What do I say in my first counselling session?

A surprising number of people put off booking because of this one worry. Not the cost, not the privacy, but the fear of sitting there with nothing coherent to say.

If that is you, the useful thing to know is that it is one of the most common reasons people delay, and it is based on a picture of counselling that does not match what actually happens.

You do not need an opening line

You are not walking into an exam. Nobody is waiting for you to produce a well organised account of your childhood.

The first few minutes are mine, not yours. I explain how sessions work, what confidentiality covers, how long we have, and then I ask what brought you here. If the answer is that you are not sure, that is a real answer and we start from there.

Quite often people begin with the small thing rather than the large one, because the small thing is easier to say. That is fine. The small thing usually turns out to be connected to the large one anyway.

If you want something to start with

Some people prefer having a sentence ready. If that is you, any of these work, and none of them require you to have worked anything out first.

• I do not really know where to start
• Something has been off for a while and I cannot name it
• This particular thing happened and I have not been the same since
• I am fine on the outside and I am not, underneath
• I need to make a decision and I keep going in circles
• Someone told me I should talk to somebody

That last one is worth saying plainly if it is true. Arriving because someone else suggested it is a perfectly normal way to arrive.

What you never have to share

You are in charge of what goes in the room. If I ask something you would rather not answer, you can say so and we move on. No explanation required, and it does not count against you.

You do not have to tell the whole story in the first hour. People sometimes feel they should empty everything out in one go and then feel exposed afterwards. Going at the pace you can actually manage is not avoidance, it is sensible.

You also do not have to cry, and you do not have to hold it together. Both happen and neither means the session went well or badly.

If you go blank

It happens, and it happens most to people who had the most to say beforehand. You sit down, the hour is finally there, and everything you had been carrying goes flat and unreachable.

That is not a failure of the session. It is usually what relief looks like before it has settled. If it happens, say so, and we work from the blankness instead. What were you thinking on the way here. What did you almost say and then decide not to. Where in your body does it sit. Those questions get further than trying to force a summary.

Writing something down first

Some people find it steadies them to make a few notes beforehand, and there is nothing wrong with reading from your phone in a session. Nobody is marking you on spontaneity.

If you do, keep it to fragments rather than a script. A list of three things that have been on your mind is more useful than a prepared account, because a script tends to keep you in the version of the story you have already told yourself.

If you are here because someone else suggested it

Worth naming, because a lot of first sessions start this way and people feel they have to pretend otherwise.

You can say outright that you are not sure you need this and you came because your partner, your parent or a friend kept asking. That is a legitimate place to start, and it often opens a more honest conversation than arriving convinced. It is also entirely allowed to decide, at the end, that it is not for you right now.

What I will probably ask

So there are no surprises, the shape of a first session is usually something like this.

• What brought you now, as opposed to six months ago
• How long this has been going on
• What it affects day to day: sleep, work, appetite, the people around you
• What you have already tried, and what helped even slightly
• Whether you have spoken to anyone before, professionally or otherwise
• What you would like to be different

That last question catches people out, and it is fine not to have an answer. Not knowing what you want yet is often the actual starting point.

After the first session

People often feel a bit wrung out, and sometimes lighter than expected. Both are normal. It is worth not scheduling anything demanding straight afterwards if you can avoid it.

You are not committed to a second session. If it did not feel right, you are allowed to say that, or simply not book again.

When it needs more than counselling

If you are having thoughts of harming yourself, please treat that as urgent rather than something to raise at a future appointment. Counselling is not emergency care. Contact emergency services on 112, or Tele MANAS on 14416, at any hour, and tell one person near you.

If you want to talk

A first message can be one line. You do not have to describe the problem to ask for a time, and individual counselling starts from wherever you actually are rather than where you think you should be. If it would settle things to know the practical shape of the hour first, there is a walkthrough of what a session is like.