My First Psychotherapy Session

Why does that sound like the last in a range of ‘My First…” books for toddlers? I actually wish that book existed, to be quite honest…

But, you know what? It actually went OK! A lot of it was just talking over how this is going to work, that Relationally-oriented Integrated Therapy isn’t like a lot of standard therapies: its main focus is the therapeutic relationship (rather than the therapeutic relationship being one of the secondary – but still core and very important – elements of many other therapies), using this to work on my current and past experiences through ‘integrating’ a vast range of psychological techniques (e.g. psychodynamic, mentalization, DBT) as and when appropriate. Apparently all I have to do is bring myself and be brutally honest…which is a brand new experience for me and much more easily said than done! I tend to hide or minimise myself as much as possible in relationships, and I certainly never am honest about criticisms or anger or sadness or fear or boredom or confusion or hurt or…or…or… I have to try to remove all those filters in my head and remove my complete preoccupation with making sure the other person is OK above and beyond myself, and trust R* when she says that she will never take anything personally; apparently a lot of the most important work is done when the negative things are thought, felt and expressed honestly, in the moment. This is most definitely going to be a monumental challenge for me – it feels like (and, actually, my formulation letter from her suggests) I am hard-wired to minimise me/my needs and always sacrifice myself to look after everyone else, even the people that I most definitely have no responsibility or need to do that for…everyone is more important than me and their needs should be considered above mine. Especially considering that I’m not ever sure there is a ‘me’! So, as part of the start of this therapy it seems like we’re going to have to tear the cover off, rip the wiring out, and start from scratch. Has anyone got some spare pliers?!

But, despite my fears about whether or not I’m capable of this, as I spoke to the crisis team yesterday evening I spoke words that a crisis nurse who knows me very well made me pause and think about: “I’ve made a list of the positives from today and a list of my worries – they are almost equal and that is OK“. This might not seem like much, but for me it is truly monumental. My worries always massively outweigh any positives or tentative optimism, and I never allow myself to accept that it’s actually OK that I have worries/concerns or that these don’t negate any positives. The nurse said she’d never heard me say anything anywhere near as optimistic as that and we had a little emotional moment, where her happiness for me struck a chord and really made me think. Maybe we really are finally going to get somewhere with this!

So, what is this special and important list?

Psychotherapy Session 1 of 60

Good Things


  • I like R
  • I feel like R understands me
  • R is hopeful it will work out better with C** in terms of:
    • therapeutic relationship
    • communication
    • stability
    • dealing with risk
  • There’s no ‘right’ way: I just have to bring myself, be as honest as possible, try to remove filters and be completely honest
  • R will never take anything personally
  • It feels like this is really focussed on me specifically – not trying to squeeze me into ill-fitting boxes
  • It will be driven by me and by what comes up, rather than being very rigid or goal-driven
  • R completely understands the impact of invalidation and shaming comments that I regularly receive from other professionals: “it’s like they’re emotionally running away from you whilst lobbing rocks over their shoulders!”
  • R thinks that problems with professionals are often down to their emotional/instinctive reactions to my struggles – not down to me or my fault
  • We have a similar sense of humour – a great way to connect and get through the hard stuff
  • I have to somehow be completely honest, without pre-thinking everything I say and using the many layers of filtering that goes on in my head before I speak
    – brand new for me
  • I have to do most of the talking in quite a free way – not just respond to questions
  • There will only be vague goals/direction – I don’t cope too well with not knowing what to expect
  • She wants me to be honest about anything that annoys/upsets/angers/frustrates/confuses/bores me – I’ve never been able to do this
  • I don’t really know what these 60 sessions ‘look like’ – and neither does ‘R’!
  • I’m already worrying about the end considering that this therapy is all about building up a really strong relationship over 18 months – and R flagged this up as something that will likely be difficult
  • I need to try out for the first time ever just talking about what’s on my mind, drive the focus of our time together, focus on what I want and need – terrifying!
    • I’m also scared that I just won’t be able to
  • She wants me to be honest if I’m not happy about the way our sessions are going, if something she does/says evokes an emotional reaction, and even openly criticise her – EEEK!

Cautious, guilt-ridden gratitude and *whispers* optimism continues…


*R = Psychotherapist/Clinical Psychologist
** C = New Care Coordinator

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s