What to expect in therapy: A first-timer’s guide

Are you wondering what to expect in therapy? This article explores what happens in a session, how therapy feels, and what you might discover about yourself along the way.

This article draws on existential psychotherapy, an approach that can help you explore how you relate to yourself, others, and the world around you, while also giving yourself permission to be seen and heard as you make sense of your experiences.

The decision to begin therapy

If you find yourself here, it’s likely that you are considering therapy and confronting feelings of uncertainty about what to expect. This is a very normal experience in the face of the unknown.

You may be wondering, amongst other things, “How will I know what to say?” or “What if my therapist judges me?”. It’s ok, you don’t have to know what to say to begin with. Therapy is a collaborative process, and you can explore these questions with your therapist to help you feel more at ease. To the latter, therapy is a space in which to be seen and heard, and met with compassion and curiosity, not judgement. 

Existential psychotherapy is a process of self-discovery and exploration of lived experience, rather than a quick fix. 

Choosing to begin therapy is an act of courage - the choice to meet yourself with honesty and explore your struggles, rather than leaning into avoidance because it offers comfort in the short-term. 

What actually happens in a session

There is no right way to do therapy. If you show up with the intention to meet yourself with honesty, you’re already doing it.

Your therapist may ask about what brings you to therapy, your hopes, or what feels difficult right now. There’s no pressure to have it all figured out.

Existential psychotherapy isn’t technique-based but is instead a conversation between two people who share the intention of seeking to understand your lived experience. The conversation follows what matters to you in any given moment, no matter what that is. 

In a first session, you can expect talking, listening, and reflecting. The first few weeks of therapy set the groundwork for the work that’s to come. Therapy is a process that unfolds over time, rather than a quick solution or set of answers offered by your therapist. What matters is how you engage with that process, and how you meet yourself along the way. 

The therapeutic relationship

The cornerstone of the therapeutic process is the relationship you have with your therapist. This is something that develops over time and is a space to explore what it means to be yourself with another person. 

When you begin therapy, it’s important to allow a few weeks to get a sense of whether it’s the right relationship for you. 

Naturally, you may not trust or feel safe with your therapist straight away, as these qualities are earned and take time to develop. When you start out, notice how you feel with your therapist… Do you get a feeling of the possibility of trust or safety? Do you feel comfortable enough with them to embark on the therapeutic journey? 

The therapeutic relationship, once established, allows the space for a rare kind of honesty where you can bring all the parts of yourself that perhaps you might usually keep hidden. It allows you to experience how it feels to have those parts seen by a trusted other. 

Common experiences in the early stages

Early therapy sessions can bring a mix of feelings like relief, awkwardness, hope, doubt, and everything in between. All of this is normal; you are not alone in feeling this way. 

Opening up about your feelings to a complete stranger can feel uncomfortable. You might find it hard to talk about your feelings in the first place, let alone to someone you don’t know. Or, it might be a relief to be able to speak to someone who doesn’t know you. 

However you’re feeling, it’s ok. Facing ourselves can feel truly daunting and uncomfortable, especially having someone bearing witness to it. Know that this is all part of the process of therapy, and it can open up immense possibilities for growth. 

You may also find that unexpected emotions begin to emerge once you start meeting yourself more fully and give yourself the space to be with your experience. 

How therapy can help

How psychotherapy works can feel mysterious, as it’s different for everyone. Ultimately, it is a subjective experience that works in different ways for different people. 

The goal of existential psychotherapy is not to eliminate feelings or eradicate suffering, but to understand and accept them as part of being human. 

Growth often comes from awareness, acceptance and the freedom to choose. Therapy invites us to explore what it means to live authentically by making choices that are aligned with who we are, rather than who we think we should be.

Freedom comes from meeting yourself with acceptance and compassion, and choosing to live in a way that works for you. 

Progress and expectations

Progress in therapy is not linear, nor is it measured by the absence of feelings. Feelings will go up and down for the rest of time; this is what it means to be a human being. Real growth often happens quietly, through greater awareness, patience, and the ability to stay present with yourself. 

We can think about progress as a feeling of clarity towards one’s experiences, acceptance of what can’t be controlled, and the courage to be who we are in the world (the ultimate challenge of all). 

Each person’s journey is different, and progress can’t be measured outside of a person’s subjective experience of themselves in their lives. 

Ending therapy (when it’s time to move on)

Endings are an important part of the therapeutic process and can bring about various feelings to be explored together with your therapist. 

Self-reflection doesn’t end when therapy ends. Therapy gives you the tools to self-reflect alone, and the ending of therapy is the beginning of a more conscious relationship with yourself. 

The end of therapy is about reflecting on what you’ve learnt, how you intend to carry it forward into your life, and saying goodbye to the therapeutic relationship in a meaningful way. 

Feeling unsure, uncertain, anxious, afraid or nervous are all normal feelings to have when considering therapy. If you feel it’s time for you to take the leap of faith into the unknown, all you have to do is show up as you are. The rest will unfold in its own time.