What you can expect after your first appointment
- Ayelet Krieger
- Oct 30
- 3 min read
You thought about therapy. You may have read a bunch of blogs or listened to some podcasts on the issue you are struggling with. Maybe you talked about it with your partner or friends. You finally took the plunge and called and booked your appointment. You wondered how it would go and ran through all the best and worst-case scenarios in your head, and then you got here and made it through your first appointment of therapy.
You did it, well done! You prioritized your mental and emotional health, which is a hard, but incredibly important thing to do.
What can you expect now?
At the outset of therapy, we commonly see one of these two reactions in our clients after the first few appointments:
You feel worse. This is usually the response when the pain you are feeling has been avoided, numbed out, or distracted away from for a while...and now you are taking the risk to face it head-on.
You feel better. This is usually the response when the pain you are feeling is a result of not being able to figure out/talk about the issues you are struggling with, and hope is renewed that you can find a way out of this suffering.
Of course, you might have neither of these reactions, but these are pretty common responses I see at the beginning of therapy.
When clients come for regular appointments, they learn new ways of dealing with the challenge that brought them in, and get a chance to practice these new patterns of thinking and acting.
This is another point of “riding the high” of therapy. It feels good, changes are taking place, and the pain is not as severe as when you first came in.
But then we commonly see a “crash” around session 4 or 5, since, well, old habits die hard, and it's easy to go right back into old styles of thinking and acting.
At this time, it's easy to think that the therapy isn’t working, or to feel hopeless that things will ever change.
It takes a few cycles of the same dynamic to repeat itself (a fight in your relationship about that same old issue, another big presentation at work, another experience of rejection by coworkers, etc.) to build up your new habits of thinking and acting, and keep out of that old rut.
I know there are points in the therapy when the pain feels less or more intense, and that can lead you to putting other obligations before making it in for a therapy session.
Thoughts like “I feel good, I’m not sure I need this anymore” or “what’s the point of therapy? I am not feeling any better” are really normal half-way through your course of treatment.
But like a good coach or personal trainer, I will be here, right by your side, reminding you of this really normal process of change (one step forward, one step back, two steps forward, one step back, three steps forward, etc.) and encourage you to keep going, so we can help you make the lasting change you want.
We don’t want to stick a bandaid on the problem. I want to help you see the whole process of change through to the end. To help you see you can make it there, and get to that goal of yours in a way that you can sustain on your own for years to come.
And when you can do this for yourself, really show up for yourself, that is the stuff of building resilience, self-confidence, and self love.
One last thought on this natural arc of therapy: I can only help if I know what is really going on. At my practice, I am encouraging of radical honesty and authenticity. So please clue me in on what you have been going through session to session. This way, they can meet you exactly where you are on your path towards your goal, and help you get there faster, and more sustainably.
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