The anticipation of the first session

Individual therapy provides an opportunity to work through conflicts in a safe environment with a well trained and experienced clinician. Chances are it has taken you a lot of time to work up the nerve to reach out for help. Meeting someone for the first time, even if it is a therapist, can be very scary, especially when you may be sharing details about yourself and your life that you have never disclosed to anyone before.


It takes a lot of courage to ask for help, and it is okay to feel nervous, anxious and even scared when you are beginning treatment.

So please, take time and give yourself credit for initiating this step toward change. Before your first visit, you might find yourself thinking, “How am I going to explain everything that is going on with me when I don’t even understand it myself?” Or, “What if the therapist thinks I am crazy?” Please try to refrain from imposing this kind of stress on yourself.

You will not be alone in the room, the therapist will be there to provide you with the support you need to express what you have been going through.

Feeling comfortable in therapy will be something that comes with time as the therapeutic relationship develops. Something to keep in mind is that you are the expert about yourself, and in therapy you are simply sharing information that helps the therapist understand your struggles as well as your needs.

Typically, individual therapy is initiated when uncomfortable emotions have been triggered by a life event.  The reason why people choose to enter therapy can vary for everyone.


Some common reasons that people engage in therapy include:

  • Generalized anxiety
  • Social anxiety
  • Contention within a significant relationship
  • Stress brought on by a professional complication
  • Life feeling a little off balance
  • Low self-esteem or feelings of inadequacy or depression. (Here we will define depression as experiencing the loss of interest in activities or relationships that were once associated with happiness and pleasure, and  feelings of emptiness or loneliness that either can or cannot be explained by your current circumstances.)  

The beginning of therapy is your opportunity to share with the therapist what your particular reason for seeking treatment is.

You will be able to explain your present conflict or conflicts as well as the events that have led up to them. This first session is also an opportunity to establish rapport with the therapist as well as determining if you think the therapist is a good fit for you.

Sometimes conflicts can be complex in nature. For example, let’s imagine that at this particular time in your life you are struggling with emotions related to a job loss. Clearly, the loss of your job and the various complications leading to it are a crisis that you are dealing with right now, in the present. Let’s also assume that the concerns you are having in response to losing your job are legitimate and even justified. However, in addition to the valid feelings you are experiencing, you might also recognize that some old and unwanted feelings have also shown up to pay you a visit . So now, you are not only dealing with an urgent professional problem and its associated feelings, your distress is being compounded by ‘ghosts of problems past.’

It is common for painful thoughts or feelings from our history to rear their ugly head when we are under duress.

With that being said, what was already a complicated and stressful situation has now become convoluted with painful parts of yourself that have never been adequately addressed or resolved. Therefore, your ability to respond objectively to your current problem can become compromised creating further despondency.

Working one on one with a therapist can help to address each component of your problem. You will have the opportunity to deal with the manifest content, which is the current problem that you are faced with and the feelings associated with it as well as the latent content, which speaks to emotional issues that lie beneath the surface of your awareness because they are too painful to deal with.

I would like to continue to use the latter vignette of a job loss to further delineate manifest and latent content and the way in which these concepts materialize in our emotional response to environmental stimuli.


If we continue to imagine that you are in a therapy session because you have just lost your job and you are feeling anxious and traumatized, initially, as a client you begin to explain the details leading up to losing your job and the feelings that you have around it. For example, you might explain that you think you were unfairly terminated or that you think that you were treated unreasonably throughout your employment and that you are experiencing feelings of shock, disbelief, shame, embarrassment and worry. Each of these thoughts and feelings are examples of appropriate and congruent responses to what is happening in the here and now. At this point in the session, you have just disclosed the source of your pain and stress, the manifest content, to the therapist.

Additionally, you might also tell your therapist that losing your job has created other thoughts and feelings such as:

  • “I have never been able to do anything right.”
  • “I am not good enough.”
  • “No one needs or wants me.”
  • “I am a loser and a failure.”
  • “From a young age, I knew I would never be happy.”

Each of these thoughts and feelings are examples of emotional responses that are disproportionate to the problem at hand. At this point in the session you have disclosed to your therapist that the stress of losing your job has also stirred-up old or unresolved wounds from your history, the latent content.

Understanding the complexities of your emotional experience is an important part of the therapeutic process because conflicts outside of your awareness can impede your ability to stay strong and focus on conquering the problem at hand.

As a human being, you have a unique ability to defend yourself from emotional pain that has been produced by history of trauma. This ability is referred to as unique because it operates involuntarily outside of your conscious awareness. So, you are unconsciously building defenses all of the time to help bury emotional pain that might be too much to handle. Something positive about creating defense mechanisms is that you can prevent yourself from being flooded or inundated with painful emotions that you are ill equipped deal with, thereby allowing you to establish a sense of control over your own emotional experience.

While defense mechanisms work to protect you, they can also inadvertently hurt you. A defense mechanism that worked for a period of time in your life may no longer be appropriate for dealing with problems in the current phase of your life.

Because defense mechanisms tend to operate ‘under the radar,’ you may not even be aware that you are using them. This can result in you unknowingly trying to resolve a problem using a technique that no longer works. A therapist can help you to identify defense mechanisms that you have used in the past or that you are using presently that have now become a barrier for you, precluding more adaptive coping skills from taking place. Consequently, emotions that you repress because they feel threatening can motivate negative behaviors and thoughts.


Within the process of therapy, you can work through the layers of yourself and your problems; one step at a time, at a pace that you determine and with the support of your therapist.

Instead of being afraid to acknowledge your shortcomings or vulnerabilities, you can learn to embrace them and integrate all of the parts of yourself in order to become the strongest, most empowered individual that you can be.