I remember it vividly, and think about it often – the first time that I really considered going to therapy. I was 20-years-old, and I was taking a long walk with a friend on a Saturday afternoon. He and I were having one of those deep talks about life and sharing some of the struggles we had been through. He told me about how his father had died after a long battle with cancer when he was in high school, and about the difficult aftermath for him and his family. He then told me that what has helped him through it the most was that he has been meeting with a therapist for the past year. At that time, the only thing I knew about therapy was what it looked like in the movies and on TV, but I remember having the feeling for at least a couple of years prior to that conversation that therapy might be something I would like to try. As far as I knew, I hadn’t ever met anyone who had been in therapy, and I had never spoken to anyone about what it was actually like. My friend told me that he was able to say whatever he wanted to his therapist, that he never felt judged, and that his therapist helped him to make sense of things. He spoke highly of therapy and his therapist in particular. He also said that he convinced several friends to go into therapy as well, and that they were all glad they did.

Soon after that day, I had my first therapy appointment scheduled with that very friend’s therapist. I remember feeling a mixture of curiosity and nervousness leading up to that appointment. I remember feeling like my mind was racing with thoughts about what it would be like. Would I like it? Would I love it? Would I hate it? I remember walking to the location for the first time, finding the nondescript entrance on the side of a house on a residential street. I remember sitting in the waiting area and noticing everything about my surroundings. The smell, the art on the wall. I remember waiting to be greeted, hoping I had remembered the right time and wondering if I was in the right place. I do not have any specific memories about the actual session, but I do know that the impact of that day and the therapy sessions that followed changed my life profoundly. It is how I am writing this blog today.

Now that I am a therapist myself, I think about that story when I meet someone for their first therapy session. I wonder what was happening with this person before deciding to come to therapy. What did it take to get here? How long has this person been thinking about seeking therapy before this moment?

I often learn in a first session that someone has been thinking about coming to therapy for a long time before making it to this moment. I may also learn that someone has been in therapy before, either with an outcome they felt good about, or perhaps not-so-good. Either way, I usually hear some description of how a person almost went to therapy before today, but somehow has not been until now. To me, this makes this moment all the more special.

man talking to therapist on a couch

When I meet with someone for their first therapy session, the first main question I always ask is, “What is it that brings you to therapy?” As you can imagine, there are so many places we may go from here. Some begin by describing recent and/or past symptoms of depression or anxiety. Some begin by describing a current issue related to their work or school life, a situation in their interpersonal relationships, or a major life transition. Some seem just to want to dive right in and tell me the stories of their lives wherever they can manage to start, and end up bouncing around between events and people, eventually pausing for a moment and saying something like, “Woah. That was pretty all over the place. Where was I? Did that make any sense?” Others say that they do not really know why they are here, or that they find it difficult to articulate what is going on inside or what they want or are even able to say about it. All of these are fine ways to start therapy. There are no right or wrong ways to begin talking about oneself in therapy. Anything that is said is important, and the most important elements tend to find a way to the surface soon enough.

I am often struck by a sense of awe in a first therapy session. If a person has been thinking about therapy for a long time, I can’t help but feel that it is profound that we are here together in this moment. I think about the fact that the person in the room with me brings with them a life full of experiences and stories from before they arrived at my office. I am keenly aware of the fact that until now, we are complete strangers and I am inviting them to discuss the intimate details of their lives with me. This is not something that most people ordinarily do, and it is not lost on me that this takes a lot of guts! So, in that first session (and beyond), I am thinking about the courage it takes to participate in therapy. For me to be in the company of such courage is a privilege. It makes me want to both congratulate and thank them for being at this first session. And sometimes I do just that. I also honor this privilege by listening carefully and respectfully, asking follow-up questions, and communicating my understanding as best I can. This is because a first session is about more than me the therapist learning about what brings a person to therapy, or the details of their life history. It is also about facilitating a sense of connection and trust to lay a foundation for our future work together.

For those who are about to enter therapy, I have a message and a suggestion. My message is to welcome you! You made it here somehow, and the route may not have been a simple, straight line. This leads me to my suggestion: Think back those moments when you first began to consider therapy. How did it come up? What was going on in your life when it sounded like it might be a good idea? What other thoughts and feelings did you have around it? What were some of the obstacles that prevented you from starting immediately? What happened after that? What might there be to learn about yourself from recalling this part of your story? I have the feeling there may be quite a bit. You have an important story to tell. And you have my deep admiration for the leap you are taking to tell it.

But do not only consider my words about getting to therapy. Take the words of someone else who has reflected on their route. The following is taken, with permission, from a social media post of someone I know urging their friends to consider therapy for themselves:

“Many years ago before I was married and before I was divorced and before I was the blooming wildflower you know and love, I was hesitant to attend couples and individual therapy. I honestly don’t remember why. Maybe I didn’t have a reason, per se. My resistant attitude didn’t last long.

Since then, individual therapy and couples therapy have provided some of the most empowering and satisfying experiences of my life. It is now hard for me to imagine being hesitant or resistant about therapy. I have grown to love the therapeutic process, the safe, curious, consistent space my therapists would hold for me weekly, our humorous rapport, and that I could share my struggles without feeling like I was burdening or beholden to this person for it.

I believe our worlds would all be so much sweeter if we all had psychotherapy in our lives, if not always, at least for a time or at times when we are struggling or need change. I am of the opinion that life itself is a mental health struggle – perhaps especially in this ill society. I’ve watched so many dear ones live lives dampened or knocked off-course by untreated but treatable mental health struggles. Often when I suggest therapy to folks who seem like they could use it but have never been, I encounter resistance. And of course I don’t press the issue. People have their reasons for not going and I respect that.

However, if you, dear reader, are not currently in therapy, I implore you to take this moment and consider gettin yourself all therapized up in the brain zone. It will create more joy and peace for you, the people who love you, and society at large.”