You’re three minutes late. You can’t find parking. You run to the office. Which door is it again? You don’t even have time to sit in the waiting room, she’s already let you in. “Welcome,” she says, in her usual tone. You finally take your seat and turn off your phone. Deep breath.
“OK. What am I going to talk about?”
You aren’t prepared for your therapy session. Time and money are on the line, and you’re drawing a blank. You’re kicking yourself for not taking the time to prepare. But maybe not preparing is the best thing ever.
As a psychologist who has seen hundreds of clients for tens of thousands of sessions, I can say that many of the best sessions were unplanned. In fact, much of the time, the more you script your session, the less impactful it will be.
Let’s back up. It’s completely understandable for you to prepare. You came to find relief from a problem, so you want to make sure you’re covering all aspects of that problem. You plan to share all of the details while giving plenty of time for the professional to opine with their observations and recommendations. This time costs money, so you want to get the most from each moment. You give the A + B, they provide the = C, right? That’s how it works in other professions.
When you go to your M.D., you bring your symptoms, they prescribe a treatment. When you go to your financial planner you bring your goals and paystubs, they recommend certain investments. When you go to the salon you bring a photo of the hairstyle, they make the cuts. Why not the same in therapy?
There’s an important difference between therapy and those examples. I like to say therapy is both the lecture and the laboratory. By this, I mean therapy is a “lecture” where you receive tools and observations and insights (although most of us don’t really lecture you), but it’s also a laboratory where you let your problems be shown in real-time and you work on the solution together.
In other words, when you come to therapy it works best to show the real you. If the real you isn’t always prepared and organized, then you should bring that to therapy, too.
Let’s say that you came to therapy because you’re struggling with anxiety that makes it difficult to perform your best at work and it’s hard to connect with your friends and family. This is a common problem, and nothing to be ashamed of. If you came to therapy always well-prepared and clear about your topic for the day, you’d get a good “lecture” about relaxation and time management, tools that could help you a great deal. This is good head knowledge, stuff you can apply if you remember to do so.
But if you show your anxiety as you arrive and don’t know what to talk about, then we’re in the laboratory. If you say, “I’m feeling really anxious and confused right now,” then we invite the foe into the room. Together we can sort through your feelings, find real-time tools to help you, and get to practice overcoming your anxiety in an actual social situation. We get to share an experience of your anxiety and work through it together.
If you don’t have anything to say, why not talk about that? Maybe you can learn from expressing yourself in the moment and solve the problem in real time. Then you’ll have both the lecture of knowledge, and the lab of practicing the resolution in a real situation.
Irvin Yalom, the unofficial grandfather of modern psychotherapy, writes about the importance of the here-and-now in therapy, the times when immediate needs match immediate interventions. “The interpersonal problems of the patient will manifest themselves in the here-and-now of the therapy relationship,” he writes. In other words, if it’s a problem in the rest of your life, it will eventually become a problem in therapy. And that’s OK, because now you can work on it together.
You might find it helpful to have a few prompts to ease you into this discussion. If you feel totally unprepared, try asking yourself these questions:
- What am I noticing about myself this week? Take a deep breath and look back on your week. What observations do you have about yourself? Did you tend to get nervous when put on the spot? Do you find yourself people-pleasing an annoying co-worker? Do you push away self-care when others ask for your time? Anything goes, whether your observation is positive or not, you’ll find good material to talk through here.
- What do I want? Gut check time. What is it you really want? More time to yourself? More friends? Fewer obligations? To be taken care of? Checking your wants can give an excellent glimpse into the deficits in your life and provide plenty of material to discuss.
- How do I feel? Ah yes, the classic therapy question. Identifying your feelings isn’t the only point of therapy, but can be a key piece of data that helps you understand your natural reaction to life. Do you feel anxious or angry right now because you don’t know what to talk about? There’s a good starting point.
- What’s happening right now? A “State of the Union” is always fair game in a therapy session. So, where are you right now? How do you feel about the therapist? Have you resolved your goals and now think it’s time to end therapy? Have you felt frustrated because you don’t follow the therapist’s jargon? Talk about that.
- What were my goals? Typically, a client and therapist establish goals for therapy in the first few sessions. If you don’t know what to talk about, reviewing these goals could be a great place to start. So, you wanted to become more assertive and ask for a better position at work? How is that going?
Not coming with an agenda allows you to work with where you are in the moment instead of working from a prepared script. This could feel scary, because maybe that script helped you control where the session went, and not having one feels vulnerable. But it’s OK to give non-bullet-point therapy a try, you may find this is some of the best work you’ll ever do in therapy.
