When Tony first came to see me he was visibly anxious. This may have been his usual way of socially presenting but I also sensed that what may be amplifying his anxiety was the fact that he was consulting a therapist for the first time. One of the common misconceptions about psychologists is that people believe we have some magical ability to look deeply into the soul of the person before us and know instantly all his/her hidden fears and shames and secret guilts.
I reassured him that ‘no, I was not able to look deeply into his eyes and know everything about him’ but rather what I was able to do was to offer him a safe space within which he could gradually at his own pace begin to tell me what were the painful issues/concerns/problems that had brought him to my door.
So after the initial pleasantries of exchanging names and perhaps comments about the weather or traffic, (perennial topics in Hanoi), I’ll then simply ask you the following questions: ‘Is this your first time in therapy and if not, how helpful was the previous therapy(s)? Whatever has brought you here, is it an urgent matter or is it something that you’ve been thinking about doing for a while? Generally what is/are the problem(s) and what are you hoping therapy will achieve?’
After asking these questions clients such as yourself will often all ask something like, ‘ I don’t know where to start’. To which I will reply something like, ‘Just start anywhere and as you speak I will ask questions to help me become clearer as to what your concerns are and hopefully by the end of this session I will have a fair idea of what your situation is and some ideas about what might be some constructive ways of dealing with your situation(s).’
From that point on the first session can go in a variety of directions depending upon the ‘problem’ presented by you and my decision as to whether it would be helpful to begin looking together at your childhood and family of origin or perhaps stick to present concerns and begin to work out what factors in your present life are responsible for the maintenance of the problem you have just described.
The way I conceptualise therapy is that I see it as a collaborative affair. I invite you, my client through questions and conversation to join with me in observing and analysing the problem that you have brought to therapy in a mutual searching for understandings and solutions. Clients who come to me are not passive recipients of my knowledge and skills but active participants in an exploration of the ‘terrain’ of the problem they have brought to therapy.
I am not one of those therapists that smokes a pipe, listens and nods and occasionally offers an opinion. I am quite actively engaging my client in a mutual problem solving enterprise which involves the learning of skills, such as meditation and mindfulness; observation of one’s thoughts and feelings; suggestions about different ways to think and act regarding my clients issues and at the end of therapy I often suggest some non-compulsory homework to put into practice some of the understandings we have arrived at through the course of the initial session.
I look forward to meeting with you whenever you make the decision to reach out and make that first appointment.
- Matthew Ryan