Becoming a Psychologist—My First Day as a Therapist

The day I opened my private practice as a psychologist, I sat smugly in my office. Fortified with the knowledge I’d acquired, taking comfort in the rules I’d learned, I looked forward to having patients I could “cure.”

I was deluded.

I had no idea that psychotherapy wasn’t the psychologist solving problems but rather two people facing each other, week after week, endeavoring to reach some kind of psychological truth we could agree on.

Fortunately, I had no idea at the time what a messy business clinical psychology was or I may have opted for pure research, an area where I’d have control over my subjects and variables. Instead, I had to learn how to be flexible as new information trickled in weekly. I had no idea on that first day that psychotherapy wasn’t the psychologist solving problems but rather two people facing each other, week after week, endeavoring to reach some kind of psychological truth we could agree on.

No one brought this home to me more than Laura Wilkes, my first patient. She was referred to me through a general practitioner, who in his recorded message said, “She’ll fill you in on the details.” I don’t know who was more frightened, Laura or I. I was newly transformed from a student in jeans and a T-shirt to a professional, decked out in a silk blouse and a designer suit with linebacker shoulder pads, de rigueur in the early eighties. I sat behind my huge mahogany desk looking like a cross between Anna Freud and Joan Crawford. Luckily I had prematurely white hair in my twenties, which added some much-needed gravitas to my demeanor.

Laura was barely five feet high, with an hourglass figure, huge almond eyes, and such full lips that had it been thirty years later, I would have suspected Botox injections. She had masses of shoulder-length blond highlighted hair and her porcelain skin contrasted sharply with her dark eyes. Perfect makeup, with bright red lipstick, set off her features. She was chic in spike heels, a tailored silk blouse, and a black pencil skirt.

She said she was twenty-six, single, and working in a large securities firm. She’d started out as a secretary but had been promoted to the human resources department.

I continued to wait in what’s called a therapeutic silence—an uncomfortable quiet that’s supposed to elicit truth from the patient.

When I asked how I could help her, Laura sat for a long time looking out the window. I waited for her to tell me the problem. I continued to wait in what’s called a therapeutic silence—an uncomfortable quiet that’s supposed to elicit truth from the patient. Finally, she said, “I have herpes.”

I asked,...

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