If you’ve never had therapy before, it’s normal to be a little apprehensive about what to expect, and especially to wonder exactly what you’re going to be talking about during your sessions.
But even if you’ve been having therapy for a while now, it’s still totally normal to not always know what to talk about in therapy.
Perhaps there are some topics you’ve not yet broached, and are wondering whether you should or not? Maybe you’re unsure if you’re talking about the “right” things with your therapist? Or it might be that you feel you’ve run out of things to talk about, and are wondering what that means, or what to do?
Worrying or thinking about what you should bring up during therapy is often part of the process. And rest assured, there are no “right or wrong” things to talk about.
But this article will hopefully give you a clearer picture of what to expect, and the type of things you might want to explore and talk about with your therapist.
What to expect from your therapy sessions
Therapy is a highly personalized and individual process, so when it comes to what to talk about in therapy, the truth is that there are no rules at all.
Most people start therapy with a specific problem or issue they want help with, but it’s very common to gradually explore and work on entirely different issues or aspects of your life, as your therapy progresses.
This usually happens naturally, as you start to express different thoughts, feelings, and behaviors with your therapist, so being honest and open to talking about everything is the way to gain the greatest benefits from one-to-one therapy.
Depending on the type of talk therapy you are having, and the issues you are primarily there to work through, therapists can take very different approaches. Some will take a structured approach and guide the sessions (and topics) themselves, whereas others will let you lead the conversation more. Often, there will be a combination of both approaches.
What’s most important to remember is that there is no “fixed” way when it comes to therapy, there are no “rules”, and there is also no rush.
Common topics to talk about in therapy
Whether you’re seeing a therapist to address a specific concern such as depression or anxiety, for help working through a life transition, or for any number of other specific concerns or general issues, there are a wide range of topics that you are likely to cover as you progress on your therapeutic journey.
Common topics to discuss in therapy can include:
- Current challenges and stressors
- Your goals
- Relationships and interpersonal issues
- Emotions and feelings
- Childhood experiences
- Generational patterns/family experiences
- Traumatic experiences
- Grief and loss
- Self-esteem and self-image
- Sex and sexuality
- Patterns of behavior
- Medical history
- Current job/career
- Coping mechanisms and strategies
- Hopes and fears about the future
- And much more
One of the cornerstones of psychotherapy is that our thoughts, beliefs, and behaviors are all interrelated, and they are all impacted by our life experiences – from childhood through to adulthood and everyday life.
This means that everything and anything – from the “big” stuff to the seemingly insignificant – can all be interesting and beneficial to explore.
However, when there are so many topics to choose from, it can sometimes be hard to know where to start.
So if you’re feeling stuck or worried about what to talk about in therapy, here are a few tips for identifying things to talk about:
- Keep a journal. Documenting your thoughts and feelings can help you identify recurring themes or issues that your therapist will be able to help you work through.
- Make notes. Start to think about things in your life – past or recent events, relationships, feelings, traumas, etc – and make a note of anything that causes a noticeable emotion, behavior, or other reaction in you.
- Think about your goals. Clarifying what you’re hoping to achieve in therapy can help you or your therapist identify topics to focus on.
- Don’t disregard the “small” things. If something is on your mind, it’s important. And the small things often turn out to be much bigger than we realize.
It’s common to feel like you need to focus on the big, serious, “deep” topics in therapy, but the reality is that the biggest breakthroughs in therapy often come from unexpected places, so letting your thoughts flow freely is always beneficial.
But most important is to remember that therapy is completely individual, and there is no right or wrong thing to talk about. Simply put, it’s okay to talk about anything at all during your sessions.
Breaking the ice: what to talk about in your first session
The first therapy session can be daunting, especially when not knowing where to start or what to talk about, but it’s usually a little different to later sessions for this exact reason, so don’t worry.
Your first session is the opportunity for you and your therapist to get to know each other, and your therapist will usually guide you to share certain things, such as:
- A little about you and your background
- Your reasons for seeking therapy
- What you hope to achieve from therapy
- Any immediate concerns
Your therapist will also take the opportunity to explain more about themselves, their approach to therapy, and what you can expect from and during your sessions.
While it’s natural to feel a little anxious, and sometimes even awkward – especially if you’re not used to speaking freely in front of others, try to remember that your therapist is a trained professional and you can trust in them completely.
Do I have to tell my therapist everything?
While you don’t have to tell your therapist everything, bear in mind that the more you tell them, the better they will be able to help you.
A reluctance to share certain things is normal. We’re not used to sharing our innermost thoughts and secrets with others, but remember that therapy is a private, confidential, and judgment-free zone, designed specifically to help you.
Therapists are bound by ethical guidelines to keep everything you share with them private, which should ease any fears you have about sharing sensitive information.
A core purpose of therapy is having the opportunity to share things that you wouldn’t usually, so you can understand why you do certain things or feel a certain way, and to break negative thought and behavior patterns. So if, for example, you’ve engaged in illegal activities, your therapist will want you to talk about this – but only so that they can help you understand why, and how to break those cycles; they won’t be looking to report you to the police.
The only time therapists are allowed (or required) to break confidentiality is in the following situations:
- If you present an imminent and real risk of harm to yourself or others
- If you reveal information about child abuse, elder abuse, or vulnerable adult abuse
- If your therapist receives a court order to release information
However, even in the above instances, there are many nuances and your therapist will always aim to protect your confidentiality first and foremost.
For example, if you disclose abuse that you have personally experienced in the past, your therapist will typically not be required to report that information. Equally, it’s important to feel able to share any suicidal thoughts with your therapist without fear of repercussion or medical intervention. In many cases, therapy is the very solution to helping people overcome severe depression and suicidal thoughts, and they will only refer you to another professional (usually a psychiatrist who will help you manage your symptoms with medication or certain treatments for depression) when it is genuinely in your best interest.
Honesty is crucial for effective therapy, and while you may feel that not telling your therapist certain things won’t make a difference, it’s usually the things we don’t want to share that are behind a lot of the problems we’re facing. Trusting in your therapist and sharing the hardest, scariest, and most honest truths about yourself is the best way to help yourself in the long run.
However, you don’t have to tell your therapist everything right away. Feeling comfortable and safe in your therapeutic relationship is equally important. So start with what feels comfortable, and gradually open up as trust builds.
Is there anything I shouldn’t tell my therapist?
In short? No. There aren’t any topics that should be off-limits in therapy.
It’s worth avoiding the topics you normally use to avoid connecting with how you’re really feeling, such as small talk, gossip, or general chit-chat, purely because these won’t be an effective use of your therapy time.
Equally, try to be aware of “untruths” you may regularly tell yourself to cover up your true feelings or emotions. It can be easy to forget that these are a protection mechanism rather than your true feelings, and therapy is the perfect opportunity to understand and explore the reasons behind them.
Running out of things to say during therapy
It’s very normal to reach a point when you just don’t know what to talk about in therapy or feel like you’ve run out of things to say or discuss. And there are many reasons behind this, as well as important things that this can lead to.
Often, running out of things to say proves to be the start of a shift. What starts out as silence, can suddenly lead to an outpouring of things you weren’t aware you wanted or needed to share.
Other times, your therapist will use this as an opportunity to revisit things you’d previously mentioned, and steer you towards a topic they have identified as needing deeper exploration.
It can also be a good opportunity to reflect on what you have achieved so far throughout your therapeutic journey, and revisit the goals you started out with to see how far you have come.
And sometimes, feeling like you have nothing to work on or talk about in therapy is because you’ve reached a natural end. Talk therapy isn’t supposed to be an unending process, and if you truly can’t think of anything you want to talk about or work through it may be a sign that you’re ready to take a break from therapy, reduce your sessions, or end it (at least for the time being) entirely.
Discover the benefits of “uncensored” talk therapy
Knowing what to talk about in therapy is a vital part of achieving the most from it.
Talk therapy is a powerful tool for improving mental health and overall well-being, and being completely open and honest with your therapist makes it much more effective.
Knowing that you can safely tell your therapist everything and anything that you have experienced, thought about, or done – all without fear of judgment, embarrassment, or repercussion – is what makes it such a powerful and beneficial process.
If you’re ready to start your therapeutic journey toward better mental health, contact us today for a no-obligation chat with our intake specialists, and find out the different ways that we can help you.
With multiple centers around Cleveland, Ohio as well as teletherapy options, we’re able to help people of all ages facing all manner of life challenges or mental health conditions, across the entire state of Ohio.