Bumpy starts...how to begin your therapy session.

Posted: Wednesday, March 14, 2018

Sometimes the beginning of sessions can feel stifled and awkward. Clients may wonder why their therapist doesn’t tell them exactly what to talk about. In my own practice with couples, a common sight is for one partner to look to the other in confusion – hoping the other person will jump in and set the agenda for the next hour. When that fails to yield a response, both people will fix me a stare and perhaps say: "Well, you’re the expert. We'll take our cues from you".

Many therapists will set an agenda for the session and keep that in focus for the whole hour; others will take a leap of faith, trusting in what needs to emerge and where the client needs to start from (and go to). In counselling, both therapist and client enter into a close relationship where each is impacted by the other. It is a relationship like no other that I know. It is intense, funny, committed – all of what you would expect in any healthy relationship - but it is boundaried by time, place, money and so forth.

At the heart of therapy, both therapist and client(s) are questioning and negotiating their interests and needs every step of the way; moment-to-moment interaction, a deep presence, tuning into each and every facial expression, listening to the slightest change of tone. Both of us are talking and listening - yes - but it is the process behind the words that draws us in and keeps us connected.

However, it is the client's needs that are prioritised in the therapeutic hour. When I consider making an intervention (that's just a fancy word for 'saying something') I ask myself: "whose needs are being met in what I am about to say?". I may think: "Is this really about me or about the person sitting in front of me?" This allows me to make an informed decision about how I might direct the process. Of course, I don't always get it right! And maybe this is okay too. I am human after all and once I begin working with a client, that relationship matters to me – it matters a lot. Leaving myself out of the picture seems somehow disingenuous to the true relationship - that of two people (or three in the case of couples work) genuinely "relating". No relationship is perfect. Perfectly imperfect perhaps.

Setting counselling goals and having a clear idea of what you’re hoping to get out of therapy is well-advised. It provides a map and ensures that therapist and client are on the same page. We may choose to go down a different road than the one you expected to travel on, and we might even slow down the pace of how we get there. This might be frustrating, enlightening, new, unknown…who knows.

But what happens if you find yourself following a plan that was really never yours in the first place? What if the therapist sets the goals and sticks to her own agenda – after all, she is "the expert"! Some of us naturally bend to other peoples' wills. This is how we are in every relationship. Somewhere along the way, we learned that our needs are not as important as others and we would do well to submit. Showing this way of being in therapy can often provide a useful framework for exploring these interpersonal struggles and we can then work through that together. It becomes a problem however when the therapist fails to see this for what it is and assumes the more powerful role in the relationship. This simply repeats destructive patterns from the rest of your life.

"Where will we begin?" is a question I often ask at the beginning of the session. While it can be difficult for you to immediately know the answer, by allowing you to take the lead, the hour will be driven by your own needs and desires. In my own personal therapy, some of my most insightful sessions were those where I had no idea what was really going on for me. Sure, my default would be to try to come in with a topic on many occasions – perhaps ensuring that I would get "value for money" – but it never really took me into that place in myself that needed fuller expression. As both a client and a therapist, I have found that it is when I can get out of my own way – so to speak – something true and authentic gets the chance to be heard. And that can be both painful and beautiful.

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