What to Talk About in Therapy: 17 Topics to Consider
Whether you’re preparing for your first online therapy session or heading into a regular weekly session, we don’t always know what to talk about in therapy. Maybe we have too many things bouncing around the mind, or perhaps we don’t have one single issue we really want to talk about.
There really isn’t one correct thing to talk about in therapy, nor is there something we shouldn’t talk about. We’ll cover what you might expect in therapy if you’re new, and give some ideas of things you can talk about in therapy. We’ll also touch on the feeling of not having anything to talk about!
What to Expect in Therapy
Your therapist will have tools, prompts, and questions to help create a useful conversation. If it’s your first online therapy session, you may start with a bit of history-taking, goal-setting, and background information. This often provides a clear jumping-off point for the therapeutic conversation.
In weekly sessions, your therapist may start by asking you what’s going on. You may have a specific issue or experience you wish to address, or maybe you don’t have much to talk about. That’s okay! Even without a single issue to focus on, therapy can still be useful. Your therapist will work with you to investigate what may be useful to you during your time together.
You don’t need to prepare a list of things to talk about before going into therapy. If you have things you do want to talk about, great. But your therapist does not expect you to arrive with a list of things to talk about. You might take some time for reflection and consider what’s present for you before going into session.
Things to Talk About in Therapy
You can talk about anything present for you in therapy. If you’re not sure what to discuss, here are some points you might consider in your life. There are many different types of counselors, and some of these topics may be more relevant for specific modalities and individuals.
Anxiety or Stress
This is one of the most common things people reach out to us for. Survey data finds 28.2% of adults in California experience symptoms of an anxiety disorder. Further research finds that anxiety increased 22% from 2013 to 2020, and it may continue to be on the rise. It’s a very common experience, and one worth discussing with your therapist.
Whether or not you’re reaching out for therapy for anxiety, you might talk with your therapist about any present anxieties or stressors. These may be experiences like panic or anxiety attacks, or low-grade chronic stress related to work, family, or repsonsibilities. Stress serves as a great indicator of potential work to be done, and offers a jumping off point for your session.
Relationship Dynamics
If you have a partner or are dating, relationship dynamics are a great thing to talk about in therapy. These relationships often form an important part of our identity and day-to-day experience. Maybe the relationships are difficult or fulfilling. They don’t have to be hard relationships to be worth discussing!
You might discuss any difficulties you are facing in your relationships in life, including dating difficulties, communication problems, emotional affairs, or life transitions you are going through together. The therapist isn’t there to judge you or your partner, but may be able to work with you to address any issues. At very least, it will give your therapist more context and understanding.
Work and Career
Much like relationships, our work life and careers are a foundational part of our identities and lived experiences. When people reach out to us for online therapy in California, work seems to be a topic that comes up quite quickly. It makes sense! We spend a lot of time at work (or looking for work).
You might talk with your therapist about any difficulties or stress at work, your goals and aspirations, or dynamics you face at your job. Even if something feels small, you might consider discussing it and seeing what comes from the conversation.
Family Life
Outside relationship dynamics, you also might reflect on your family life. This may be your family of origin or family of creation. Relationships with family or loved ones have unique power to impact our experience and wellbeing. You can discuss difficult relationships or aspects such as childcare, sibling dynamics, caring for parents, or how you see yourself as a member of the family unit.
Habits and Behaviors
We all have habits, behaviors, and patterns of thinking that may not be working for us. With a little bit of reflection, you might identify what these are. Are there certain behaviors that seem to get you in trouble or cause suffering in your life? Where do you struggle? You might talk with your therapist about any patterns you notice.
Present Feelings
A great option for what to talk about in therapy is simply whatever is going on for you right now. What feelings are present? Maybe you’ve experienced some joy or success recently, or maybe you’re wondering why you’ve been so emotional lately. Whatever is present, bring it to therapy. Together with your therapist, you can begin to unpack it.
Rumination
We all ruminate from time to time. This is a good topic for a therapy session. When the mind ruminates, where does it go? Are there certain memories, experiences, or aspects of your life that seem to come up repeatedly? Often these ruminations tell us something is not fully resolved, and perhaps there is work to do.
Traumas and Difficult Memories
If you have trauma or difficult memories, these can be the perfect things to discuss in therapy. These can be difficult to discuss, and your therapist will understand that. Open up in a way that feels safe for you; don’t rush it. There are specific techniques and modalities, like EMDR therapy, that can be especially useful in processing these memories.
Transitions and Life Challenges
Many people underestimate the impact of life transitions and challenges. Maybe it’s the stress of moving, a divorce, menopause, kids moving out, or moving to a new place. These transitions and changes in our lives can cause effects on all aspects of our lives. As such, they make for a wonderful topic to discuss with your therapist.
Things We Judge Ourselves For
Something I often tell people is to question if there is some part of themselves that they judge harshly. Are there actions you’ve taken, thoughts you have, or traits that you feel shame or guilt over? These can be quite insightful to discuss. As you dig in with your therapist you may discover new ways to approach these things, how to behave differently in the future, and how to change your relationship with yourself.
Difficulty Opening Up
Do you have difficulty opening up or being vulnerable? Maybe it’s specifically with your therapist, or in general. Although it seems paradoxical, this is a great topic for therapy. You don’t have to divulge information you’re not comfortable sharing. You can talk about the feeling of struggling with vulnerability, and start from there.
Things You Want to Change
There may be things you want to change about your life or internal experience. Maybe you want to stop thinking about work at night, figure out how to be more present with your partner, or not judge yourself so harshly for anxious thoughts. We all have things we want to change. No matter how big or small they may be, they may be worth discussing with your therapist.
Your Self-Talk
The way you talk to yourself matters. That inner voice can say a lot about your relationship with yourself. You might tune in to the tone of voice in your head. See what you notice, and bring it to therapy. Are there harsh thoughts? Maybe there is a lot of judgement. Or maybe the voice is dismissive. Whatever it is, bring it to therapy.
Any Goals or Intentions
Therapy isn’t just focused on what’s wrong. We need to have treatment goals and intentions. There’s no right or wrong answer. Share with your therapist what you hope to get out of therapy, what goals you have in life, and anything you’d like to achieve with your personal growth.
Therapeutic Relationship
Teh therapeutic relationship should always be discussed if there’s something worth discussing. If you don’t feel comfortable with your therapist for whatever reason, you might talk about this in therapy. Your therapist may help you address any issues together, or perhaps help you find a therapist that feels more supportive to your growth and work.
Anything You’re Curious About
Part of therapy might be psychoeducation. It can be useful to learn about the brain and body, and how they work. If you have curiosity about something you’re experiencing, why you behave in a certain way, or how something works, bring it up in therapy. Your therapist can help you understand, and the curiosity itself might be insightful.
Not Knowing What to Talk About
If you aren’t sure what to talk about, say that! Sometimes we show up to therapy and just have nothing we feel is important to say. There’s nothing wrong with that. Be honest. Telling your therapist you don’t know what to talk about helps them get to know you better, and they will be able to find a topic for the week.
Is It Okay to Not Talk About Something?
Yes. If there are traumas, very painful memories, or strong shame surrounding behavior, it can be difficult to discuss with anyone. This is especially true in new therapeutic relationships. As you get to know your therapist, the trust will hopefully grow until you feel safe discussing them.
A therapist might give you a nudge to discuss something, but won’t force you to talk about something you want to avoid for now. Know your limits and your boundaries!