Starting Therapy
It's normal to be nervous. Here's what to actually expect.
You'll talk. I'll listen. We'll figure out whether we're a good fit to work together.
The first session is longer than usual - 90 minutes rather than 50. This gives us time to get a sense of what's brought you to therapy, what you're hoping for, and whether I'm the right person to help.
There's no lying on a couch. No inkblots. No one asking "and how does that make you feel?" in a clichéd voice. Just two people in a room having a conversation about what's going on in your life.
Most people feel nervous beforehand and relieved afterwards. The anticipation is usually worse than the reality.
You don't need to prepare anything. There's no homework, no forms to fill out in advance, no need to have your thoughts organised or your story straight.
Some people find it helpful to think about what brought them to therapy now - why this moment rather than six months ago or six months from now. But if you haven't, that's fine. We'll figure it out together.
Practical things: know where you're going and give yourself time to arrive without rushing. If you're coming to my practice in Croydon, it's near East Croydon station. If we're meeting online, test your connection beforehand and find somewhere private where you won't be interrupted.
That's it. You don't need to bring anything except yourself.
We'll start with the basics. What's brought you here? What are you struggling with? How long has this been going on?
I'll ask about your life more broadly - work, relationships, family background. Not because I need your entire history in one session, but because context matters. The anxiety you're experiencing now usually connects to things that came before.
I'll explain how I work - the psychodynamic approach, what to expect from sessions, practical things like frequency and fees. You can ask me anything. This is as much about you assessing me as me assessing you.
Towards the end, we'll talk about whether it makes sense to continue. Sometimes it's clear we're a good fit. Sometimes one of us isn't sure. Sometimes I'll think someone else would serve you better and say so.
The first session isn't therapy yet. It's two people deciding whether to do therapy together.
While you're talking, I'm listening on several levels. The content of what you're saying, obviously. But also how you're saying it. What you emphasise and what you skip over. Where you get animated and where you go flat.
I'm noticing my own responses too. What draws my curiosity. Where I feel pulled to rescue or reassure. What remains unclear. These reactions tell me something about how you might affect other people in your life.
I'm also assessing whether I can help. Not everyone needs psychodynamic therapy. Not everyone is ready for it. Sometimes a different approach would serve you better, or therapy isn't what you need right now at all. Part of my job is being honest about this.
None of this is a test you can fail. I'm not looking for right answers. I'm trying to understand you well enough to know whether working together makes sense.
Nervous beforehand. Almost everyone is. You're about to tell a stranger things you might not have told anyone. That's vulnerable. The nerves are appropriate.
Uncertain what to say. That's fine. I'll guide the conversation. You don't need to have a script.
Emotional during. Sometimes things come up that surprise you. Tears happen. This isn't a problem - it often means we're touching something important.
Tired afterwards. Talking about yourself at this depth is more exhausting than you'd expect. Plan something low-key for afterwards, not a work presentation or difficult conversation.
Relieved. Most people feel lighter having finally said some of this stuff out loud. Even if nothing is solved yet, being heard helps.
Unsure. Sometimes you leave not knowing whether this is right for you. That's okay. You don't have to decide immediately.
If we both want to continue, we'll arrange to meet regularly - usually weekly or twice weekly. The ongoing sessions are 50 minutes rather than 90.
If you're unsure, take time to think. You don't have to commit on the spot. Some people need a few days to process before they know.
If it's not right - whether that's my sense or yours - that's useful information, not failure. Finding the right therapist matters more than starting with the first one you meet. I'd rather you work with someone who's genuinely right for you than stick with me out of politeness.
The first session is just the beginning. The real work happens over time, as patterns emerge and trust develops. But it starts here - with showing up and being willing to talk about what's actually going on.
I'm a psychodynamic therapist practising in Croydon, South London. First sessions are 90 minutes and cost £70.
If you're ready to start, you can get in touch to arrange a session. If you want to know more first, read about how psychodynamic therapy works or how long therapy typically takes.