Just scheduled my first therapy session

[Nuitari]

I'm actually nervous about this. I've always been an introvert, and its not easy for me to talk about personal stuff, especially to a complete stranger. So that's going to be hard. At the same time, though, I'm very eager. I've been needing this for a long time. I'm new to therapy, so I really have no idea what to expect. Can anyone give me an idea of what I'm in for? I don't expect to break a lot of ground on the first session, but what exactly happens during the first session? I'm so overwhelmed with so much inner turmoil, I think the hardest part for me is knowing where to even begin.

Here's something else that I'm concerned with. Do any of you have therapists of the opposite sex? If so, does this ever make you feel uncomfortable sharing certain personal things? For example, there are a lot of stories being shared in another thread about borderlines and sex that I would find difficult sharing with someone of the opposite sex. My therapist is a woman, but she comes highly recommended. I've heard nothing but good things about her, and I think her background makes her ideal for helping me with my situation. There is so much I need help figuring out. Not just with my ex, but with myself too. I am mystified at some of the choices I made in this relationship. But I'm rambling. At some point I'm afraid I'm going to feel compelled to share things that I would otherwise be hesitant talk about in mixed company. Do people commonly discuss very personal issues with therapists of the opposite sex? Is that normal? Should I find a male therapist instead? There are so many things I need to get out, and I don't want to feel like I can't discuss certain things that I feel are important. Otherwise, what is the point?  Can I say all the same stuff to woman therapist that I can a man therapist with it being awkward? Is it common to have a therapist of the opposite sex, or is that weird for the reasons I mentioned above?   

[Naughty Nibbler]

HI Nuitari: 

Male or female therapist? I think whatever you are comfortable with is best for you.  You might find that you will feel comfortable talking to the female therapist you have an appointment with.

One way to think about the first session, is that you are interviewing the therapist to work for you.  You might want to ask the therapist about what therapy methods she prefers, about her background and what she specializes in. 

On the first visit, you will likely be asked to fill out a survey that will ask you questions about whether you are anxious, depressed, etc.  After that, it can be kinda like telling a friend your problems and just venting. 

If you want to discuss subjects of a sexual nature in therapy, probably best to get it out there on the first visit.  Perhaps bring a written list of things you want to address and hand it to the therapist at the start of the session.  You can briefly talk over the list. Admit to the female therapist that you don't know if you will be comfortable talking to her about X, Y or Z.  By handing her the list early on, it could be a bit of a relief to get all the issues out there.

If after going through the overview of what you want to get out of therapy, you find you aren't comfortable with the female therapist, you could ask her for a referral to a male therapist.

After a few weeks of therapy, my therapist recommended I read the book, Stop Walking of Egg Shells.  Since then, I've asked her for suggested reading material.  I said, "I think I worry too much, any suggestions on a book".  She recommended "The Worry Cure", by Robert Leahy and The Happiness Trap by Russ Harris. 

I'm an introvert as well.  Once you feel comfortable with you therapist, you will turn into a  motor mouth and find that the sessions are over before you know it and you may even look forward to the next week.

Best wishes!

[Turkish]

I think the suggestion about interviewing your T is good. You're the client.  

You mentioned gender.  Is this an issue of possibly being uncomfortable regarding sex,  or does it go back to your FOO?

Being the only child of a single mother,  I chose a male  T against my instincts (because I thought I always related better to women... .and so many women over the years told me this), so I purposely chose to abandon my comfort zone.  Never had a dad or significant male figure in my life, so I chose to explore what I didn't know. I wanted to be challenged outside of my comfort zone.  This is just my story.  Take what you will.  

I always thought crying was weak,  but when I broke down in his office,  I let it flow.  Still,  my analytical mind said,  "he's seen worse,  you're paying him,  this is what he does for a living. " Yes, that may telegraph my personal view or shame (I trend old school where is better to hide one's emotions... .thanks BPD mom),  but therapy is a safe place.  You own the sessions,  not the therapist. Embrace your power.  

[heartandwhole]

Hi Nuitari,

I can understand your nervousness about going to your first session. It's something new and you don't know what to expect; it makes perfect sense to have a lot of questions and feel a bit anxious.

Naughty Nibbler and Turkish have given great advice. I'd also add that in the first session, you might want to give a brief overview of what brought you to therapy and then just start talking about whatever issue is on your mind today. In other words, you can start wherever you are right now; things don't have to be chronological or follow a straight line.

In my first session, I think I talked about how hollow I felt, how the breakup had brought up so many feelings of loss and hopelessness in my life, unlike any other breakup I'd experienced. And my therapist listened and asked questions, and so did I.

Once you feel safe with your therapist, each session will unfold organically. Sometimes I had specific things I wanted to talk about when I came. Other times I just showed up and let whatever needed to come out, come out. You'll see how it is with you and your therapist. Each one is of course unique with his/her own style.

As for the gender question: I think it is entirely up to you, and if, for example, you end up feeling comfortable with your therapist and want to continue therapy with her, but talking about sexual things isn't quite comfortable, you can always bring exactly that issue up with her! That is what she is there for.

I wish you a helpful first session, Nuitari! 

heartandwhole

[seenr]

I have to say I find it easier to talk to female therapists.

Also, someone in & around the same age as me was beneficial too. First session just give an overview and after that go from there.

Remember if it is important to you it is important!

[Nuitari]

Thanks for your replies.

About the gender thing, I guess what I was wondering more than anything else was, is it common to have a therapist of the opposite sex? Especially when the topic of sex will most likely crop up from time to time. How normal is it for a male patient to discuss sexual issues with a female therapist? Should I expect my therapist to feel uncomfortable when this happens? Is she going to be secretly thinking "why didn't this guy choose a male therapist for this stuff?" Or is it such a common thing in her practice that its not going to phase her? Knowing that it isn't awkward for my therapist will make it less awkward for me.

[seenr]

I have had three, all female.

No problems discussing anything. One was older and had trained as a sex therapist and gave me fantastic insight into my ex and how our sex life worked.

My advice - dont be afraid, discuss what you need to, see how the session goes for you. A trained therapist will get you to talk about things you had not connected in your own mind and can help shine a light on you that leads to healing, answers etc.

That is just my experience, others may see things differently.

[steelwork]

Hard for us to say what normal is, but just as a data point, I've had male and female therapists, and the ease with which I talked about sex with them varied--but not by gender. I think it's just gotten easier over time for me to talk about sex in general. If it's not easy for you, and if you feel it would be easier with a male therapist, ask for a referral. But do give it a shot. Try to keep an open mind. Best of luck!

[fromheeltoheal]

About the gender thing, I guess what I was wondering more than anything else was, is it common to have a therapist of the opposite sex? Especially when the topic of sex will most likely crop up from time to time. How normal is it for a male patient to discuss sexual issues with a female therapist? Should I expect my therapist to feel uncomfortable when this happens? Is she going to be secretly thinking "why didn't this guy choose a male therapist for this stuff?" Or is it such a common thing in her practice that its not going to phase her? Knowing that it isn't awkward for my therapist will make it less awkward for me.

Hey Nuitari-

You can think of therapy as just a conversation, one you're paying for, and you'll be having it with someone who is trained to have conversations and offer information that you can use in your life.  And the therapist is a human, and you'll either connect well with that human or you won't, and you can assume they are trying to connect with you, that's what you're paying them for.

The sex thing seems significant to you, and one way to look at it is you have sex with women, so who better to talk to about it with than a woman?  And you may have deeper conversations about it than you've had with the women who've been in your life, which could help quite a bit.  Anyway, therapy is about the vibe and the comfort level for you, the patient, therapists see folks who are nervous at first pretty much every time, and it's about establishing that comfort level at first, which usually happens quickly, and that hour will just fly by.  We look forward to updates!

[Meili]

I am far more comfortable with my female therapist than I would be with a male. I have yet to find anything that has shocked her. Even the sexual abuse that was done to me as a child. But, she has 20+ years of dealing with adult survivors and abuse victims.

My advice to you would be to voice your uneasiness to the therapist. You need to feel that you can express whatever you want/need to. If you do not feel that you can be safe and open then the therapy won't be as effective.

Good luck!

[seenr]

Meili

Thanks for being honest again on another topic. I too was abused, but cannot remember how many times. I told my ex about it and initially she was helpful but as time wore on it got so bad that any row had her saying 'this is what happens when you don't get help for being abused'.

Over the course of therapy three successive counsellors told me that the initial abuse had a minimal effect on me, but the repeated mention of it by my ex had a huge effect on me. It was crushing to my self esteem to have it mentioned time and again. Worse again, she accused me of abusing our son. That literally made me vomit.

Nuitari, you can see some of the topics some of us have discussed with therapists that they are varied, can be difficult, but in my experience worth it. I feel a lot of value from the sessions so far.

Hopefully you find that value too.

I am far more comfortable with my female therapist than I would be with a male. I have yet to find anything that has shocked her. Even the sexual abuse that was done to me as a child. But, she has 20+ years of dealing with adult survivors and abuse victims.

[Meili]

I will also add that finding a safe place to openly and completely discuss our experiences is truly helpful to the healing process. If we feel that we have to hold part of something back, it seems to be because we are ashamed. Carrying that shame with us everywhere does nothing but perpetuate the damage.

[Nuitari]

I just got back from my first session. I can't believe I waited so long to do this. After one session I can see immediately how much I've been needing this. I was extremely nervous going in, to the point where I was thinking about backing out. It's hard enough for me to discuss personal issues with people close to me, let alone a complete stranger. But by the end of the hour, I didn't want to stop talking. I can't wait for my next session. Waiting a whole week is going to be torture.

About the sex stuff, I expressed my concerns about talking with her in those areas, and she pretty much reaffirmed for me what you guys already told me.  She said it was about my comfort zone, not her's.  I was left feeling like I can say whatever is on my mind.

My only real complaint is that I didn't detect a lot of warmth or emotions on her end. She seemed distant. It didn't feel like a natural conversation between too people.  The session felt way too formal for my taste. I would have felt more at ease if she had at least smiled at some point during the session, or made a comment about the weather outside, or something like that.

[Naughty Nibbler]

HEY NUITARI:

I'm glad you had a good first session.  

My only real complaint is that I didn't detect a lot of warmth or emotions on her end. She seemed distant. It didn't feel like a natural conversation between too people.  The session felt way too formal for my taste. I would have felt more at ease if she had at least smiled at some point during the session, or made a comment about the weather outside, or something like that.

Check out the link below, where some therapists give their opinions about displaying emotions during sessions.  It appears to vary with the style of therapy used and what they believe is best for the client at a given point in time.

https://www.quora.com/Do-psychotherapists-hide-their-emotions-during-therapy

You will ease into you own level of comfort.  I'd have to say that my first session was strictly business.  After that, I have generally started the session, talking a couple of minutes to talk about  the weather, the weekend, the therapist's dog (brought to the office a few times) and the birds that visit the water feature that surrounds the therapist's building. (topics similar to talking about the weather)

Part of the therapist's job is to not get too personal with their client, so they aren't apt to talk too much about general pleasantries.  My therapist has laughed with me a few times, like when I told her that the ringtone I had assigned to my uBPD sister was the wicked witch of the.  I guess some of us here think alike (or vent alike), because I learned that others use the same ringtone for a pwBPD.

[fromheeltoheal]

My only real complaint is that I didn't detect a lot of warmth or emotions on her end. She seemed distant. It didn't feel like a natural conversation between too people.  The session felt way too formal for my taste. I would have felt more at ease if she had at least smiled at some point during the session, or made a comment about the weather outside, or something like that.

Good for you for going Nuitari!  It's not supposed to be two pals chatting, it's a professional relationship between a mental health professional and a patient, you, so it's not supposed to be an equal peer to peer thing, you'd wonder why you were paying for it if it was.  But that said, your nervousness probably was a factor, plus who knows what a new patient is going to say, someone might walk in there and tell the therapist all of his girlfriends are buried in his backyard, as a wacky example, so it's a matter of building a relationship, which will happen as you spend more time together and you get more comfortable.  In any case, I'd tell her it would be nice if she'd comment on the weather or smile or whatever, just because there's no point if there are barriers to your communication, so might as well spew whatever comes up.  Good luck next week, the hour will just fly by!

[Nuitari]

I understand that its a professional relationship. Its just that she seemed "cold." The session felt extremely impersonal. Given what we're going to be discussing, it would be nice to see some signs of compassion or empathy on her end. I didn't detect a lot of that. I guess I was expecting too much from my first session. And you're probably right that my nervousness might have been a big factor in creating the tone of our session. I'm sure my apprehension showed through in a big way. That's something that I'll hopefully improve on with time.

[steelwork]

Nutari: since this is your first experience in therapy, you might be unconsciously expecting it to follow the conventions of an intimate conversation. It might take a while to get used to the ways in which it doesn't do that. Remember that the therapist doesn't know you yet, either, and she might not want to assume what the appropriate responses are (laughter, smile, frown). Also, if her affect is less expressive, you might eventually feel freer to talk about difficult things, because you won't be anticipating a response from her. She becomes smaller in the room so that you can be larger.

Since you did seem to feel the first session went well, it sounds like it's worth giving this therapist a little bit of a spin at least!

I'm sure my apprehension showed through in a big way. That's something that I'll hopefully improve on with time.

I would caution you against trying to be "a good patient." That can work against you. Just be honest and brave and curious about your life! If you feel apprehensive, have no qualms about letting it show. Then you can explore why you feel apprehensive. Anything you feel acutely, no matter how unrelated it might seem to the issues that brought you there, is something you and your therapist can work with to get in deeper.

[Meili]

I'm glad to hear that it went well and that you're looking forward to returning!

I was going to say basically what Steel said about the therapist not knowing you yet and may not have determined what you would deem as an acceptable response. Can you imagine how damaging it would be in that situation with the therapist were to assume something was a joke and the client was being serious?

But, yes, voice any concerns to her.

[Nuitari]

My therapist is awesome! I had my second session today. I take back what I said about her being cold. I didn't get that feeling at all this time. This session felt more like a conversation between two people. It felt more natural. Maybe last time it was my own apprehension that was creating that uneasy atmosphere that I thought I sensed. Or maybe she just wasn't feeling well that day. Who knows. But she is far from cold. She seems genuinely invested in helping me get past what I'm feeling so that I can improve my life. Her questions force me to think and re-examine myself and my behavior in my relationship. Only two sessions in, and she's already challenged some of my old ways of thinking. I feel like I am given free reign over the conversation. She's very good at letting me steer the discussion in directions I want to take it. We haven't yet gotten to those really personal issues that I was feeling reluctant to share. But I'm no longer concerned about that. When the time comes I don't think I'll have any problems. After this session I've been made to feel like I can discuss anything with her. My apprehension is gone. The hardest part for me is waiting an entire week to pick up where we left off. I'm actually very surprised at myself. I was so reluctant at first to discuss my problems with anyone. Now I feel like a dam has burst, and now everything is coming out.  

[ICantFixHer]

Yay Nuitari! I am very happy you are seeing someone and that after two visits you are feeling better about things. I am in the exact same boat -- I have seen my therapist twice over the last 2 weeks. I'm a man and so is he, he's a bit clinical but he's asking me some hard questions and I feel this is going to be really good thing for me.

I vow to stick with it if you do.

Wait -- we're NON's right? Of course we will stick with it and actually learn from it (unlike my exBPDgf -- 4 different courses of therapy over 10 years, her behavior hasn't changed a single bit).

[bunny4523]

I guess what I was wondering more than anything else was, is it common to have a therapist of the opposite sex? Especially when the topic of sex... .

The ones I've been to have been trained to make you feel comfortable and at ease discussing it.  I find it easier if I see a therapist of the opposite sex.  Women therapists make me feel uncomfortable a little - there is like a judgement or competition... .so do what works for you.  I'm sure the therapist you pick will have "heard it all" so don't worry about that.  I would say that is the place to feel safe opening up about anything.

Good luck to you!
Bunny

[bunny4523]

I just got back from my first session... .My only real complaint is that I didn't detect a lot of warmth or emotions on her end. She seemed distant. It didn't feel like a natural conversation between too people.  

Also it may change in the sessions to come.  The loosen up and get more comfortable too but I think at first they are focused on you.  I'm glad you had a good session!
Bunny

[steelwork]

Yay! So happy to hear this, Nutari.

[Meili]

I'm glad that the session went well and that you are more comfortable!

I've experienced the same thing that you described about all sorts of things just pouring out of my mouth and directing the conversation. It is very liberating.

Waiting for a week between sessions is difficult sometimes. As I process all that was discussed, many questions pop into my head and I want them answered right then.

Do you have that problem?

[Nuitari]

Yeah. What's frustrating is having so many things I want to say and ask, and then we're suddenly out of time. That feeling of having to hold those thoughts for another week feel's like torture. But processing what we discussed is a nice and productive way for me to kill the time until our next session.