Not sure what to tell my new counsellor

[Fermatslittletheorem]

So I decided to book an appointment with a private counsellor (feels ridiculously extortionate and self-indulgent to be honest) and I am a bit worried about it.

I have had lots of therapy and a bit of counselling in the past, but have always been referred so they knew a lot about me already, and knew what we were meant to be working on specifically.

I presume she'll ask me what I want to get out of seeing her, but I don't really know. Normally when they ask that I cobble something together that I think will make me sound motivated but not too self-pitying. But I don't really even know why I want to see her. I kind of just want to talk to someone who will actually listen and understand. My family and CPN are amazing but they know me too well to be objective, if you see what I mean. I want to talk to someone fresh who will listen to me and not draw conclusions based on assumptions they make about me. And also, I could maybe do with a bit of untangling. Do I tell her this? But maybe she will tell me she is not there to give advice (I have a feeling counsellors don't give advice - although she is also trained in CBT so maybe different?), and then I will feel really silly and embarrassed and not know what to say.

Also, do you think she will want to know about my past psychiatric history? Hopefully not as I am not going for a psychiatric problem particularly (although others tell me I'm depressed). But do you think it will come up? I'm kind of thinking of course it will. Not because I am affected by it now, but because it's been a big part of my life in that I spent over ten years in hospital in total, which is why I am in my thirties and only in the second year at uni. Also I have had three admissions in the first half of this year (I am fine now though), and it's probably reasonable to think that this might come up without much delving into things. I don't mind talking about it at all - I'm really open and also I'm really detached from myself so it's like talking about a case study. But I don't want to scare her off (some of it is quite hardcore, particularly the terrifying experiences I had earlier this year, and the associated things I did to protect myself and save the world). I found her on a directory where there is a list where they must have ticked boxes to say what they treat. She hadn't ticked psychosis. I am not psychotic and have no need to talk about when I was, but I'm scared she will think I am "too much" for her. I have had that happen before. Particularly as a teenager. They would leave me with no one to help rather than letting me talk to someone not sufficiently trained to help me.

How do I reassure her that that is in the past and I need help with pulling myself together and motivating myself to behave like a responsible and kind human being? And can she even help me with this?

Sorry this is so long. Basically what I want to know is: what will she want to know, how honest do I be, and what is her actual role defined as (listening or advice giving or what?)

Does anyone have any experience with private counsellors as opposed to NHS ones? Thank you so much for taking the time to read all my waffling on!

Hi Fermats, I am a counsellor in private practice so maybe I can help a bit?

I presume she'll ask me what I want to get out of seeing her, but I don't really know. Normally when they ask that I cobble something together that I think will make me sound motivated but not too self-pitying. But I don't really even know why I want to see her. I kind of just want to talk to someone who will actually listen and understand. My family and CPN are amazing but they know me too well to be objective, if you see what I mean. I want to talk to someone fresh who will listen to me and not draw conclusions based on assumptions they make about me. And also, I could maybe do with a bit of untangling. Do I tell her this? But maybe she will tell me she is not there to give advice (I have a feeling counsellors don't give advice - although she is also trained in CBT so maybe different?), and then I will feel really silly and embarrassed and not know what to say.

Then tell her that, it sounds fine. Many people find talking to a counsellor to work things out easier than talking to a friend or relative because the counsellor isn’t “in” their life - there will be no agenda or fallout. You don’t need to worry about sounding motivated or non self pitying, it’s best if you are able to be as honest as you feel comfortable being. Counsellors don’t give advice in the sense of “you should quit that job and move to a flat”, but we do give suggestions and guidance such as “have you considered thinking about it from this point of view?” or “what would it be like if you stopped doing that thing?”. A CBT therapist is likely to give you exercises to try between sessions as well.

I think your psychiatric history is bound to come up, because it’s had such a big impact on your life. Please don’t feel the need to reassure your counsellor or avoid her thinking you are “too much” - if your problems turn out to be outside her ability or experience to work with then ask her to refer you to a colleague who can help.

You don’t need to “reassure” her it’s in the past, and yes she can help you to “pull yourself together and motivate yourself” into becoming the person you want to be. But she can’t do it for you, and she can’t fix you - she can only guide you, the hard work is yours.

Be as honest as you feel comfortable being. We are quite used to people not telling us the deepest and most difficult things until a few sessions in, because we know we are strangers to you and it takes a while to build a trusting relationship. A CBT counsellor is likely to be more active and offer more interventions, so it won’t be just “listening”, but she won’t tell you what to do either.

And if you decide you don’t get on with her, you are always free to seek another counsellor. It’s okay to do that, and to do this - no matter how “self indulgent” you feel it is!

Majestic, thank you so much for your response. It's really helpful and I'm glad to know that the counsellor will be able to help me with changing rather than just being a sounding board making the occasional sympathetic "mmm"!

Thanks as well for warning me about having to do hard work - don't worry, I have been around long enough to know that no one can fix me, it has to be me. I have done some very active therapies in the past (with CAT I had a lot of homework tasks to do for example), so actually quite like having to make an effort as it feels more effective. The problem is I kind of can't see the wood for the trees and don't know where to start. It's like seeing a maths problem and not understanding the question let alone how to start solving it. I just want someone to help me understand the question and then if I'm still stuck, give me some pointers on how I could start to tackle it.

I am happy being very honest and don't find it difficult at all - as I say, it's all very detached from me, and also I have had so much treatment that you get used to telling your life story and deepest darkest fears to someone you have never met before!

It just feels self-indulgent because I probably should be saving money for more important things. I am not saying mental health isn't important, but I am actually really well, it is more other people questioning my mental health. I know I am a bit of a bitch and very lazy but I think that is actually just who I am as a person rather than mental health problems. Still, I can try it and see what happens, and then stop if it does still seem pointless.

Anyway, thank you again for taking the time to reply to me.

You’re welcome Fermats, I’m glad I was able to help a little bit. It sounds like you have a good idea of what you want from your counsellor, so feel free to state it to her. I hope it goes well for you.