The Stakes Are High: The Start of Psychotherapy

BY CASEY WEITZMAN, M.A., L.M.F.T.

When a prospective client phones my office, I am acutely aware how frightened the voice on the other end might be. I have been a licensed marriage and family therapist (LMFT) in California for more than 25 years and it is has been — and always will be — a humbling experience.

The same can be said for that first appointment together. Typically, when clients come to me for the first time, they are often unsure of what to say or if they should say anything at all. Can they trust me? Will I really understand where they are coming from? Maybe they made a mistake? They will describe that they feel shame and embarrassment and have held this secret from everyone in their lives — even themselves — for 20 or 30 years and was hoping to never have to deal with it. “Why is it coming up now?,” they wonder. So many clients will look me in the eye and say to me, “Can you give me a pill and make this go away?” There are others that sit down and start crying, feeling relieved that they have found someone that won’t judge them and understand what they are about to disclose or explore. They have recently started to cross dress and, perhaps, have been caught by their spouse and are freaking out. Or, they are finally ready to face that they are transgender and begin to transition, realizing they need experienced mental health support.

Many clients who come to see me after having seen other therapists before report that the therapist had no experience with working with transgender or gender non-conforming clients. Others will tell me that they didn’t feel comfortable sharing this part of their lives and ended therapy because of this. Beyond the lack of experience, I want to understand what else didn’t work and ask these clients to share with me what they will need going forward. I know that building trust takes time and I am sensitive to checking in with them regularly, making sure they feel that therapy is providing them with what they are needing.

Beyond these generalizations, here are some other things you should know, should you be reading this and considering your first phone call or your first visit with me:

1. Whether new to therapy or not, some of my clients want to change into different gender-specific attire that they feel most comfortable in, for the therapy session so, I provide a private space for them to be able to do that. When the session is over, they then change back into their regular attire until the next time we meet.
2. Confidentiality is a legal and ethical issue and I am bound and abide by professional licenses.
3. My office is located in West Los Angeles in a lovely garden building where there is plenty of street parking and security is on the premises at night.
4. I am sensitive to the relatively new use of non-binary pronouns and names — it is so important to ask each person that enters our offices how they would like to be addressed. Rather than him/her or she/he, many prefer as a singular gender-neutral third person gender to be called they/them or ze/zir. I ask what you prefer and conform to that.

In summary, I understand the stakes are high when someone reaches out to me. I understand that there are many reasons you seek therapy and I never make assumptions. I keep an open mind and I’m here to support and guide you in your journey, wherever it takes you. I place great investment in the outcome and I hope to help in providing some clarity and relief in the pain you may be experiencing while supporting the joy of your new discovery and happiness as you figure out how to live a more authentic life. As I mentioned above, meeting you will be a humbling experience and I’m committed to helping you figure things out.

— Casey

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**Request a FREE, 20-minute phone consultation with Casey to see if working with GWLA might be a fit for you.