What Should I Talk About in Therapy?: 10 Places to Start

If you’ve visited my website and blog before you may have seen some of my previous posts focused on supporting you to figure out what you should bring with you to your first therapy appointment and what to do if your therapist asks you about something and your immediate response is “I don’t know.”

Over the past few months I’ve noticed a trend in other searches people are making that lead them to my site: “What should I talk about in therapy?” In response to this I’ve decided to share some ideas with you on this topic. Sometimes we walk into a therapy appointment and the conversation and stories flow out of us - other times (especially during the first few appointments as we get to know our therapists) it can be more difficult to know what (or how) to bring things up. If this is something you’re struggling with or wondering about, maybe some of these ideas will help you out.

  1. What did you seek out a therapist for in the first place?

    Ways to bring it up: “I want to talk about my anxiety.” “I’m not happy with my relationship and want to know how to improve it.”

  2. What has changed for you in the past week (or since you last saw your therapist), for better or worse?

    Ways to bring it up: “I had an anxiety attack on Monday but was able to get myself through it!” “I have felt stuck in a rut this past week and haven’t been able to get myself out of it.”

  3. What kind of emotions have you been dealing with/experiencing?

    Ways to bring it up: “I have been feeling really sad lately.” “I have felt kind of empty over the last week - it’s like none of my emotions are there anymore.”

  4. Is there anything you’ve tried doing differently recently?

    Ways to bring it up: “I tried going to bed at a set time last week but I had some trouble.” “I tried using the technique you told me about and it was really helpful with ______.”

  5. Do you have any worries?

    Ways to bring it up: “I’m really worried about my upcoming exam.” “I’m worried I’m never going to feel better.”

  6. Do you have any questions?

    Ways to bring it up: “I don’t know if I should be feeling better by now.” “Could you explain to me again how to use mindfulness to calm down?” “Are there any coping strategies you’d suggest I try?”

  7. What do you wish was different in your life?

    Ways to bring it up: “I wish I didn’t feel so angry.” “I want to get a new job, can we talk about that?”

  8. If you were to describe your life with one word, what would it be?

    Ways to bring it up: “If I had to describe my life in one word it would be failure.” “If I were to describe my life and experiences in one word it would be a ferris wheel.”

  9. When was the last time you felt you were at your best?

    Ways to bring it up: “This time last year I felt like I was at my absolute best - I miss feeling that way.” “I remember when I was 7 and we went to the park with my cousin I was the happiest I had ever been.”

  10. What is a recent situation that you found difficult, stressful or upsetting?

    Ways to bring it up: “I had my review at work last week - my boss had a lot of criticism and I was really upset for hours after.” “Finding out that my uncle had been diagnosed with cancer was heartbreaking for me. I have never felt so upset.”

Opening up in therapy can be difficult, especially if it’s the first time you’ve seen a therapist. If you find yourself getting ready to head to your appointment and are worried you won’t know what to say, try one of the ideas above - chances are that once you share these thought with your therapist they will be able to ask questions and guide you into a conversation from there.

If in doubt, remember you can always tell your therapist something along the lines of: “I’m not quite sure what to say or where to start.” They should be more than happy to help you find your way. That’s what they’re there for, after all.