What to expect in counselling

If you haven’t tried therapy before, you might wonder what the experience will be like

When I trained as a psychotherapist, me and my fellow students were given the assignment of doing something we’d never done before. The course tutors wanted us to get in touch with how scary it can be to do something new, to feel the fear of the unknown. I chose to jump out of a plane, which seemed a little excessive when I found out that a fellow student had chosen to bake their first cake! But actually, when I consider the fear that some people feel around coming for their first counselling session, I think it was a good choice.

New clients generally come for their first sessions full of anxious questions. What will happen in counselling? Will you give me a diagnosis? What should I talk about? Where should I start? Do I lie on a couch? Is it ok to cry? Or to swear? What will the therapist think of me? Can they fix me? And so on. I hope that by answering some of these questions here, I can make it a little less scary for you to embark on counselling.

Counselling in a unique experience for everyone — so expect the unexpected

First, let me paint a picture for you of what happens in the counselling room. You and the therapist sit across from each other and talk about whatever you want to talk about. That’s all. In your first session, the therapist may take notes. After that, they probably won’t.

Ceri Hiles, who was based at our Covent Garden practice, points out that many people’s expectations of counselling or therapy are based on what they’ve seen in films. “If your idea of therapy comes mostly from the movies, then you might have a rather unhelpful sense of what it is like. You probably won’t be reclining on a couch while a severe, bearded man peers at you over his glasses and asks questions about your mother!”

These days, the therapy relationship is much more equal, with the therapist and client working collaboratively. Therapists don’t diagnose and we don’t fix. That’s because you’re not broken. Our job is to be alongside you as you work out who you are, what you want from life and how you might get it. Therapists support and guide their clients, and together the therapist and client can create amazing change, but it’s not a case of the therapist telling the client what to do or prescribing a magic pill.

So, what to talk about and where to start? Psychodynamic therapist, Barbara Perrini, stresses that every client’s experience of therapy is unique and there is no right or wrong subject matter. “It is very much individual, as it is about your personal experience and feelings. It goes at your pace and you talk about whatever you want to talk about in each session.”

Sometimes you might not know what to focus on. That’s fine. Your therapist will help you to get to the heart of the matter, whichever point you start from.

Some clients start in the past, some in the present, some talk about the same issue each week, some bring something new each week. It all works.

Your therapist will help you along the way

That said, there are effective ways to use personal counselling sessions and your therapist will support you to find what works well for you. Good therapists recognise that new clients may need a bit more help. For example, with a new client who doesn’t know what to talk about, I ask a few questions to help them start. As clients become more comfortable in therapy, they tend to need less of this.

Many clients want to be “good” at therapy and for their therapists to think well of them. That’s only natural and the client’s desire to be good can be valuable to explore in itself. But sometimes it gets in the way of the therapy. The more you can be yourself with your therapist, the better. That might mean showing parts of yourself that you usually hide, parts that are vulnerable, messy, dark and so on.

So yes, it’s ok to cry. And yes, it’s ok to swear. Therapists are used to all sorts of emotional expression. In fact, it’s one of the most precious things about counselling, that you can be yourself and be accepted just as you are by your therapist. Dwayne Jackson, who founded One Therapy, says, “There is something unique about the open, non-judgemental relationship between client and therapist that’s unlike relationships you get anywhere else. There is a unique type of honesty in therapy, shared only by the client and the therapist.”

So what to expect in counselling is on the one hand mundane – just two people talking – and I hope that this takes away some of the fear of the unknown. Because on the other hand, what to expect is something exceptional – a relationship unlike any other, which will support you to create what you really want for your life.

Kate Crawford is Head of Therapy Services at One Therapy London.
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