The reason many sessions here begin with “Where would you like to start?”

If you’ve started therapy at Belonging Partnership and noticed we don’t open with “How are you?”, there’s a reason for it. Most sessions here are intentionally different, starting with a single question: “Where would you like to start?”

“How are you?”  asks for a script

Linguists have a name for exchanges like this one. Phatic communication or social norms that do not actually request real information, and subsequent work on the phrase found that native English speakers reliably answer “How are you?” with an automatic “fine,” even in settings such as a doctor’s office where a truer answer is appropriate. 

By the time you sits down for a session, you have likely delivered that same script many times already that week: at work, in a checkout line, in passing with a neighbor. Therapy is one of the few places where the script isn’t required and social niceties can be left at the door.

What a different opening question offers

Asking “Where would you like to start?” sets aside some of that reflexive habit. A client doesn’t need to reassure the therapist, arrive with thoughts already organized, or offer an answer that sounds acceptable. For people who have spent years tracking other people’s emotions or minimizing their own needs, that permission to take up space as you are can take some getting used to.

The breadth of “How are you?” is part of what makes it hard to answer honestly. Emotionally, physically, at work, in relationships, compared to yesterday, compared to last year: there is no single true answer to something that broad, so most people default to a summary. A narrower prompt gives a client’s attention somewhere specific to land without dictating what they’re supposed to find there.  Yet, for some clients, particularly those early in treatment, in acute distress, wide open invitation can feel disorienting rather than freeing. In these instances a  Relational clinician will work with a client to discover what exactly is needed to invite entering into the work of therapy.

Much of the history of Western mental health treatment grew out of medical models built around diagnosing symptoms and identifying what’s wrong. Some clinicians argue that legacy still shapes the language people default to, including the implicit “Are you okay?” tucked inside “How are you?” Therapy that leads with curiosity rather than evaluation is a significant attempt to work against that inheritance and to forge a new legacy that is not pathologizing pain. 

Greetings also vary across communities in what they assume and where they send a listener’s attention. For example, “What’s good?”, common in Black American Language, tends to presuppose that something worth noticing already exists, rather than opening the door to a complaint. 

The question sets the relationship

From the first moment, an opening question begins shaping what kind of hour this will be. Outside therapy, most of us manage conversation by staying agreeable, keeping things balanced, protecting other people from our harder feelings. “Where would you like to start?” asks a client to set some of that management aside and notice what’s actually present, even if that means beginning with silence.

Many clients report that after a few sessions they start to notice how often they reassure others or move away from their own experience out of habit. That noticing is itself part of the work, Every aspect of our approach, including the very first question we ask, is intentional and grounded in evidence-informed, thoughtfully considered clinical practice designed to foster greater self awareness, authenticity, and lasting psychological change. 

Looking for therapy in California or New York?

If anxiety, perfectionism, people pleasing, burnout, trauma, OCD, or depression have left you managing everyone else’s expectations before your own, therapy can offer a different kind of conversation. Belonging Partnership provides trauma-informed, relational psychotherapy for adults, in person in Berkeley and Menlo Park and via telehealth throughout California and New York. From the first question, the goal is a space where genuine self-understanding, not performance, can begin.

References:

Bacal, H. A., & Carlton, L. (2011). The power of specificity in psychotherapy: When therapy works and when it doesn’t. 

Boxer, D. (2002). Applying sociolinguistics: Domains and face to face interaction. John Benjamins Publishing Company.

Malinowski, B. (1923). The problem of meaning in primitive languages. In C. K. Ogden & I. A. Richards (Eds.), The meaning of meaning: A study of the influence of language upon thought and of the science of symbolism (pp. 296 to 336). Kegan Paul, Trench, Trubner & Co.