Most people I see have rehearsed the first session in their head before they ever sit down. They’ve tried to organize what they’re going to say, decided which parts are “the relevant ones,” and quietly braced for the moment they have to summarize a life in 90 minutes.
You do not have to do this.
What helps to bring
A list of any current medications and supplements, with doses if you know them. A rough timeline of any past psychiatric care — even just “saw someone in 2019, can’t remember the medication.” If you’ve had recent labs (thyroid, iron, B12, vitamin D), bring those too — they’re often part of the picture.
That’s the practical part.
What you can leave behind
The pressure to present cleanly. The need to know the right name for what you’re feeling. The instinct to start with whatever sounds the most legitimate — “I think I have anxiety” — when what’s actually on your mind is something quieter that you’d rather not say out loud yet.
A first session is not an audition. It is where we begin to make sense of things.
I’d rather be with the version that’s hard to put into words than the version that fits neatly into a category. The neat version is sometimes a defense — useful, but not where the work happens.
What we’ll actually do
We’ll talk. I’ll ask questions, some directly related to what brought you in, others that help fill in the context. I’ll take notes so I can hold onto the details. I won’t rush. Toward the end, I’ll share what I’m thinking, what’s still unclear, and we’ll decide together whether a small first plan makes sense.
You can leave with no plan at all and that is also fine. Sometimes the work is done in the space that is not rushed into a plan.