You’ve decided to seek out a therapist. You google the qualities you’re looking for in your ideal clinician: younger, older, experience level, pricing, specialties, and so forth. You call and book the appointment. When you first walk into your therapist’s office you’ll review and sign something called the “informed consent;” which is you, the patient, giving permission to your therapist to treat you from a psychotherapeutic standpoint. While signing this, we agree who might play an essential role in your treatment, matters of payment, your expectations of the psychotherapeutic process, and what outside persons it makes sense to consult with (primary care physician, spouse, other mental health professionals, etc.).
Now what? How do you begin to talk to this educated stranger about your life and disclose your hopes, failures, dreams, feelings, and secrets? What is the best way to initiate communication with your therapist?
The truth is there is no real “best way”, but there are some things that help us help you more effectively. From a therapist’s perspective I will tell you that our goal is to build therapeutic rapport, which means we are trying to get to know you and help you to get to know us in a comfortable, safe, and healthy environment. If you don’t feel comfortable with your therapist, it’s harder for you to trust us. This means you will be more reserved and less likely to be successful with therapy, which results in wasting your time and money.
As a disclaimer I will let you all in on a little secret; although therapists and psychologists obtained fancy master’s degrees, and/or Ph.D.’s, have written papers, and spent hours studying about the mysteries of the mind and how she operates, we sometimes get stumped, and need to do more research about what you’re struggling with. We maybe even collaborate with a colleague or two. Every patient we encounter is different even if you have the same diagnosis. Trust me, we desperately want to help you, but we don’t know everything. Be patient with us, because although we may have worked hard in graduate school and passed state boards, we are still human, and constantly learning more about this fast-growing field. We can’t work with you if you’re working against us.
One great way to begin session is by talking about why you originally called for an appointment. Is work stress getting to be too much? Are you hearing voices? Are you struggling with addiction? Do you have intrusive thoughts that are interfering with your daily activities? Describe your symptoms to us, and how they affect you on a daily, weekly, seasonally, or situational basis. Begin therapy by reviewing your biopsychosocial history with your therapist. This simply means review you biological (bio), psychological (psycho), and social (social) history. For example, do you have any medical conditions? Are you currently taking any medication, vitamins, or supplements? Have you met with a therapist before? Do you have family history of mental illness? How is your social life? Do you have a good support system at home? The more information we know the better.
Symptoms don’t always have to be purely psychological. For example, let’s say you have a big presentation coming up, and you’re feeling more nervous than usual. Maybe you feel sweaty, your heart is racing, you clench your jaw, and you have a headache. These are physiological symptoms that could be signs of anxiety. Describing any physiological symptoms that are active when you have certain feelings can help your therapist better assess what psychological condition you may be experiencing. Your therapist should be asking you questions about both your physical health, as well as your mental health. How you treat your body physically can have a great impact on your mental wellness. For example, some good questions for your therapist to ask could be regarding your overall diet, water intake, and daily requirements for vitamin D. Do you ingest any substances such as alcohol, nicotine, caffeine, marijuana, and so forth? The answers to these questions could be part of the cause of your psychological symptoms that sometimes are overlooked by therapists that do not have a holistic approach to treatment. You are the best source of information about your symptoms, so, help us help you.
This brings me to my last point on how to best begin communicating with your therapist and have the best psychotherapeutic outcome. We’re here to help you, but we can’t help you until you are ready to help yourself. Believe it or not, a therapist cannot, and should not tell you what to do, and how to live your life. Our job is to help you help yourself, and give you tools, coping skills, preventative strategies, mindfulness skills, and more that help you approach your concerns, problems, and everyday life struggles. Therapy is not easy. In fact, diving into the depths of your most intimate thoughts, revealing what keeps your awake at night, and admitting problems, is one of the most vulnerable, but brave acts a person can do. But your therapist can’t force you to be ready to talk, just like your primary care physician can’t force you to change your diet and couldn’t convince you to say no to that deep fried Oreo (and funnel cake, popcorn, corn dog, and turkey leg) at the Houston Livestock Show & Rodeo. This process is about you, and you alone. When you’re ready to talk, we will be here.
About the Author
Kathryn Wainscott, M.A., LPC-A's primary clinical interests lie in helping to develop the coping skills of children, adolescents, and adults during major transitional periods in their lives. Additionally, she has experience with mental health disorders varying from ADHD, the autism spectrum in children, personality disorders, bipolar disorder, depression, and anxiety.