What to expect in your first grief therapy session
In 2007, after my uncle died by suicide, I had a few grief sessions through an Employee Assistance Program.
He told me I felt too much. And then he ended our sessions.
I did not go back to therapy after that for a very long time.
And then in 2014, another family suicide, and this one stopped me cold in a way I could not just push through anymore. The losses that year broke something open that I could not close back up.
I want to tell you that story because I think it matters enormously that the person writing a guide about what to expect in your first grief therapy session has a complicated relationship with what it costs to walk through that door. I know what it is to have that courage met badly. I know what it does to you. I know how long it can take to try again.
If you are reading this because you are thinking about booking a first session and you are not sure what you are walking into, this is for you. And if you have had a bad experience before and you are trying to work up to trying again, this is especially for you.
Why the first session feels so hard to book
Most people who eventually come to grief therapy have been thinking about it for longer than they would like to admit. Weeks, sometimes months, sometimes years. The grief has been there the whole time. What has been missing is the combination of readiness, courage, and the right circumstances to actually make the call.
There are a few things that tend to get in the way.
Not knowing what will happen in the room is one of them. The unknown is uncomfortable at the best of times. When you are already carrying grief, the idea of walking into an unfamiliar space and being asked to open something up, without knowing what will happen when you do, can feel genuinely threatening.
Fear of falling apart is another. Most people who have been holding it together, and most people who come to grief therapy have been holding it together, are afraid that if they start, they will not be able to stop. That the session will undo them in a way they cannot come back from.
And then there is the fear I understand most personally, which is the fear of being told, in some form, that what you are too much. That the grief is excessive, or prolonged, or dramatic, or not quite right. That fear is not irrational. It is based on what some of us have actually been told.
What actually happens in a free consultation
We talk about what brought you in. As much and as quickly and as deep as you want to go. Enough to understand what you are carrying and what you are hoping for. I will ask you some questions about your history, your current life, what support you have around you. You will have the opportunity to ask me questions too, about how I work, what therapy with me looks like, whether I have experience with what you are dealing with.
It is a conversation, not a test or an ambush.
At the end of the session, we talk about whether it feels like a good fit and what working together might look like. You are not committed to anything. You can take time to think about it. You can decide it is not right and look for someone else. A good therapist will not pressure you either way, because the therapeutic relationship only works when both people have genuinely chosen it.
What you are allowed to say and not say
You are allowed to say you are not ready to talk about something yet.
You are allowed to say this is hard and you need a moment.
You are allowed to say you are not sure why you came or what you are looking for.
You are allowed to say you had a bad experience before and you are nervous.
You are allowed to feel too much.
You are allowed to cry. You are allowed to not cry.
You are allowed to feel nothing, which is also a very common response when the nervous system is protecting itself.
What you are not required to do is perform grief in a way that looks the way you think it is supposed to look. Grief does not have a correct presentation. Some people come in barely able to speak. Some people come in talking a mile a minute and are surprised to realize they are using words to stay on the surface. Both are fine.
A good therapist works with wherever you actually are, not with where they think you should be.
What makes a grief therapist the right fit
This is the part I wish someone had told me before 2007.
Not every therapist who offers grief counselling is equipped to sit with the kind of grief you might be carrying. Grief after suicide loss is specific. Complicated grief is specific. Grief that has been accumulating for years without a place to land is specific. And grief that arrives in someone who has spent their whole life over-functioning, managing, refusing to need things, requires a therapist who understands how hard it is for that person to be in the room at all.
What you are looking for is someone who does not flinch. Who does not tell you that you feel too much. Who understands that the intensity of your grief is not a problem to be managed but information to be worked with. Who has some familiarity with the kind of loss you are carrying, whether that is suicide loss, complicated grief, accumulated loss, or grief that has never had a name.
In Ontario, grief therapy is offered by registered psychotherapists, registered social workers, and psychologists. The designations matter because they determine what your extended health benefits will cover. As a Registered Psychotherapist (Qualifying) with CRPO registration #21683, my services are covered by most extended health benefit plans under the psychotherapy category. Check with your provider before booking to confirm your coverage.
What the first session looks like
If the consultation goes well and you decide to continue, the first session tends to feel different. Something has already been opened. The room is slightly less unknown. You have a small amount of shared language and shared history with the therapist, and that changes what is possible.
This is where the actual work begins. For some people that work takes months. For some it takes longer. There is no correct timeline and a good therapist will not impose one. Grief does not follow a schedule and neither does therapy.
What I can tell you is that it is different from carrying it alone. Not easier, not at first. But different in a way that matters. There is something that shifts when grief finally has somewhere to go.
A note on what happened in 2007
I want to come back to that EAP counsellor, because I think about him sometimes, with a kind of clarity about what that experience taught me.
He was not equipped for what I brought in. That is not an excuse for what he said. But it is true that not every therapist is trained to sit with intense, complicated, accumulated grief, and that the fit between client and therapist matters enormously.
If you have a bad first experience, it does not mean therapy does not work or that your grief is too much. It means that particular therapist was not the right person. The work is finding the right one, which I understand takes courage you may not feel like you have right now.
But you are reading this. Which means some part of you is still looking. That part is worth listening to.
I offer virtual grief therapy for adults across Ontario and in-person sessions in Ottawa.
If you had a bad experience before and are not sure whether to try again, you are welcome to mention that when you book. It is useful for me to know.