out that it is my therapy, not my therapist's until about year 10 :-( Therapists can't initiate much because it is not their problems, they can't reach into your mind and find what you want/need to talk about and questions only go so far in the beginning.

One of my favorite sessions in 18 years with the same therapist was the session where just near the end I said, "I don't think we talked about what we should have" and my T thought for a moment and then replied, "I think you're right." That's the first time I realized that I was the one "in charge" and had to lead the way, my therapist was just "with" me. Her job was to try to stay on the same page I was on (not easy :-) and help me understand whatever page that was.