“How’re you doing today?” “I’m fine” “....tell me about ‘fine.’”
Welcome to the first few lines of many therapy sessions (though we find our own ways of asking what “fine” means).
Similarly, “I’m good” “Alright” these all fall into what I jokingly refer to as “the swear words of therapy”. Why? Because usually, it isn’t true. ‘Fine’ (oh what an “f bomb”!) can stand in for so much more that isn’t ‘fine’. It’s distracting from what the conversation is meant to be. And as a therapist, I read it as a flag.
What’s wrong with “fine”?
When you’re talking with your acquaintances, or answering a cursory question from a customer service agent, “fine” totally works! Do you really want to talk about the intricacies of how you’re feeling or what’s been going on in your life? Probably not. Even with friends sometimes, you want to get into something else beyond how you’re doing. “Fine” is the word of acknowledgement, that is usually followed by “and how’re you?” or something of the like. Nothing wrong with it in that case. I say it too!!
But in the therapy room-- the question “How are you doing?” isn’t just a nicety, it’s an inquiry to begin a check in and ultimately a deeper conversation.
Doesn’t “fine” or “good” say that I’m doing well?
Does it? I will ask “tell me what that means for you this week” or “what was good about it?” so that I can understand where we’re starting from. And most of the time-- it’s a facade. It’s a way of glossing over a week that really wasn’t so great, or wasn’t out of the ordinary. Again, when you’re having a conversation that’s about something else, glossing over the not-great parts of your day or week makes sense! But in therapy, it’s part of the point. We talk about what isn’t working, and how you dealt with it, so we can create new possibilities for next time, and/or process the stress of that situation.
So… How does a therapy session start?
Glad you asked! (haha, thanks for continuing to read!) Be real! Let’s just get started. Something like “This week was going well until…” or “I really had a hard time working on what we talked about last week” (see my earlier post on what I ask of my clients and where this fits in!) or “I was surprised that I had [this] reaction after our last conversation”. Also, a super starter: “I’m really looking to work on/ talk about_____in our session today”. If my client is having a hard time, I’ll ask follow up questions to what we last discussed, and any therapeutic homework I suggested.
Courtesy is great, and makes some otherwise awkward conversations a tad easier; but therapy is the space to dig deeper than that. The most courtesy I need is a “hello.” Really! Personally, I love my job and seeing my clients each week. I genuinely want to know how you’re doing, and I want to help you make the most of our time together.
What if that feels wrong?
That sounds like an important conversation that needs to happen. I would first ask: What feels wrong about it? If you’re worried about not observing the niceties, that’s actually something worth discussing. What does that courtesy mean to you? How does it help you to use it? Maybe you’re not comfortable with jumping directly into what you’re struggling with that week. This is a great opportunity to address that concern with your therapist. Is there something the two of you need to do to help you feel safer starting out? Is it a relationship concern? Addressing bumps in the therapeutic relationship is crucial to continuing to work together. Part of the therapeutic relationship is creating a space where you can practice talking about how you feel and what you need when things aren’t going the way you hoped.
Other therapy “swear words”
When you’re starting a deeper conversation, and you just say “fine” or “good” or “okay” as stand-alone phrases, it can come off as disinterest, either in the conversation … or even the person. Sometimes, that’s true, but the person claiming to be fine is worried about being polite. There are some conversations that are just not great. Not one you want to have. We all know that! Try being up front with it if you can. In a therapy session, that is useful information that can help diffuse the discomfort. If you aren’t interested in talking about something because it’s “boring” or not pertinent to what you feel is more important to talk about--that’s good information too! Let’s get the conversation back on track.
Additionally, when you’re talking about an action item, or making progress towards a goal and a suggestion is offered, the hardest responses to decipher are “maybe”, “possibly”, “probably” or (eeek!) “sure” as whole answers. When I’m meeting with someone who has an over-controlled personality (click the link for more information!) I question those answers because that personality type increases desire to be socially agreeable, and so give affirmative answers (the “right answer”) when asked to do something, even or especially, when it’s something that they have hard time wanting to do. Again, as I’ve said before, by being direct about a possibly hard response, we can talk through what’s hard about it, what you’re uncomfortable about, or what you flat out don’t want to do. Maybe the suggestion was explained in a way that doesn’t click for you, maybe it reminds you of something that has been hard or traumatic in the past, maybe it’s triggering something else. In any case, it can do more to fulfill a goal to be direct than to say what you think a therapist wants to hear.
I’m new to therapy! I don’t know what I’m supposed to do!
Having a deep, personal conversation with someone can feel tremendously awkward, maybe even scary, for the first while. On top of that, not every therapist is right for every client. As you find what you need from your therapist, you may interview several, and it may take several sessions before you find if it’s a good fit for you. A way that you continue to assess and establish a good working relationship is to communicate openly and honestly. It also helps to understand where the expectations are. If you expect to always come in feeling awful and leaving feeling great, I would suggest exploring that idea (spoiler: that isn’t how therapy usually works). If you’re open to conversations where you explore old ideas, new ideas, and new ways to look at your own history--sometimes feeling better and sometimes feeling conflicted or raw, let’s give it a whirl!
Elizabeth Bolton, NCC, LPC
P.S.: about the “regular” swear words: it’s a style area, but if it’s part of your regular vocabulary, be authentic about it. I, personally and professionally, don’t care if someone swears in session. If it’s something you don’t like, that’s 100% your right. No requirement either way!