What to Talk About in Therapy: A Guide to Getting the Most Out of Your Sessions


what to talk about in therapyWhat are people supposed to talk about in therapy, anyway?  The past? The happenings of the week?  Their deepest, darkest fears?  What topics are considered “therapy-worthy”?


Many clients, especially at the beginning of therapy, feel uncertain about which details of their life are worth sharing.  Should I talk about my stress at work or about the dream I had last night?  How much should I talk about my feelings? How much background do I need to share for this story to make sense? Is my therapist expecting me to talk about something in particular? 


Some clients may feel like they have to come up with new and interesting insights each session, or that they have to come prepared with an agenda to discuss. Some may come to therapy just hoping to learn more about themselves and have a space to verbally process their experiences, but then start to doubt whether they’re accomplishing anything when there’s a shortage of earth-shattering revelations to talk about.


When my clients have brought up these types of concerns (and I’m so glad when they do!), it usually sparks some great conversations.  Here are a few take-aways that might help you, too, as you think about what to talk about in therapy and how to mentally prepare for your sessions.


1. Everything is relevant.
Everything you talk about – your son’s baseball game, your relationship with your boss, your trouble sleeping, your random thoughts while driving to therapy – all shed a little more light on what it’s like to be you, and how you operate in and make sense of the world.  All of that is so helpful for your therapist to know as they work to really get to know you, and to understand better where you’re coming from in life – your strengths, your goals, as well as the things that keep you stuck.


2. If it feels important, it is.
Sometimes you just want to talk about the first thing on your mind, even if it doesn’t “fit” last week’s session or you can’t quite figure out why it’s such a big deal to you.  That’s OK.  You don’t need to know where all of the puzzle pieces fit to start talking about them.  Your job is just to be you; your therapist is there to help you make sense of the themes running through your life and story and to help you begin to navigate in the direction you’re hoping to go.


3. Pay attention to your gut.

Life often teaches us to dismiss and downplay our feelings, but if you notice that you have a strong feeling connected to something, that’s your brain’s way of signaling its importance. Be willing to listen to where your gut wants to go and to bring up what you’re feeling, even if your mind hasn’t figured out yet why it’s worth mentioning.  Chances are, the things you feel the most strongly will be the areas where therapy can help the most.


What to Talk about in Therapy: Still feeling like you need somewhere specific to start?

Here are some questions you can use to jumpstart your thinking when you’re not sure what to talk about in session:


What bothered you this week more than it should have?  The things that trigger us often have important things to say about old hurts in our life that need to be resolved, and offer clues about the ways we have learned to exist in life, and why.  You can learn a lot about yourself by spending some time thinking through what sorts of things make you the angriest, the saddest, or the most nervous.


What kinds of things did you say to yourself when you were upset? When you’re stressed out, or discouraged, or you feel inadequate, what’s the content of your self-talk? By letting your therapist in on your “inner monologue,” the two of you can learn all kinds of things about your typical coping behaviors, including the ones that work best for you as well as the ones that do more harm than good.  When we know what it is we typically say to ourselves, it gives us a great starting point for change.


What are you feeling right now, in the therapy room? It may take a bit of time before you’re comfortable sharing this, but how do you actually feel in session?  What does it feel like to talk about the things you talk about?  What brings you relief during therapy?  What makes you nervous or start to doubt yourself? What leaves you feeling disappointed? The receptive therapist will be open to discussing these things with you, and will help you explore the ways in which therapy does or doesn’t mirror the way you feel in the rest of your life, and why.  This can be a rich area for discussion, and your therapist will hopefully invite this kind of conversation frequently.  However, you are always welcome to bring it up first, especially if you’re feeling that something you need is not being addressed.


Therapy is an investment into the life you want to be living.  The best way to make it worthwhile is to be yourself – good, bad, ugly; unfiltered and perhaps even socially awkward at times.  Those are the best kind of people to counsel, because after all those are the only type of people there really are: real ones.


Need help? Reach out to the author

Rachel Engels, MA, NCC

(626) 598-6234