Everybody has a first day on the job, and sometimes that day doesn’t go as planned. Psychotherapist Lori Gottlieb spent countless hours in classroom study and observing trained therapists at work with their patients, but nothing could have prepared her for what happened with her first patient. At the Atlantic, Gottlieb recounts her first session as a trainee therapist with a woman who sobbed uncontrollably during their allotted hour.

All through graduate school, we students had been awaiting the big day when we would lose our therapeutic virginity, and mine turned out to be more disgrace than thrill.

Michelle is tall and too thin. Her clothes are rumpled, her hair unkempt, her skin pasty. Once we’re seated, I open by asking what brings her here, and she tells me that recently she has had trouble doing anything but cry. Then, as if on cue, she starts crying. And by crying, I mean howling in the way one might if just informed that the person one loves most in the world has just died. There’s no warm-up, no wetness in her eyes that leads to a light drizzle and then gradually a downpour. This is a tsunami. Her entire body shakes, mucus drips from her nose, wheezy noises emanate from her throat, and, frankly, I’m not sure how she can breathe.

We’re 30 seconds in. This isn’t how the simulated intakes went at school.

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