Before Our First Session
You’re beginning therapy because, in some way, you feel bad and want to feel better. Before our first session, I encourage you to consider what exactly “feeling bad” looks like and what “feeling better” would mean.
Feeling Bad. What image or metaphor captures this feeling? Does it have a bodily sensation? How might it look to others?
Feeling Better. What would feeling better involve? How would you spend your time differently? How would others notice the change?
I want to understand these things from the start. That way, I can know what you’re hoping for and can hold myself accountable for helping you move toward it.
Keep in mind that your goals can shift. Many people begin therapy thinking they’ll focus on one issue, only to discover that something deeper is at play. Self-discovery is like an archaeological dig — it’s often impossible to know what’s at the bottom without brushing away some outer layers.
The Goal of Insight
Our most stubborn struggles often stem from not fully knowing ourselves. Many of our most important thoughts, feelings, impulses, and wishes have been pushed out of awareness. At one time, this may have protected us from pain, but over time, this unawareness can contribute to our suffering. It can feel as if we’re navigating life blindfolded.
The purpose of psychodynamic therapy is to gently remove that blindfold. As both a patient and clinician, I’ve found that certain truths about ourselves can only be reached in the context of a therapeutic relationship. We’re simply too adept at deceiving ourselves; in certain important ways, we can only see clearly with the help of another.
The insight gained in therapy is often misunderstood. Many movies give the impression that therapy hinges on sudden breakthroughs or dramatic epiphanies. While “aha” moments can occur, understanding usually emerges gradually and is sometimes only truly appreciated in retrospect.
Moreover, therapeutic understanding is largely experiential. It’s about gaining new insights about yourself but also processing the emotions that come with these insights. It involves discovering what you’ve kept yourself from feeling and finally allowing yourself to feel it.
How Therapy Works
Our sessions will primarily involve you talking and me listening. It will be your responsibility to choose what we talk about each session. A good rule of thumb is to share whatever feels most alive at that moment. This might be an event that happened that week, a dream you had, or an emotionally intense memory that came to mind.
It’s important that you speak as freely and truthfully as possible. I’ll also want to know how you experience me, since the way you relate to me might reflect patterns that show up in your other relationships. Exploring that together can provide valuable insights.
My role is to listen carefully and nonjudgmentally. I will ask questions — sometimes for clarification, sometimes to help you further explore an aspect of your experience. I may offer observations or possibilities to consider, not as proclamations but simply as encouragements for further exploration.
You will probably leave some sessions feeling energized and others feeling tired and even frustrated. That’s normal. The path of therapy is rarely linear. But over time, as you keep speaking freely and engaging with the process, you’ll come to better understand yourself — and with that, discover new ways to get your needs met and address the problems that first brought you here. This is slow, meaningful work, and it can open the door to lasting change.