What You Might Be Thinking After Your First Session

You did it. You made the appointment, showed up, and spent 45 minutes talking to a stranger about things you’ve never said out loud. Ideally, you came out of the session feeling heard and hopeful. But often, that isn’t the case. With so much anticipation around starting therapy, many people end up feeling a bit disoriented or even discouraged.

If you feel that way right now, you might assume your therapist isn’t a good fit for you or that maybe therapy isn’t right for you. Before you come to that conclusion, it’s important to know that it’s normal for the first couple of therapy sessions to feel more practical than profound.

In fact, research shows that it takes 3+ therapy visits on average before the “therapeutic alliance” begins to develop. Therapeutic alliance is a clinical term for the deep alignment and partnership most people come to feel when they find the right therapist. This alliance, more than any other aspect of therapy, is key to achieving positive results.

Ideally, you’ll stick with therapy long enough to see if that alliance develop. In the meantime, let’s dive into what might be going through your head, right now.

“I expected insights. Instead we talked logistics.”

The first session in therapy is very much a healthcare intake session. Your therapist is clinically required to make detailed notes about your relevant health history, current symptoms or challenges, and what you hope to gain from therapy. That means asking a lot of structured questions. It’s not exactly the meaningful exchange you might have been anticipating.

This is likely to be the only visit in which your therapist has a laptop open in front of them and spends more time typing than connecting with you. They may even seem rushed. This is typically because they know they have a lot of note-taking to get through, and they’re eager to learn about you and your needs so the “real work” can begin.

“I feel weird about all the stuff I shared.”

One of the most common things people feel after a first session is something akin to what Dr. Brené Brown has called the "vulnerability hangover." You may have shared private, emotional stories about your life, but didn't get the kind of real-time feedback you'd get in any other conversation. Did they judge you? Did you say too much? Were you supposed to cry, or not cry, or talk faster, or start somewhere else?

The uncertainty is uncomfortable. And it's completely normal to feel it.

Some people land on the opposite end of the spectrum and are surprised by how easy it was to open up, and then a little unsettled by that ease. Feeling vulnerable after being extremely candid is a reasonable response to an unusual situation. It doesn't mean something went wrong.

“I didn’t feel a special connection with my therapist.”

Again, the success of therapy largely depends on the quality of the relationship between you and your therapist, so it’s good to be focused on this aspect. You might have gotten a strong sense of who this person is and how you feel in their presence. Or you might have gotten almost none at all. Both are common outcomes of a first appointment.

If you're not sure yet, consider it a reason to go back. Relationships take time to develop, and this one is no exception.

It can be helpful to think about how you typically react to new people. If you usually need a few interactions before you get a sense of who they are and whether or not you click, expect the same here. If you tend to have a strong, immediate gut feeling about a person — and your gut almost always turns out to be right — take that into consideration.

One clarifying question to ask is whether you felt comfortable asking questions and sharing concerns. A skilled therapist creates a safe space for discussion very quickly. If you didn’t feel like you could speak up and speak openly, it could signal a poor fit.

“Therapy might not be right for me, after all.”

It’s common to have doubts. Rather than pushing these thoughts away, try staying with them. Notice what keeps coming back up for you. What struck you as off or not working for you? Take some notes if you’re someone who writes things down. These thoughts can be excellent material to bring to your next session.

A therapist will often start your second appointment by checking in about how the first one landed for you. If yours doesn't, you can bring it up yourself. How your therapist responds will give you more useful information to go on.

What we hope you’ll take away

The benefits of therapy tend to emerge slowly. Most people don't feel a meaningful shift until after the 3rd session. The first few sessions are about building trust, establishing a shared understanding of what you're working on, and figuring out how you and your therapist can best work together.

If after three or four sessions you're still not feeling any sense of connection or forward movement, consider scheduling a consultation with a few more therapists. But if you're still in the early weeks, aim to give it a little more time. The fact that the first session wasn’t inspiring or insightful doesn't mean that future sessions won't be.