“When you think about it, therapy is a bit of an odd proposition.”
That’s what Collin Vernay, a licensed psychologist based in Washington, D.C., told HuffPost when asked what a first therapy session is really like.
“It involves two strangers meeting to discuss some of the most intimate, vulnerable and raw details of someone’s life,” he said.
Over the past few years, more Americans have reported having poor mental health. As people start therapy for the first time, many walk into these offices without any real sense of what to expect or how they’re supposed to act.
Here’s what therapists want people to know.
Crying — or not — is normal either way.
There is no concrete list of how patients should behave when meeting a therapist for the first time.
“There is no ‘normal,’” Krista Jordan, a psychotherapist in Texas, told HuffPost. “It depends a lot on whether or not people have done therapy before.”
The first session helps establish a relationship between a therapist and a client. By sharing what brings them in, the client can help the therapist begin to shape what they need to focus on in early sessions. The client can then determine whether they want to trust the therapist and want to keep meeting to talk about more.
“A therapist is not expecting you to cry or not to cry when first meeting, nor will they force you into feelings that are too intense or overwhelming to feel just yet,” Vernay said.
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Don’t put any expectations on yourself for how free you’ll be with your emotions.
Some people are surprised by how quickly their emotions surface. “Sometimes recalling the painful or traumatic reasons for beginning therapy can lead to feelings of sadness, discomfort, anxiety or crying,” Vernay said.
But others may feel flat, and that’s just as normal as crying. “These early meetings may feel more matter-of-fact as we’re warming up to each other,” Vernay said. “It’s natural when first meeting a therapist to feel a bit nervous or awkward, and the goal of a good therapist is usually to put newcomers at ease.”
“There’s no way to know if a person will cry or not cry in the first two sessions,” Jordan said. “Patients tell me they surprise themselves.”
It can take a few sessions to feel at ease.
Feeling like you’re still sizing each other up after the first meeting doesn’t mean something is wrong.
Psychologists Arthur Bohart and Amy Greaves Wade argue in “The Client in Psychotherapy” that the relationship between a therapist and their client tends to solidify around the fifth meeting.
This timeline coincides with another factor that patients have to keep in mind: They need to actively engage with what the therapist advises and offers them, Bohart and Wade found. Therapy isn’t magic; the patient also has to put in work for the process to be effective.
“It’s normal to feel a variety of feelings when first starting therapy, and my general advice would be to stick with it for at least a few sessions before deciding whether or not a therapist is right for you,” Vernay said.
But it’s fine if you want to switch therapists.
Sometimes, it’s just not a match.
What feels off at first — that awkwardness, the nerves, that slow build of trusting the therapist — will fade as the relationship develops. “At its best, that initial nervousness melts with time into a deep trust and abiding care, feelings that are part and parcel of what makes therapy so transformative,” Vernay said.
Exactly how long it takes varies by therapist. Jordan told HuffPost she encourages patients to give therapists around six to eight visits before deciding whether the therapist is the right “fit” for them.
There is one exception, though — sticking around for about a year and then suddenly wanting out can mean something different.
“I would be concerned that maybe the therapist is starting to push you a bit (in a good way) or maybe you are getting into topics that feel uncomfortable (but are necessary),” Jordan said. “In that case, the desire to quit starts to look like what we call ‘resistance,’ which is the patient’s unconscious mind trying to sabotage the therapy [because it’s uncomfortable].”