What a first session with me is actually like

Almost every man who sits down opposite me for the first time has spent the previous week imagining it, and the version in his head is worse than the real thing in one specific way: in his version, he has to perform.

He thinks he is going to be asked to explain himself well, produce insight, cry on cue, or hand over the whole history in fifty minutes. So this piece is simply a description. What happens, in order, with the mystery removed.

Before the session

Most people start with the free fifteen-minute call. That is not a screening interview. It is so you can hear how I sound and ask whatever is actually on your mind, the fee, whether I work with what you have, whether you can do it on video, whether I am going to tell you what you already suspect about yourself. If it does not feel right, you have lost fifteen minutes and you have gained something useful.

There is intake paperwork, and it is ordinary: contact details, consent forms, the confidentiality policy and its legal limits. It does not ask you to catalogue your sexual history, and I am not going to read a form back at you in the room.

The room, or the screen

In person, the office is on Park Ave in Long Beach, a quiet room, a couch, ordinary light, no clipboard. There is no queue in a lobby and nothing on the door describing the work. By video, it is your room and mine, and you need a door that closes and headphones. Both are fifty minutes.

We sit down. I do not begin with a speech. Usually I say something close to: tell me what made you get in touch, and start wherever it is easiest.

What I will ask

A first session is mostly me trying to understand the shape of your life rather than interrogating the problem. So: who is in it, what a normal week looks like, what you do for work and what it takes out of you. What brought this to a head now rather than a year ago, which is often the most revealing question in the hour.

I will ask what you have already tried, because you have tried things, and because knowing what failed tells me a lot about what to avoid repeating. I will ask what you want to be different, not a goal in therapy language, just a description of a Tuesday that would be better than your current Tuesday.

And I will ask, in a routine way, about the safety questions any therapist has to ask at the start: whether you are having thoughts of harming yourself, how much you are drinking, whether anyone in your home is unsafe. These are asked of everyone. They are not a judgment about you.

What I will not ask

I will not ask for a detailed chronology of your sexual behavior on the first day. If that needs to be laid out at some point, it happens deliberately, at a pace you set, once we both know what it is for. Detail extracted early tends to produce shame and very little else.

I will not ask you to justify yourself, or to prove that your problem is severe enough to qualify. I will not ask you to name it correctly. Plenty of men arrive with no vocabulary for this beyond something is wrong, and that is an entirely workable starting point.

I will not tell you what you are. No label gets handed over in the first hour, or the fiftieth. I have written separately about why I do not use the word addict if you want the reasoning.

You do not have to tell me everything

This is the part I would most like you to take from this page.

It is completely acceptable to say: there is more, and I am not ready to say it today. I will take that seriously and I will not go digging. Men often expect that holding something back will be treated as resistance to be overcome. It is not. It is information about where your trust currently is, which is a reasonable thing for it to be honest about in hour one.

What I will say is that the work does eventually require the true amount out loud, and that this usually happens sooner than men expect once they discover that nothing collapses when they say a smaller version first.

How the hour ends

In the last ten minutes I will tell you what I noticed, plainly. Not a diagnosis, a working picture: this seems to be the pattern, these look like the conditions it needs, here is what I think would be worth working on and roughly how. If I think you would be better served by someone else, or by a different format, I will say so then rather than after six sessions.

Then a practical question: weekly or every other week, in person or video, and when. Weekly is usually better at the start because the work needs momentum. Nobody signs up for a course of anything. There is no package.

Most men describe the hour afterward as less exposing than the week of anticipating it, and report feeling flat or tired that evening rather than transformed. That is normal. The first session is not where things change; it is where you find out whether this is a room you can be honest in.

Practical details, in one place

Fifty minutes, $185, the same fee for video and in person, with a sliding scale between $170 and $225 when the standard fee is what stops you. Private pay, and I do not work with insurance. Sessions canceled with less than 24 hours notice are charged in full. Se habla español.

If you want to know more before you call, there is a page on working with men and one on rates. Otherwise, fifteen minutes on the phone is the smallest available version of finding out.