In the first session, I listened to him describe his difficult breathing, chest pains, sleeplessness, occasional choking episodes, along with his fear of losing complete control and "going crazy." He told me that he has always been an anxious person and had contemplated entering psychotherapy for several years, but never actually did...until now.
The initial consultation with Jack was, in my view, a mixed success. According to Jack, it was "an unbelievable success." We were able to quickly identify the sources of his current anxiety symptoms which, almost immediately, provided him with some much-needed relief. We began to outline some of the likely goals of the ongoing therapy he was "very happy to be starting, finally" and for which he eagerly arranged his next appointment with me. As the session wore on, I began to feel concerned that the initial and speedy benefits of this first session might have implications for Jack's ability to fully engage in the challenging, ongoing work of psychotherapy; something I believed he needed and from which he could derive greater benefit than symptom relief only. I became especially concerned when Jack described his first session as "maybe the best hour of my life!" and described me as, "undoubtedly, the best therapist in America!" That's when I thought I probably will never see Jack again.