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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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Tips for Attention Seekers

Attention can be a hard subject for abuse survivors. It's a basic human need, like food and water, but during abuse attention often resulted in pain. We want to be noticed, but we're scared of getting hurt; we want to rely on others, but we're afraid of rejection; we want to reach out, but we don't know how to do it constructively. Some people seem to get by with very little attention: they view it as a valuable resource, are frugal with it, and spend it wisely, only asking for the exact type of attention that they need. Others can't seem to get enough, asking for any type of attention they can get, which frustrates everyone around them and drowns them in negative backlash, destroying their self-esteem. Getting the right type of attention is a skill like any other, it takes trial and error, and a lot of practice. This page lists a few basic tips on how to make it work.

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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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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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False Rape Accusations

This is Luke Harwood from Essex, UK. When he was sixteen, a girl filed a rape complaint with the police against him. The police officers believed her story, but felt that Luke was innocent because the incident she described didn't constitute rape; she was misunderstanding what rape is. They explained it to her, and she withdrew her complaint. However, two years later she told a friend that Luke was a rapist, but that the police wouldn't press charges against him. She probably thought she was just telling her story, reaching out for support. Her friend, however, felt that justice needed to be served, tracked Luke down with two of her friends, and brutally murdered him. All three were sentenced to life in prison on multiple charges, including perverting the course of justice. Luke was eighteen years old. He had a son, Archie, and was expecting a daughter, Lilly-Rose. He was killed because of a false rape accusation. The prevalence of false rape accusations is a controversial topic; everyone seems to agree on the numbers, but interprets them differently. Here are the numbers (sources are listed on the bottom of this page): 2% of rape accusations were proven true, i.e. the accused was convicted of rape. 2% were proven false, i.e. the accuser committed perjury. 63% were never investigated because the alleged victim never filed a police report. 33% were a combination of unfounded claims (i.e. the incident described by the alleged victim does not constitute rape) and...

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Emotional Abuse

All humans need to be treated with dignity and respect, regardless of age. Parents have legal, physical, intellectual, emotional, and financial power over their children in order to care for them, to ensure their safety, welfare, appropriate development, etc. Using this power for any other purpose is wrong, just like it's wrong to mistreat prisoners of war. Children are in an even more vulnerable position because they don't process information the same way adults do; their brains are still developing, so what might be a stupid joke to an adult can cause serious trauma to a child. Young children believe what their parents tell them, and emotional abuse can cause them to draw very inaccurate conclusions about themselves and their place in the world. Older children understand that they're being mistreated, but have no recourse: they can't yell back, cut their parent off, or sue for harassment. They are stuck without options, forced to endure maltreatment. Taking advantage of this vulnerability is abusive. Emotional abuse of children is usually a part of any other type of abuse (e.g. physical, sexual, or neglect), and is mostly treated as an aggravating factor rather than a separate crime. It lacks legal definition, which makes it hard to address when it's the only type of abuse inflicted on a child. It's nearly impossible to prosecute in criminal court, but Child Protective Services work independently of law enforcement, and might remove the child from their parent's custody...

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Growing Up In A DV Environment

I grew up in a violent situation, where the adults around me were not only violent with me, but were also violent with each other. Domestic violence was really confusing for me as a kid. Then I had the fortunate opportunity of living in a completely different situation with my adoptive Mom and Dad, and the contrast between the two situations was drastic. I read something a while back that made me think about the situation. I remember really strongly how I felt as a kid when the adults around me fought with each other, argued and were violent with each other, were disrespectful towards one another, and treated each other as less than a person. Their actions had a huge impact on me--I was afraid the majority of the time, I didn't feel safe, cared about, or stable, my world felt like it was always on the brink of crumbling, and I had no way to get myself out of the situation or to improve it, so I felt really trapped. Considering I didn't have anything to compare this environment to, I figured this was just the way it had to be--that adults argued, fought, were violent, etc.--and I often felt as if these things were my fault. Fortunately, once I got out of the abuse situation and my Mom and Dad adopted me, I found out that relationships and conflict within relationships could be drastically different. My Mom and Dad often disagreed with each other, had arguments about a multitude of things, didn't see eye to eye sometimes, but they never treated each other with anything less...