What to talk about in therapy?

So you have booked an appointment with a counselor and decided to begin your journey of healing and transformation. You find yourself worrying that you would sit in complete silence while your therapist waits for you to begin conversing. It’s completely okay to not have everything figured out, as your therapist can guide you through the process of therapy.

As each session is limited, it is essential to have an idea about the topic or theme you will be bringing up in the therapy session. It is alright if you begin talking about trivial topics or themes and later bring in more deeper and existential issues you want to address. Once you get into the flow of the conversation and build rapport, you can share your goals/intentions with your therapist.

Therapy is a safe environment where you can explore anything that is currently on your mind or any difficulty that has been plaguing you for a longer duration. If it sounds daunting to start talking about yourself or the events of your life, you can make note of the themes or topics that can be typically explored during therapy. Some of the frequent topics that people bring up during therapy sessions are:

Hopes or goals in Therapy

While talking about their dreams, goals, hopes or aspirations, people can identify what they truly want in their lives. This can include diverse goals or aspirations based on various settings such as academic, professional, personal, or relationships. For example, if you want to set a personal goal of exercising 3 times a week regularly, your therapist can work with you to ensure that you continue to progress towards this goal for the duration you set.

After clarifying your goals, the duration and other details, it’s important to analyse what motivates you towards your goal or aspiration. For some people, important values like growth, stability, self-development and self-awareness can influence them toward certain goals. If you have multiple goals or intentions for therapy, you can prioritize one and focus all your energy and efforts on that particular goal first and then move to the others.

Feelings and Emotions

Most often, people want to identify, label, understand and regulate their emotions. During the therapy session, you can talk about how you’re feeling, how you felt due to an event or a relationship or other relevant contexts.

Talking about situations or people or any topic that triggers strong emotions can help you identify patterns of behavior. For example, you tend to often feel anxious when surrounded by large groups of people and struggle when going to events. After discussing about relevant symptoms, thoughts, emotions and behavior with your therapist, you might recognize this behavior as a sign of social anxiety.

By working alongside your therapist, you can gain an understanding about triggers that are deep-seated and long-term based on trauma or prolonged stress and also immediate emotional responses to events such as an argument. You can identify whether the emotions you experience are racket emotions (temporary and inauthentic) or are your authentic emotions by expressing your feelings about a person/event/situation/unresolved issues.

You could discuss about the coping mechanisms you usually employ to manage your emotions and learn the difference between healthy and unhealthy coping mechanisms. Therapy helps you to use healthier alternatives that increases the quality of your life. If you’ve been feeling emotionally numb or distant from people and don’t know why this is happening, therapy can help you unveil the source of the numbness. If you’re doubtful about where to begin, you can mention that you don’t know how to begin and focus on the particular emotion or feelings it has been making you feel. Your therapist will guide you to explore, make sense of and to recognize the source of those emotions.

Identity or self-worth in Therapy

If you’re having trouble with accepting yourself and struggle with your identity, therapy is an avenue to help you understand yourself better. By talking about identity-based challenges, issues related to confidence, sense of self, etc, you can train yourself to be cognizant and strengthen your self-perception. 

As talking about your self-identity or self-perception is a deeply personal topic, delving into it might take several sessions but it’s an important process in your healing journey. You can elaborate on the different ways in which your family, culture, and community has shaped your identity. By reflecting on your childhood and formative experiences, you can uncover deeper layers of your self-image and core beliefs.

Your therapist can also help you identify negative affirmations, thoughts or inner dialogue that directly impact your self-esteem, such as “I’m a failure” and assist in replacing these irrational beliefs with self-affirming and an overall rational thought-process. You can also gain clarity by talking about internal conflicts in which you might experience incongruence in parts of your identity and your behavior. For example, pretending to be having fun in social situations while feeling lonely inside.

Life changes or milestones such as changing careers, getting married or becoming a parent can influence our identity and behavior. Exploring about the various external influences in your life can help you recognize your internal beliefs and behavioral patterns.

Relationship Dynamics

Therapy serves as an excellent platform to address the challenges or relationship dynamics that you have with family, friends, colleagues, parents, children, spouses or romantic partners. Therapy can help you to hone your communication skills, manage conflicts, address unhealthy dynamics,etc.

Are you noticing certain patterns of behavior that keep coming up in your personal or professional relationships? You can uncover the root causes of these relationship patterns during therapy sessions. Attachment styles, parenting styles, hierarchy of needs and our love languages are some of the major influences in our lives that you can have a deeper conversation about. A therapist can support you in recognizing your role in the challenges or conflicts you face in relationships. By developing a healthy sense of self-awareness, you can reflect on your behavior and take accountability for your role in the relationship.

You can also discuss about your needs, desires, expectations and boundaries that you wish to share with your therapist to identify if they are realistic and alter the ways in which you express yourself. Trust and vulnerability are two core areas that can be focused on during therapy. If you find it challenging to trust or be vulnerable, you can mention that too. For example, “It’s tough for me to talk about my emotions because I’m afraid of being rejected or judged for those emotions .”

Mental Health Concerns

In therapy, it’s essential to bring up any concerns regarding your mental health and to be honest, vulnerable and authentic while sharing them to your therapist. Your therapist can then support you without judgement and facilitate your healing journey. Mental health concerns can range from issues like losing sleep, appetite changes to major issues like PTSD, depression or other disorders. 

In the first session, the therapist usually builds rapport with their client and guides the session by prompting you with relevant questions. If nothing comes to mind during therapy, you can ask your therapist to prompt you again. During these sessions, discussing what you’re seeking from therapy can be mutually beneficial for you and your therapist.

Here is a general list of goals you can address in therapy if you find yourself at a loss:

• To process your thoughts and feelings about a recent incident or situation.
• Developing healthy coping mechanisms such as journaling, exercising, new hobbies or habits in place of harmful ones like addiction, gambling, instant gratification, voluntary isolation, procrastination, etc.
• Coping with intense or overwhelming emotions such as anger, anxiety, sadness, grief, shame, guilt or envy.
• Learning how to communicate effectively with friends, partners, colleagues or family and to manage conflicts without toxic patterns.
• Recognizing and replacing negative self-talk and core beliefs.
• To make progressive and healthy changes in your lifestyle, behavior or routine such as improving sleep, being more active, socializing, reducing gadget usage, learning new hobbies, etc.
• Exploring deeper parts or layers of your psyche and personality to gain understanding and face life challenges. 
• To navigate and adjust to challenging events such as becoming a parent or dealing with the aftermath of a death or divorce, etc.
• Identifying the root causes of your past trauma and share your traumatic experience in a non-judgemental space.
• To practice mindfulness and be more productive in all areas of your life including academic, personal and professional.
• Making better decisions, managing time and to figure out your purpose in life. 
• To create a safety plan that can help you deal with thoughts of danger, self-harm or suicide and coping strategies, such as contacting crisis helplines, friends or family.

Conclusion

We are already quite capable of handling our own life and its challenges but additional support from a supportive and non-judgemental therapist can be the stepping stone we need to heal and modify ourselves. The efforts and investments we take to improve our mental health is more about the process than the destination or end result. Discussing intentional and realistic goals with your therapist will make your healing journey a meaningful and satisfying one.

FAQs

1. What can I talk about in therapy?

In therapy, you can talk about yourself, recent or past events, your relationships, feelings, thoughts, needs, desires, aspirations, goals and challenges.

2. What to do if you have nothing to talk about in Therapy?

You can discuss things that have happened in your life since your last session. If it is your first session and you’re at a loss, your therapist can lead the session and prompt you with questions. After multiple sessions, if you believe that you can handle everything and don’t have much to talk about, it may be a sign that you can stop undergoing therapy.

3. Is there anything you can’t mention during Therapy?

You can talk about anything that comes to your mind during therapy, including traumas, feelings or thoughts, without any censor. This also includes trivial matters that you believe could be silly or controversial but you want to address.

4. What can I tell my Therapist?

You can talk with a therapist about how you feel, what you think, how you behaved or want to behave. You can tell them about the difficulties you’re facing and discuss realistic goals you have for therapy so they can aid you to achieve them.

5. Why do people go to Therapy?

To get help with a mental health problem and get extra support if they are going through a tough time. To learn how their own mind works and understand themselves deeply. To change their mindset and navigate the challenges of life.