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What to Talk About in Therapy?

Updated: Jun 9, 2023

So, you’ve done your research, contacted a therapist, and are now ready to begin your therapy journey. While some know what they are coming in for, others have no clear direction. They may have had difficulties navigating different things (emotions, relationships, etc.) but maybe they aren’t exactly sure what is drawing them to start this process, they just know that something is off and would like some extra help from a trained professional. So now we’ve come to the first therapy session and the big question always is: what are we supposed to talk about in therapy? Are any topics off limits? How do I start? What will my therapist think if I share this information? While you may be hesitant on what direction you want to begin, there really isn’t a right or wrong way to do therapy. Often people come in with no set direction and begin sharing about how they are currently feeling and what is going on in the moment. A good therapist will help guide you through the discomforts of the beginning stages of therapy (as well as throughout your time in therapy). The more you feel comfortable communicating, the easier talk therapy becomes. It’s completely normal to feel unsure and worried about what the stranger sitting across from you may think or say, but trust in the process! The therapist is there to help you navigate and sort through all those thoughts, emotions, and everything in between. Now, if you’re still feeling unsure of what to talk about let’s explore some common therapy themes.

Current Life

When it comes to talking about what’s happening in our current life, small issues are just as important as big ones. Sometimes people have a big issue they want support with (think depression or anxiety) but understanding that our day-day life is just as stressful to navigate through. Think of everything you must do in a day, add in extra stress if you have a family, maybe you are also the breadwinner, and trying to juggle different roles you are responsible for can be overwhelming (small daily things matter). Starting on small issues can lead to opening up to bigger underlying things that you might not know are lingering. Maybe during intake, you shared that you wanted to work on one thing and before you reached your first therapy session a new life challenge had arrived that you weren’t prepared for. This is a perfect topic to discuss with your therapist as they can help you learn how to cope with change.

Getting in Your Feelings

As you are waiting for our upcoming therapy session, maybe the week brought on many different emotions such as sadness, anger, or overwhelm. But now that you’ve reached your scheduled therapy appointment, you are no longer feeling those feelings so now you are unsure of what to talk about. Don’t fret! There is no pressure to only talk about big emotions. Sometimes focusing on your current feelings is a great place to start. What you need from therapy may change day to day. Maybe previous sessions focused on a specific emotional topic about a relationship but today you’ve arrived and just want to focus on exploring your frustrations at work. Sometimes all you really need is a safe space to just vent and that is what therapy is for. Understanding your emotions can also help you navigate through different symptoms and diagnosis which can feel really overwhelming when first starting therapy. Therapy is all about shifting from each of these parts of your life to help you better understand where you are and what you need.

Past Conflicts and Traumas

People come into therapy when needing support in dealing with past issues and traumatic experiences. These are the heavy hitters, the things that have continued to impact our functioning and abilities to navigate our life, responsibilities, and relationships with others. Working with a trauma informed therapist can be helpful for you to explore these more difficult topics and a good therapist knows how to support you through this. While this topic can be hard to discuss or even bring up, the more you are open and comfortable sharing, the easier it will be for the therapist to help you explore this topic. You may start with just a few details at time and see how you feel. Therapy is hard and uncovering such important pieces of your life can take time. A therapist wants to help you do this at your pace so never feel pressured to overshare anything.

Is Therapy working for You

Maybe you’ve gone to a few therapy sessions (or a few months) and are noticing that you are still feeling uncomfortable with opening up. There are times when therapy is hard, and a therapist can help you work through that to make it less challenging. Sharing this with your therapist can help you both move forward in your therapy. However, if you are struggling to connect with your therapist, you may need to consider if the therapy and therapist is working for you. You may need to have an open conversation about this with your therapist. We expect these topics to come up and we want you to be open about this with us. We want to know what works or doesn’t work so we can better support you and your needs. Therapists understand that we are not always a perfect fit and would rather you find what you need than stay and have a not so great experience with therapy. Sometimes it’s more appropriate to end the relationship and find another therapist that may fit your style, vibe, or needs better. Always check in with yourself if things are feeling off and trust your gut (you can always fire your therapist).

Some Takeaway Thoughts

- Starting therapy is going to bring up many different feelings

- All topics are welcome and nothing is limits

- Feelings and thoughts on the direction of therapy can change day to day, each session might look different and that’s ok!

- It all depends on your comfortability level with your therapist (are we connecting, or do I need something else?)

While therapy can be hard to get going on in the beginning, it is a support tool for you and what you are going through. So, when you are starting out, don’t worry if you are not sure what to talk about, just being there and working through it will help you take care of your mental health and wellness (and always remember to feel those feelings).



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