What to Talk About In Therapy
If you're new to therapy or unsure if you're getting as much out of it as you can, you might be wondering what exactly you're supposed to be talking about in your sessions. Well, first of all, you should know there's no right or wrong topic to broach (or not to broach). Not only are you welcome to use your sessions to talk about whatever's on your mind, but your therapist is also there to prompt you, often starting with an intake questionnaire before your first session, says Amanda Jurist, L.C.S.W., CEO of The Denham Group. But if you still feel like you need guidance, here are some helpful topics to bring up with your therapist, which can support you on your healing journey.
All of these are topics worth exploring time and time again as long as they are relevant to your life and how you're feeling at any given moment, so don't hesitate to bring them up at any point during your therapy sessions — even if you've been in therapy for a while. And even though what you talk about in each session is important, both you and your therapist should keep in mind your overall goals for therapy every time you meet. "A skilled clinician will truly help the client take meaning and draw a deeper understanding of their internal world based on the content both verbally and nonverbally that may be shared during each session," says Jurist. (Related: Why You Physically Feel Like Shit After Therapy, Explained By Mental Health Pros)
Lastly, some of these topics may feel really hard to talk about, but your therapist is there to help you address them without judgment, so you can free yourself of any patterns that are no longer serving you. "There is no pressure or time limit on the work, it's your dynamic story, your truth, your work. and it deserves space and time for proper exploration and understanding," adds Jurist.
What to Talk About In Therapy
Goals for Therapy
While you can absolutely benefit from therapy if everything is going well, it's likely you have one or several specific reasons for seeking it out. Most themes will come up naturally throughout your intake assessment and first few sessions, but you should also try to have a clear idea of what you'd like to get out of therapy. "Goal-setting can help steer your time and maximize benefit," says psychotherapist Rebecca Hendrix, L.M.F.T. "[Goals] might be things like increase-self esteem, understand my relationship patterns so I can find a partner...heal a trauma, decrease anxiety or depression, etc. Therapy works by digging into certain patterns to give you a better understanding of unhelpful behaviors — for example, self-sabotaging or reacting defensively in certain situations — which in turn fosters self-compassion and helps you create new patterns that actually serve you and your growth." (Related: Self-Work Is Not About Trying to Be Perfect)
If you're not sure what your goals are, your therapist will prompt you. "Once we're done with the assessment, I'll ask the client what they hope to get out of therapy," says therapist Kelly McKenna, L.C.S.W. "How do they hope their life will be different? How would we know therapy is working? If there are areas of concern that came up over the intake assessment that they don't mention as a goal, I'll typically guide the client there. For example, I might say, 'you said you and your boyfriend weren't having sex as often as you'd like. What's a goal we can work on to improve your sex life?'"
Therapy goal-setting isn't a one-and-done affair, though. "Ideally you should set goals with your therapist when you first start working together. And you should check in on these goals every three months or so," notes McKenna. "If this isn't happening, ask your therapist if this is something you can do."
Early Childhood Experiences
Everything you lived through when you were younger has shaped you in some way — exploring those early events in therapy can help you gain insight into how you interact with the world today. "By going through this process of exploration, you will be better able to identify any maladaptive behaviors you want to work on extinguishing," says Jurist. "You will have a better understanding of your impulses and the ways in which you have learned to cope."
As a child, the things that happen to you can affect you greatly and teach you coping mechanisms that might've kept you safe but begin to hinder you later in life. For example, "if your parents never praised you, never acknowledged things about you unless they were outer focused (i.e. getting a report card filled with As), then you can start to believe that you are only lovable, acceptable, and approved of if you are accomplishing goals on the outside — a title, a salary, a book deal, a partnership — and you can, in turn, believe you are not good enough if you are not accomplishing those goals," explains Hendrix. (Related: This 5-Step Method Will Help You Shift Dysfunctional Emotional Patterns)
To start untangling this web, try to share "a little bit about each of your caretakers" — e.g. the hardest thing about living with them, how you knew you were loved, a challenging memory involving them, etc. — with your practitioner, she recommends.
But awareness of your patterns learned from childhood is just the first piece to the puzzle. "Much of what makes up who you are as an adult was informed by what you received and didn't receive from your caretakers," notes Hendrix. "Unpacking what happened to you through a lens of accepting that your parents did the best they could but also might not have been able to give everything you needed to be fully functioning adults...helps to identify what holes there are to fill." And that's where your therapist comes in.
How You Feel About Yourself
Self-esteem affects every area of your life, from your ability to step confidently into a meeting to how you feel when your Instagram post doesn't get a lot of likes. "Low self-esteem will impact our ability to achieve goals and can determine the type of friends and partners we attract," says Hendrix "Your outer experience is a reflection of your inner reality," which, more often than not, involves quite a bit of negative self-talk if you're dealing with low self-esteem. And both are topics you should bring up in therapy. That's because therapy offers an opportunity for you to challenge negative self-talk in a safe space and in doing so, hopefully, learn to love yourself more. (Related: Why You Need to Start Practicing Self-Compassion — and How to Do Just That)
"Once you understand the basis of these thoughts, you can begin the process of separating yourself from these most often false fear-based and internalized narratives," explains Jurist. "After processing and separating yourself, you begin to have more of a capacity to develop more grounding and fact-based views of self while giving yourself the grace to map out areas of your life you would like to continue developing."
Not sure if you're really engaging in negative self-talk? Or what your overall self-worth looks like? Hendrix suggests asking yourself questions such as, "Am I hard on myself?" "Can I have compassion for myself when going through a hard time?" or "Do I think I'm good enough?" You can try answering these for yourself or bring them to your next session, so your therapist can help you work through them.
Here's the thing: Folks frequently bring "unhealed wounds from earlier times in their life" into their relationships as adults, thereby negatively impacting these bonds. But recognizing that this might be the reality is no easy task — and that's why it's a good idea to talk openly about your relationships in therapy. Not only is therapy "an excellent place to develop a secure bond with another person," but it's also a "safe space to unpack what happened to you and how it impacts how you view yourself and the world today," explains McKenna.
In other words, your practitioner can help you piece together any unhealthy patterns that might be at play, and then, together, you two can dig deeper into them to ultimately figure out how to best shift them. "Patterns can be things like getting too close too fast and not being able to notice red flags in others, shutting down and cutting people off because we don't know how to talk about our feelings and handle conflict, giving too much, not being able to receive," explains Hendrix.
Anything You'd Hesitate to Share with Others
Some topics that are central to the human experience (think: sex or money) also tend to be fraught with maladaptive beliefs and negative feelings, often making them taboo to discuss vulnerably with friends and family. But in therapy? Pretty much anything goes and you should feel safe and secure in opening up about topics that might otherwise make you feel, say, uncomfortable or embarrassed.
"Generally when something feels really hard to talk about, there's an emotion that's difficult to digest in the way of it," says Jurist. Take, for example, your past experiences with sex: These might "evoke emotions like fear, shame, doubt, anxiety, and in some cases, depression," thereby making your sexuality something to talk about in therapy, she notes. That's because your practitioner can help you "learn to tolerate the emotional disruption that comes up when you think of it [and] when you say it out loud [as well as] to learn to be okay with giving it space, while also sorting through the basis of the thought [where it was originally formed]," explains Jurist.
In therapy, you will start to separate what thoughts and feelings are actually yours to keep from those that might've been imposed upon you by, say, society and thus don't serve you. "As we start to peel back these layers, we start to see, 'is this my actual feeling or is this a feeling I adopted based on other people's toxic views of themselves?'" says Jurist. Your therapist will encourage you to feel your feelings, get comfortable with them, understand where they're coming from, and eventually release them — although this process can take a long time.
Any Challenges as of Late
"Discussing recent events, interactions, and the feelings associated with them often leads to the discovery of patterns," says Hendrix. "Once these show up, you can work on these deeper patterns, beliefs, or hurts that are causing you to be upset."
If you draw a blank at the beginning of your sessions, consider this: "I suggest [clients] keep a note for therapy on their phone," says McKenna. "Write down [any] times you have uncomfortable feelings, like anger, jealousy, sadness, anxiety, low self-worth, etc. At the start of therapy, ask to go through the list. You and your therapist can work together to decide which topic to start on during that session."
As you build up a relationship, your therapist should be able to see how your current experiences fit into larger patterns and help you shift how you deal with certain emotions. For example, if receiving negative feedback from your boss sends you into a self-doubting spiral, your therapist can help you reframe your thoughts so that you can see the bigger picture — i.e. you don't need to be perfect all the time — more clearly. (Up next: How to Know When It's Okay to Stop Therapy)