What Do I Talk About In Therapy?

Therapy is a new experience for many people. If it’s new for you, it’s not unusual to feel uncertain about what to focus on with your therapist. It’s always a good idea to express these feelings in your session, and the less your censor yourself, the more benefit you will experience. Remember that nothing is off-limits and there is no right or wrong thing to talk about in therapy. Trust that your therapist is trained to guild you and ask questions to help you explore and focus on what’s most helpful. This following list is intended to provide some ideas for reflection and discussion as you go into your next therapy session.

·      How you would like to be different: What goals do you have for what you would like to change? For example, wanting to yell less often, worry less, spend more time with your family, perform better at work, etc.

·      Emotional reactions: Whether is was a small or big emotional reaction that you had over the week, something your therapist has said, or something from the past that you can’t “get over,” these are all great things to bring up in therapy. It is often useful to use a notebook to record things that may have happened in between sessions so that you remember instances of emotional reactions (e.g., a friend made a comment that you were frustrated with).

·      Self-talk: What thoughts do you have about yourself and situations you are in? Are you judging yourself harshly? What do you tend to tell yourself consistently across various types of situations?

·      What you are learning from therapy: What did you take away from last session? Did you think about it during the last week? Have you been paying more attention to your thoughts, emotions or communication patterns?

·      What do other people say about you: Sometimes it is useful to discuss how others see you and whether or not you are satisfied with that image. It may be that you decide to work to change your image or that you choose to surround yourself with different people.

·      Relationships: Humans are social beings. Relationships, in whatever form they take, tend to be important. If you are unsatisfied with certain relationships, this might be good topic to address.

·      Fears: It can be helpful to say our fears out loud, to someone who is trustworthy and nonjudgmental. Sometimes this can reduce the intensity of the feeling, either immediately or over time. It can also be useful in recognizing how some of your behavior may be driven by these fears. Some example can include: avoiding certain places or people because of anxiety, or becoming angry at your partner when you are afraid that they will leave you.

·      Progress in therapy: Have you noticed positive changes since beginning therapy? It is also possible that your therapist has noticed improvements that you have not, so feel free to ask your therapist for feedback if your therapist is not discussing progress with you.

·      Treatment goals and diagnosis: Understanding and periodically reviewing your goals can be helpful. Having an accurate understanding of your diagnosis can be an important part of therapy and increase clarity of the direction of your goals.

·      Don’t skip the details: Details are important and often very useful to help the therapist understand more about you. Don’t feel like you need to shorten a story or that you shouldn’t mention something because it doesn’t seem important. Your therapist will also help guide you in this process by asking for more clarification or directing you in a certain way (e.g., “How did you feel in that moment?” or “How did you interpret that comment?”)

·      Don’t worry about being repetitive: To truly learn and internalize something, humans often need repetition. You can always revisit something that you are still thinking about, even if you have discussed it with your therapist before.

·      Questions: Feel free to ask your therapist questions related to mental health, psychology, or their training. If you don’t understand something they have said, it is great to clarify or ask questions about it.



Michelle Kanga, Ph.D.therapy