What to expect from a first session

It is not the moment when the therapist sits down, looks at you carefully, and begins to explain you to yourself. It is not an immediate plunge into the deepest and most painful material. It is not a revelation.

A first session is an assessment. On both sides.

What most people feel before the first session

Anxiety is almost universal. The prospect of speaking to a stranger about what is most private or painful is genuinely daunting. Many people have thought about coming for months or years before they actually do. For many, shame has been the barrier.

The first session does not require a person to have everything worked out. Coming is enough. The rest unfolds from that.

What the therapist is doing

Philippe Jacquet uses the first session to gather information. Where is this person? What has brought them here, and why now? What are their therapeutic needs, and crucially, is he the right person to meet them?

This last question matters more than it might appear. Philippe will not take someone into his practice if he does not believe he is the right person for them. Different presentations call for different expertise. If someone else could do better work with this person (because of their specialism, their method, or simply who they are) he will say so and refer accordingly.

This is not rejection. It is clinical honesty.

What the therapist is listening for

The therapist listens, to the content of what is said, but also to what is not said; to the feelings that arise in the room; to the quality of the person’s relationship with their own experience.

What you might be asked

• What has brought you here now, what made this the moment
• How long the difficulty has been present, and whether anything has recently changed
• What your life looks like, work, relationships, the shape of your days
• What you are hoping for, even if you cannot fully articulate it

The chemistry question

A patient came to see Philippe presenting the pain of a recent breakup. Her ex-boyfriend was Belgian. Philippe, who is himself Belgian and carries a French accent, noticed something. He asked her directly: is my accent a difficulty for you?

She began to cry. Yes, she said. It makes the pain more unbearable.

He gave her a choice, refer her to another therapist, or continue together. She chose to stay. They worked together.

Sometimes people don’t stay. A woman arrives and knows, within the first session, that she needs to work with a woman. Someone else needs a therapist from a different background or approach. These are not failures of compatibility. They are the assessment working as it should.

The therapeutic relationship is not a commodity. Chemistry (the sense that this person can hold what I am carrying) is a legitimate part of the decision. Patients are evaluating therapists as much as therapists are evaluating patients. Both sides should take that seriously.

The twenty-minute call

Philippe is regularly asked whether he offers a short telephone call (fifteen or twenty minutes) so that a potential patient can decide whether to book.

He is not keen on this, for several reasons.

Twenty minutes on the telephone does not reflect what happens in a session. It creates an impression of the work that may be misleading in either direction.

There is also something else underneath the request, a wish for something free before committing to something that costs. Philippe understands the instinct. But he offers this image: if you go to a restaurant you have never visited, you do not ask the chef for a free starter to evaluate whether you are willing to pay for the main course.

The first session is the starter. It is what the assessment is for.

“The first session is not about me explaining you to yourself. It is about both of us finding out whether we can work together. I will not take you into my practice if I am not the right person for you. And you should not stay if I am not. The chemistry matters. The honesty matters more.” , Philippe Jacquet

After the first session

It is entirely normal to feel unsettled after a first session. The most important thing is whether something felt possible. Not certain, not comfortable, possible.

Book a consultation with Philippe Jacquet, psychotherapist and Jungian analyst, London.