I will greet you at the door, introduce myself, and show you into my office and to a chair.
When you are settled, it’s usually up to you to start; otherwise I may prompt you with a general question such as “What brings you here?” You can describe the problem you are having, or anything else that comes to mind. Don’t worry about whether you can say everything with absolute precision. As your therapist I will be able to help you get it all out.
In this first session, you can expect to do nearly all the talking. You can expect me as your therapist to listen actively. I may not say anything at all until halfway through the hour, or may make one or two interpretive comments or ask for clarification. While you are talking, I will be listening carefully, evaluating your situation and deciding on possible treatment. In order for me to do this, I must listen to you, and not influence what you say, or the way you say it.
Toward the second half of the time, I will indicate whether or not I can be of help to you. I will then propose a therapeutic structure: a schedule of appointments, a fee, and any other related details. You have the opportunity to react to this structure, and decide whether to continue. Remember that this therapeutic structure — the schedule, fees and other details — is not incidental, it is a very important element of therapy. This “holding” environment is an important step in establishing the secure frame. The proposed structure should be clear and unambiguous, and should reflect safety, consistency, and containment.
Having agreed on the fee and on a regular day and time for your appointments, you are, hopefully, on your way to emotional healing. You say goodbye and leave.
After that, your appointment should, ideally, stay the same as long as the therapy lasts; that is best for the success of your treatment. You may think that flexibility in the schedule is helpful to you; but it has been shown over and over again that to your unconscious mind, it is not. If you are depending on a structure for support, any change to that structure will leave you feeling unsafe.
Therapy sessions are typically 50 to 60 minutes. To maintain the secure frame, I as your therapist will hold you to that time absolutely. If you arrive late, you still must stop at the agreed time. At some point, it will probably happen that you will be in the middle of something deep and anguishing when the time comes to stop. This may be extremely frustrating to your conscious mind, but a good therapist will not allow you to run over the time, and that should satisfy your unconscious.