How to tell a therapist what you need at the beginning of your first session?

If we hesitate to act because
we want to know more
than we need for our next step,
we miss the chance to grow.
We accept small change in place of riches
and mistake living trees for firewood.
— Bert Hellinger

When I opened my first studio for movement learning, early on I noticed that most of my clients were women. Men came to see me, too, of course, but just not as many. Also, most men- on their first visit they would look around quite casually, take their time, and then say, “My wife sent me. She said I should try this.”  No kidding. I heard that exact same phrase over and over again.

Usually, with them I wouldn’t ask too many questions at the start of a first session. And usually they would keep their answers very short anyways. They would willingly hop onto my treatment table, but wouldn’t say much of what bothers them or what they would like to learn or improve.

However, a few minutes into a hands-on session I would discover something… like a knee that wouldn’t bend much, or a few ribs that went missing, or the top of a neck that wouldn’t bend, and then they would go, “Oh this! That’s from a sports/traffic/work accident a few years/decades ago. I went to so many unsuccessful therapies already, I basically learned to live with it!” Something like this. And then—the client and me—we would go on making their lives better, sometimes restoring function completely, sometimes even improving it to be better than it was before the accident.

And I need to stick up for these men:

Firstly, for example the male senior client with a couple of ribs gone missing. He lost those ribs almost two decades ago when a boat crashed into him from behind, with that long bowsprit some sailboats sport, looks like a spear. I mean, how would you explain that? And how would you even know that there are people that could help you with such an old injury?

Secondly, why would you open up to a complete stranger at first sight? Isn’t it just healthy behaviour to first observe a new situation, or at least get to know the style and ways of a therapist/teacher/practitioner, to build trust and comfort before revealing personal stories and details?

One day there stood a guy in my door, immobile. He was about 60 years old, slightly overweight, he leaned on a cane, he had cold sweat all over him, his soaked shirt sticked to his chest. He merely said, “My wife sent me.” I mean, I could literally SEE that he was in intense pain.

While leading him from my studio’s door all the way to my treatment table he stopped plenty of times and I got some important details. A decade of back pain, then a spinal fusion back surgery gone wrong. Another surgery out of question, as the surgeon said it’s a very complicated surgery and would most likely permanently tie him to a wheelchair. His wife booked 5 sessions with me for him. Some more details, but how much do I need to know? With plenty of supportive, well chosen and well placed padding we found a position in which he could rest without experiencing pain. “Oh my! That’s the first time I feel pain-free in months!” He said, almost in disbelieve over this simple intervention (finding a resting position he could tolerate.)

However, any ever so small movement would cause him shooting pain. Even just moving his lower leg would feel like a knife twisting in his lower back. That’s why the overworked, overly busy, insurance-backed therapists stopped working with him. They gave up on him. Every movement hurts? Water therapy out of question, too? Sorry, there’s nothing we can do for you.

We started exploring. Eye movements. Tiny head lifts. This lead to a first core stabilisation. He booked another 5 sessions. 100 meters of pain free walking. We found exercises he could do at home that were safe for him and don’t hurt.

How much do we need to tell a practitioner at the beginning of a movement session? Isn’t it an exploration? A getting to know each other? A story of discovery, calibration and adaption? And, maybe that’s the real question here, are we in the hands of a practitioner who’s suitable for us?

Not all journeys can be fully planned and defined ahead. Sometimes we just need to make that first step.