Why Does My Therapist Wait for Me to Start the Session?

Shot of person of middle years with short hair in business dress sitting on sofa, hands folded, looking to one sideEvery part of therapy can be informative. The moment you enter the room is no exception.

Different therapists have different styles, but in psychodynamic work there’s usually space left for you to start the session. What you do with that time is important. How you feel about that time is even more so.

This Is Not a Test

If your therapist doesn’t say anything when you enter the room—and I mean not even a “hi” or a “how are you?”—it doesn’t necessarily mean they’re being rude. It’s not a test, and it’s not meant to make you feel a certain way.

Believe it or not, the space is there so the therapist has less influence over the session. We don’t want to focus on what we think is important or, even subtly, walk over a feeling or thought you are having. Therapy time is your time.

Do you want to pick up from last session?

Do you want to talk about that incident with your brother-in-law over the weekend?

Do you want to discuss what happened with the guy who sold you a coffee just before you arrived at my office?

It’s up to you. Entirely.

Sure, we may hope to hear about how that discussion went with your partner, the one we’ve spent months gearing up for—but we may not ask about it. Perhaps you’ve moved on. Maybe you didn’t have the discussion and our asking about it might make you feel like you should have had it—in which case the therapy becomes about whether you’re doing what you’re “supposed” to do (and suddenly we’re replicating a relationship with your dad that you’ve been struggling with).

The only real exception I make is if you’ve talked about an ill or dying loved one. I’ll probably ask about that (but maybe I shouldn’t!).

How Do You Use the Time?

Often, people say they don’t know what to talk about. Not because they don’t know what they want to talk about, but because they don’t know how to start.

In those early silences, when you’re struggling with starting the session, it’s good to become aware of the feelings that are filling that silence.

Many people who come to therapy, particularly those who often put others first, have a difficult time just jumping in and talking about themselves. A giveaway for this is when a person immediately asks about my week. They may tell me they’re doing so because it’s polite and they’re making small talk, but therapy is fully about you. You’re paying me and you want to know how my week was? It’s a nice thing to do, but didn’t you say in our first session you want to be more assertive? That people take advantage of you? Well, guess what—that’s what we’re working on by talking about what’s happening between you and me.

Pay Attention to the Feeling in Those First Few Moments

In those early silences, when you’re struggling with starting the session, it’s good to become aware of the feelings that are filling that silence. This can help us understand your (perhaps) social anxiety, your reluctance to speak up in a class or group, your tendency to “live in your head” and intellectualize everything.

Awareness of the shyness, nervousness, anger, worry, or whatever else is in the silence can inform all those other times outside the therapy room when you don’t jump in and say what you want to say. Once you’re aware of the feeling, we can explore it to stop it from getting in the way of your action (or inaction).

Conclusion

Your therapist probably isn’t trying to be a jerk by not starting the session for you. We’re aware of how difficult it can be. To that end, we may, after a time, ask a starter question along the lines of, “What’s it like to be back here today?”

Sometimes we’ll process the silence or the “how are you?” and sometimes we’ll just see where you take the conversation. The major point I’d like you to take away from this is to talk about what’s going on for you in relation to the therapist.

Tell your therapist how awkward it is and how much you wish they’d just start for you. How angry you are because your therapist should be the one to direct the session; you’re paying them for their expertise, after all! Or how overwhelmed you are because of all that’s happening and you just can’t prioritize and need help doing so.

Or, just maybe, you feel you have nothing to say. Well, say that then. We’re here to guide you, but also to do all we can to not influence you.

© Copyright 2017 GoodTherapy.org. All rights reserved. Permission to publish granted by Justin Lioi, LCSW, therapist in Brooklyn, New York

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • 13 comments
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  • Jameson

    Jameson

    September 18th, 2017 at 7:36 AM

    I am not so sure that I would know how to react if I entered the room and he said nothing. I think that it would be appropriate to at least say hello and go from there. Ask if there’s something specific that you would like to discuss today. I think that for me it would be kind of off putting to walk in and him not say a word.

  • Justin Lioi

    Justin Lioi

    June 14th, 2018 at 7:14 AM

    Jameson, thanks for this. I don’t usually start the first session this way, but find it important to get “out of the way” as soon as possible with clients.

  • jackie

    jackie

    September 19th, 2017 at 10:02 AM

    Gives you a little more openness to talk about what you would like to talk about and not simply follow him or her on a path. It really gives you much more opportunity to steer the session in more of a direction that feels right for you for that visit. And that can actually be a wonderful tool for helping you learn to talk about the things that are important to you at this time!

  • Justin Lioi

    Justin Lioi

    June 14th, 2018 at 7:14 AM

    I agree, Jackie. Thanks!

  • S.topper

    S.topper

    September 20th, 2017 at 8:58 AM

    Perhaps if those guys would take the time to explain to a client the sorts of things one is to talk about in order to help with the reason the client hired them in the first place. Otherwise it is all guessing and stabbing and wastes a lot of time and money – which only benefits the therapist.

  • Justin Lioi

    Justin Lioi

    June 14th, 2018 at 7:16 AM

    Those are definitely areas to explore with the therapist–the sense that they are wasting time and money to benefit their own needs. Thanks for putting that out there. I would hope there is some initial understanding of the client’s goals and hope for the treatment that gets talked about early on!

  • Braylon

    Braylon

    September 20th, 2017 at 10:55 AM

    I agree with S. topper. It can start to feel like the clock is ticking and I am running out of time if I don’t start right away with the best topic to explore/

  • Justin Lioi

    Justin Lioi

    June 14th, 2018 at 7:17 AM

    That sense of urgency is a great place to dive in and explore. Thanks for writing!

  • John S

    John S

    September 22nd, 2017 at 3:28 AM

    I agree with you, psychologists have a different thought process towards their patients and yes, this is their own way to start a session. Perfect explanation. Thanks for making your thoughts available here for all.
    iandowlingphysio.ie/

  • Justin Lioi

    Justin Lioi

    June 14th, 2018 at 7:18 AM

    Thanks, John.

  • constance

    constance

    September 22nd, 2017 at 2:12 PM

    I didn’t like that too much either and I finally said something about it. He completely understood and agreed that he would always start the session and then we could go from there. That has been a much more comfortable situation to me, and for what it’s worth, without his help, I would have never in the past have been able to speak up about my own comfort level so I knew that this was coming from a good place and I think that he did too.

  • Justin Lioi

    Justin Lioi

    June 14th, 2018 at 7:19 AM

    Constance–that’s great that you trusted enough to have that conversation and that it was heard and not dismissed! Thanks for writing.

  • CC

    CC

    October 5th, 2018 at 9:01 AM

    This is a little different, when I talk about a difficulty that is going on with another person and the therapist says, “I don’t know that person, but..” it bothers me because the therapist doesn’t know anyone I deal with unless they are in therapy with me and does it matter if they know them or not? It feels minimizing to me. Also I stated that it bothers me when people I know say that to me. I am going to talk about it with the therapist, but to me it sounds like they doubt my perceptions. Thanks.

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