Having been working as a psychologist now for some 15 years, I have a tendency to become complacent about the idea of what it must be like for someone going to see a psychologist for the first time. The thought came to me as I was discussing with a friend that their work environment and what was expected of their customers was a foreign concept to their customers. It got me thinking about a few new clients who rang to make their first appointment only to cancel the day before the appointment. I realised that for many people, the idea of what to expect from seeing a psychologist is usually based on what's portrayed in movies or television. Going to see a psychologist is not necessarily a common activity, nor do many people talk about it. Secondly, knowing that you should see a psychologist and actually going to see a psychologist are two very different things. I have lost count of the amount of times I've heard a client say "I should've come to see you earlier".
Making an appointment and attending the appointment for the first time is hard. Often it means acknowledging that something is not quite right or there is a problem that won't go away by itself. That can be very challenging to admit. For some, they worry that the psychologist will judge them. A lot of people don't know how to put how they feel into words, and that can stop them attending. I've written about this in another blog, sometimes we use strategies that take away the problem or reduce the symptoms, but may not be so helpful in the long run.
What to expect at the first session
The first appointment is very different from other appointments. It's a lot more formal, where the psychologist will explain issues around confidentiality and consent to release information. Typically, the first appointment is more of an assessment, where the psychologist will ask a lot of questions to get a good understanding of the problem as well as other factors that might be contributing to the issue. It's also an opportunity for you to get to know the psychologist and whether you feel you will be a fit and can work together.
The psychologist will likely give you some feedback on what you discussed in the appointment, but you may not get a clear plan of treatment after the first session. This is important to acknowledge, because sometimes the issue is quite complex and you may need another session to get a clearer picture of the problem. But, hopefully you've finished the first session with a sense that the psychologist understands the problem.
It can be hard to put feelings into words
Sometimes it's difficult to find the right words or a way to express your feelings about the problem. Part of the process of therapy is working through this difficulty, finding the words, and putting the problem into context. Talking about the problem and having it reflected back can be therapeutic in itself. It allows you to fully explore the issue in a way that you can't do by just thinking about it. The process of seeing a psychologist is somewhat different from seeing other health professionals where the process of discussing the issue, helping through pain points and blocks, is collaborative rather than receiving expert opinion. Many clients have told me over the years that they had seen another psychologist but "they didn't say much". That's probably more an error on the behalf of the psychologist in not explaining the process and the difference with other professionals.
Sometimes it hurts to express the feelings
Our brain is a truly amazing thing in that it can avoid processing painful emotions even when we are thinking about the problem. In a therapy session with a psychologist, however, when we discuss the problem and the associated emotions we then activate this part of the brain and as a result, we can experience intense emotional responses. Although it is hard, and maybe even painful, this is where the healing can occur, and working with a psychologist to help manage the feelings so you are not overwhelmed.
Talking to a psychologist is different to talking to a friend
Your psychologist is not your friend. They will most likely be very friendly towards you and caring, but they are not your friend. What I mean by that is that when we speak to our friends, it is often a two-way communication experience - you tell your friend something, they listen, are sympathetic, maybe give advice, then talk about their experience or problem and there is a back and forth process in the conversation. With a psychologist, the interaction is not two-ways. You communicate, the psychologist reflects what you've said, asks clarifying questions, gives interpretations, asks your opinion, and maybe asks you to think about it some more in between appointments. Although I believe talking to your friends is vitally important, there is a distinction in the interactions. The psychologist also has no interactions with you outside of these times, they don't know the people you are talking about, which means you can be more candid than you might be with a friend. They may even be more provocative than your friends - asking you to reflect on your own behaviours or coping responses.
Why it's worth it
It can be very challenging in making the decision to go and see a psychologist. However, the pay-off is that you can process difficult emotions or thoughts, and learn new ways to cope, that perhaps you were unable to by yourself. Taking time to explore issues about your life also opens up new opportunities to perhaps do things differently and achieve different results, for example finding out what is holding you back in making new friends or going for a promotion at work.
If you've made the first step of booking an appointment with a psychologist, then I congratulate you. When you follow through and attend, make sure afterwards that you congratulate yourself and pat yourself on the back.