What actually happens in a counselling session (and what doesn't)
If you've never been to counselling, you'll naturally wonder what happens in a session. Perhaps you've seen therapy portrayed in films or on TV, or maybe you've heard stories from friends about their experiences and you're not sure if yours would be the same. The uncertainty can be enough to put people off taking that first step.
So it might be useful for me to explain what does happen in a counselling session with me, and just as importantly, what doesn't happen.
You won't be forced to talk about anything
One of the biggest worries people have is thinking they'll be made to talk about things they're not ready to discuss. You might think you'll be asked difficult questions about your childhood, or your relationships, or your worst fears, and you'll feel put on the spot or stupid.
But actually I'm not going to interrogate you. The conversation unfolds naturally, following your lead, not my agenda. (I don't have one) If there's something you don't want to talk about, you simply don't talk about it. That might change over time as you feel more comfortable, or it might not, and both of those are fine.
You don't have to make it all make sense
Or you might worry that you won't be able to communicate your experience or situation or thoughts or feelings in a way that another person can understand. Maybe it all feels tangled and confused in your own mind, so how can you possibly explain it to someone else?
You don't have to have it all figured out before we 'meet'. You don't have to present me with a neat summary of your problems or know exactly what you want from counselling. Part of what we do together is make sense of things.
You won't be 'diagnosed' with a mental health condition
Many people worry they'll be told they have a mental health disorder, that they'll be labelled or categorised in a way that feels frightening or limiting. I don't 'diagnose' conditions and I don't prescribe medication.
If you're experiencing anxiety, for instance, I won't be calling it a 'disorder' We'll talk about what anxiety is like for you, what triggers it, what makes it worse or better, and how you might live with less of it. I'll give you some insights and strategies to dial it down.
You won't be judged or criticized
You may have thoughts or feelings that you think you 'shouldn't' feel. Or maybe you're coping in ways you know aren't healthy. The idea of telling someone else about these things can feel impossible. What if they judge you? What if they think badly of you?
When I say I listen without judgment, I don't mean I'm silently judging without saying so - it means I'm genuinely not thinking judgmental thoughts about you. I understand that people do what they do for reasons; this is a space where anything at all can be said out loud, maybe for the first time.
You won't be told what to do
Some forms of counselling or therapy (I use the words interchangeably), and some counsellors or therapists, would give you direct advice and instructions, and that's fine - you can find those if you'd be more comfortable with that, but it's not what you'd find working with me.
You might say it's less like going to a mechanic who'll fix your car, and more like having a knowledgeable companion with a map and a compass as you navigate difficult terrain. I can help you see the landscape and the different paths more clearly, but I'm not here to tell you which one to take.
You won't be tied in for months of sessions
Many people avoid counselling because they imagine they'll be committed to weekly sessions for months or even years, and they're not sure they can afford that or if they fit it into their lives. It's worth knowing that you're never locked in. Some people have a few sessions to work through something specific like anxiety or insomnia. Others continue for longer, perhaps for support going through a life change, or to explore something deeper. How long you continue is entirely up to you.
So what does happen?
If all of that is what doesn't happen, what actually does?
You could say that counselling is simply a conversation and that's true as far as it goes - it's just different from ordinary conversations for the reasons above and in some other important ways: it's confidential, I'm not part of your life, I don't take sides and you never have to say 'anyway that's enough about me, how are you?' or wonder if you're worrying me. It's ok to be however you are – whether that's nervous, upset, confused, frustrated, you'll be equally welcomed.
You talk about what's on your mind or on your heart, what's been troubling you, what you're finding difficult. I listen - really listen. I will ask some questions, not to catch you out or push you into uncomfortable territory, but I find that being curious unearths surprising insights. I might offer a different perspective, or wonder about patterns or connections between different parts of your life.
You get the space to step back from the busyness of everyday life, and from those stories you've been telling yourself for years and look at them with fresh eyes, without the weight of the 'shoulds musts and oughts'. It's a chance to work through the thoughts that keep you stuck, the decisions you keep going over, the ways of coping that aren't serving you anymore. All this happens at the pace that feels ok for you – there's no rush.
Clients are often surprised, even amazed, by how things can shift when they can speak freely and know they're heard by someone who accepts them as they are, who doesn't try to fix them or tell them it could be worse and they should be grateful and put it all behind them now.
If you want them, I'll offer practical strategies you can use outside sessions to bring more ease - empowering you with tools you can use between and beyond our work together, for example in relation to anxiety or insomnia.
What happens in the first session?
First sessions are different because there is some practical information to cover – for example about confidentiality, what to do if you need to cancel, any questions you might have. I'll want to get a sense of what's brought you to counselling and what you're hoping to get from it. Don't worry if you're not sure - together we'll get to that sense of it. I won't be expecting you to have everything mapped out clearly.
Perhaps you worry that your reasons for reaching out won't make sense when you say them out loud. But if you're reading this, there's a part of you that wants to be heard and understood, and that matters.
A first session is also a chance to see if I'm someone you could trust and feel able to share difficult things with. Nobody is everybody's flavour, and it's fundamental to find out whether I could be the right person for you. People nearly always say that I'm friendly and easy to talk to, and that's a kind of progress and a relief in itself. After that, you can decide whether you want to continue. There's no pressure, no obligation.
It's meant to help, not add to your stress
The idea of talking about difficult things to a complete stranger can be really daunting, especially if you're already struggling. But it shouldn't feel like another burden. The fact of you being here and reading this tells me you're wondering about counselling and about counselling with me. I hope this has given you a sense of how it would be to do that, but the only way to really know is to try it. One session, just to see. Just a start.
Caroline Midmore is an accredited counsellor working online and by phone with clients across the UK. She specialises in supporting people with anxiety, insomnia, cancer, and sight loss. Her relational approach draws on evidence-based tools when helpful.