How does your therapy session start?

T: "How are you doing?" I respond briefly, usually just like, "I'm doing OK." Then he'll generally say something like, "So what do you want to talk about today?"

MC is fairly similar, though often our response to "How are you doing?" can be quite long, with H talking about stuff that happened over the past week. Sometimes he'll say, "What do you want to discuss today?" and sometimes we just get there ourselves.

He asks how I am and follows up on certain things. Then we just roll from there

She asks about my week, I deflect and then ask about hers. She allows small talk for a few minutes before bringing it back to me and my week and we run from there.

I couldn't deal with that at all...I assume I'd just start rambling about something, even if it's the weather, just to avoid the silence. And I know MC and probably current T wouldn't just let us sit there in silence, either...

I wouldn't like the blank stare approach, it wouldn't entice me to open up.
My t usually starts with asking me to go inside for a moment and then when I am ready to let her know what would be most helpful . I like this because it really helps me to focus on what is figure for me in that moment.

(sort-of-ex-)T: we'd usually start by making an agenda what to talk about that session, I think she then started by asking me how I was, then we'd work off the list. Or maybe we'd first talk a little about how I am, then we made an agenda, then work off the agenda. Don't remember exactly.

Pdoc: sometimes he starts with mentioning/asking about something we (I) emailed about (I email him a lot, I told him he doesn't need to reply - it's just that if something noteworthy has happened I'll send him a short email, or if I've visited a doctor or something) or how I've been sleeping if my sleep meds have changed recently, or lab results. Often he'll finish with "But more on that later - how are you/how was your week/..?" (I talk to him every week, one week it's on the phone the other week I visit him)
If he doesn't start with something 'short and pressing' like I described above, we just start with how I am or how my week has been, and the 'pressing' things will come up later.

Usually just a quick catch up and then I paint

If there aren't any logistics to cover (like upcoming scheduling issues) then mine will typically let the silence roll for a bit at the beginning of the session as well. If I really can't start, he'll eventually come in with something like "What's on your mind?" It stresses me out from time to time, and I'm still often not able to get started without a fair amount of hemming and hawing and hand wringing, but it's kind of just something that comes with the psychoanalytic/psychodynamic territory in this case. And I have to admit that I think this approach makes me less prone to spending half the session venting about my week before diving into deeper stuff than if he were asking something more directive/specific, and ultimately is a better fit for what I need. Even if it's also the most awkward feeling in the world

Usually I start talking right away but my T likes to say something like: "why don't you settle in first? Look around the room, then can you feel your feet on the floor? Can you feel yourself on the sofa? Close your eyes and go inside and see what is a good place to start." When she remembers, she asks if her chair is at a comfortable distance from me, or do I want her to sit closer or further. She hasn't asked that for awhile, though.

Interesting, starfishing. So after I hem & haw, I usually go through my week because I don’t really know what else to say. Are you saying you do something different? With this method are you able to “dive deep” right away? Ideally I would like to do this since I ultimately want to get the most out of therapy. Can you give an example of something you might bring up at the start of a session??? I’m just trying to learn how to do this better!!!

Lately I've mostly been trying to pick up where I left off the previous session, or at least pick back up on a substantial thread from last time, or start off by talking about how things from the previous session have been sitting with me or any new insights I've had. I sometimes recount events from my week if they're particularly weighing on me or feel especially pressing, but I think I do that more purposefully and less reflexively than if my therapist were giving me more of an "out" or pointing me more in that direction by asking how I've been doing or how things have been going or something similar. Also worth noting that I think it's easier for me to "pick up where I left off" right now because there are a couple of pressing major themes we've been paying particular attention to and digging at week after week, so there are some obvious topics to go to right away.

As cliche as it sounds, it helped to talk to my therapist about the difficulties I was having with getting started, and what it seemed like I was avoiding, so maybe that's worth a try! Have you discussed what things are like for you when you're trying to get things started?