The foundation of therapy is safety.  It is only when we feel safe that we can be vulnerable, and only when we are vulnerable that we can heal and live arms open wide as our authentic selves.  One primary element of safety is consistency. We need a measure of predictability so we can take risks.

I begin each one of my sessions the same way. 

We greet each other, sit down, and then I invite the client to close their eyes and take several slow deep breaths as I do the same. I begin this way, so we can both ground ourselves in the room together, as I recognize that my clients are often coming from work or class or running errands and can benefit from slowing down for a few moments. 

The practice of breathing deeply for a couple minutes also marks the transition into our time together, as if to say, “This space is sacred ground, let us enter it mindfully.” I have had numerous clients tell me, “I find myself pausing to take deep breaths throughout my week now, whenever I feel overwhelmed.” I share the technique of “box breathing,” which involves breathing in through the nose for a count of four, holding the breath in for a count of four, and then releasing the breath through the mouth for a count of four. This method of breathing is physiologically proven to calm the body. 

I also ask the same question at the outset of every session, inviting the client to share by inquiring, “Where are you at today?”

I start with this question for multiple reasons. First, I am well aware many clients experience anxiety as they anticipate a session, especially if they are new to therapy. Beginning with the same question every time can offer the client some comfort, as it gives them one item to prepare for mentally and emotionally. I have had a client ruefully respond, “I was thinking about my answer as I drove to your office because I knewyou were going to ask me this.” The expectation of this question can mitigate some of the fear of the unknown. 

 Therapy can be highly unpredictable. Clients are regularly surprised by what comes up when they are given the space and quiet, non- judgmental presence of another. It is not unusual for a client to say, “I do not really know why I am here,” only to answer their own question later in the session or soon after. It is not uncommon for a client to be taken aback by the tears or anger or even laughter which arises as we sit together with their experiences, as well as their thoughts and feelings about those experiences. 

 As we end our sessions together, I also like to ask all my clients a similar question: How will you care for yourself this week? Or “What can you do following our session to honor the work we just did?” Some clients like to treat themselves to their favorite coffee or tea, walk outside for 15 or 20 minutes before they return to work or their families, or snuggle with a pet. 

I strive to provide a consistent framework for how we begin and end our time together, so my clients feel safe and cared for as they do the difficult work of healing.