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What to tell your therapist first time you meet them

The thought of seeing a therapist for the first time can be anxiety provoking, even if you saw other therapists before. For many people a big part of this anxiety is wondering what to tell this new therapist during the first session. While obviously this depends on what do you want from them, there are a couple of ideas below - not to use as directions, but simply as an invitation for creativity. Maybe reading what other people discuss with their therapists on first session would help you clarify what is it that YOU want (or don't want) to talk with your new therapist about.

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Emergency Escape Plan

Being involved in a violent relationship is kind of like living on top of a volcano. Some people leave once they realize it and never look back. Others run off during the eruption, wait out the danger, and come back once things calm down. Many go back and forth a few times, but eventually leave for good. Whatever your long-term plan is (staying or leaving), it's crucial to ensure your basic safety in the here and now, while you're still sharing the house with your abuser and the volcano can erupt any minute. The beauty of an emergency escape plan is that you don't have to hide it, because it's applicable in any emergency: fire, flood, earthquake, burglary, etc. Any reasonable person would commend you for being conscious of safety, your partner won't question your motives, and your friends and family won't suspect abuse (if you wish to keep it secret). You can even disguise your plan as a joke, a game, or a hobby (e.g. zombie apocalypses). It consists of simple adjustments that are easy to implement, but that would drastically increase your chances of surviving violence at home, and eventually escaping it.

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Tips for Secondary Survivors

Many people experience trauma in their lives: car accident, death of a loved one, 911, hurricane Sandy. These things leave us overwhelmed, scared, confused, in pain. We might struggle trying to understand why did this have to happen. We might constantly relive traumatic memory, or avoid reminders of it. We might be denying the impact it had on us, or be angry and look for someone to blame for our pain. We might start questioning people in general, world, or God. Or we might blame ourselves. Abuse is a type of trauma that is inflicted on one person by another. Maybe I was raped, or beaten up, or yelled at daily and played mind games with, or maybe my parents did things that a parent isn't supposed to do to a child. The effect it had on me might be compared to a natural disaster, except abuse is perpetrated by a specific person (which I might have had a strong emotional bond with), often as a repeating pattern rather than a single occurrence, and usually isn't something I could talk of freely. I'll never be the same after such an experience, but I can repair the damage, re-adjust, grow, and have a happy, healthy, productive life. Takes time though. Often - years. Each survivor faces their own unique issues, but there are some common traits that many survivors share, and many supporters find confusing, frustrating, disturbing, or otherwise difficult to handle. Here's an attempt to explain a few of them. Abuse royally messed up my relationship skills. Part of the abuse...

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Post-Traumatic Stress Disorder

Abuse is a serious psychological trauma, often involving threat to life, so it's not surprising that many of us struggle with PTSD, the same condition that's experienced by many combat veterans. PTSD is not a weakness, and cannot be overcome by willpower, i.e. sucking it up and pretending you're fine till it passes. It's a mental health condition that needs to be diagnosed and treated by a mental health professional. DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria for PTSD include a history of exposure to a traumatic event (that meets specific stipulations), and symptoms of four different types: intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. Symptoms of each type need to be present for more than one month, causing significant distress or functional impairment (e.g. loss of employment), and cannot be due to medications, substance abuse, or other illnesses. This page lists and illustrates the four types of PTSD symptoms, so that survivors would seek professional help if they need it, and supporters would better understand what their loved one is going through and why they act the way they do.

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Neglect

Neglect means failure to provide adequate care to the child in one's custody. It's by far the most common (and the most lethal) form of child abuse, yet the least spoken about. Many people struggle placing "child abuser" label on a parent who didn't mean to harm their child, who struggles with various hardships and failed to do their job as well as they should have. However, visiting one's problems on a child is inappropriate because the child has no remedy: they cannot divorce their parents and live independently. Without adequate care, they get sick or even die; those who survive often suffer serious psychological trauma, chronic physical illnesses, and/or developmental problems, sometimes irreversible. Overcoming parental hardships is a part of being a parent. People who can't afford bare necessities can apply for government assistance or reach out to charities. People who don't know how to maintain a clean house can google tutorials or hire a cleaning lady. People who aren't sure how to care for their child can take parenting classes. At the end of the day, the parents are obligated to either provide appropriate care to their child or surrender him/her to the authorities. Failure to do so constitutes child abuse.

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Cycle Of Abuse

The cycle of abuse theory was developed in 1979 by Lenore E. Walker, a licensed psychologist who interviewed 1,500 women involved in domestic violence and noticed that their stories followed a similar pattern. She described it as a controlling patriarchal behavior of men who felt entitled to batter their wives. In reality, both men and women perpetrate domestic abuse on their partners, and the pattern is similar regardless of gender. It doesn't apply to every abusive relationship, but many survivors find it relevant. The cycle consists of four main phases that repeat over and over, alternating abuse with reconciliations. It makes you unsure if you're being abused or making a big deal out of nothing, since the relationship includes both the good and the bad times. Also, reconciliation phase often involves mutual apologies and promises (e.g. "I won't punch you again if you don't provoke me"), which makes the situation appear normal; all couples fight and reconcile, so you lose perspective on the difference between a healthy relationship and a violent one. This on-and-off nature of violence allows it to gradually intensify over the time without you noticing it, like a frog in a pot of boiling water. Each incident isn't drastically worse than the previous one, so you don't know where to draw the line, and end up tolerating things you wouldn't dream of tolerating when the relationship just started. Recognizing the pattern might help break free from it.

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Journaling

Many abuse survivors struggle with depression, addictions, unhealthy relationships, even suicide thoughts. One of the reasons it's happening is that abuse robs you of your identity, so once it's over - you feel lost and unsure of who you are anymore, and try to fill your life with unhealthy distractions. Another reason is that abuse causes a lot of conflicting feelings: pain, anger, fear, frustration, love, confusion, self-blame, hope. Talking of these feelings is hard, and even the most supportive friends can't listen 24/7. Journaling resolves both of these problems. It allows you to express your thoughts, feelings, desires, plans, hopes - free of judgment or limitations. To re-discover who you are and what you want to do with your life. This page lists a few of the most common approaches to journaling - pick the one that seems most inviting, or experiment with them all.