Therapy can be challenging, healing, and highly beneficial; however, it can also be awkward, and uncomfortable, especially in the beginning. In reality, there are no “wrong” things to talk about in therapy. Small things and big things are all OK to bring to your therapist. If it’s on your mind, it’s important.
Note that while it is great to prepare for therapy and have an idea of what you’re going to talk about, your therapist should be a professional question-asker, so to speak. If you find that you can’t talk to your therapist and/or your therapist doesn’t offer you any prompts, it may be that you need to seek a therapist with a more engaged approach.
Although your therapist should be able to engage you in conversation, it doesn’t hurt to think about what you might discuss. Therapy has many benefits, especially when the client/therapist relationship is a good match, so think of it as a way to try and get the most out of the experience.
Here are 20 things to talk about with your therapist:
1. What Prompted You to Contact a Therapist?
Think about when you made the decision to search for a therapist. What was happening in your life? What were you looking for? Talking about the reasons you think therapy could be beneficial for you is a great way to set goals with your therapist.
2. Feelings About Therapy
If you feel anxious or doubtful, tell your therapist! Saying that you are uncomfortable or not feeling safe enough to answer certain questions is honest, which is even more important than just answering questions.
3. Previous Experiences With Therapy
What’s your previous experience with therapy? Knowing what has been helpful/unhelpful in the past allows your therapist to understand how your mind works and avoid any unintentional triggers.
4. Current Relationships
Our relationships with significant others, family members, coworkers, friends, and even enemies shape and affect our lives. Discussing these relationships allows you to uncover and address patterns regarding communication, attachment, and boundaries.
5. Sexuality
Sex and sexuality are important parts of life. A licensed professional will not be embarrassed to discuss sexuality. For most clinicians, there is no “TMI” (Too Much Information). If sexuality is a specific interest or concern for you, you can even seek a therapist who specializes in sexuality issues and/or sex therapy.
6. Current Job/Career
Our career paths and interests serve as windows into our psyches. Talking about your place of business, workplace dynamics, or areas of professional interest can serve as ways to discuss bigger issues like communication and relationship patterns. Professional interests also help your therapist understand how your mind works and the ways you interpret the world around you.
7. Places Where You Feel Stuck
Where do you feel like you’ve hit a wall? Feeling stuck or trapped in an area can be a sign that something is not quite right. Therapy can help you process those stuck points and give you strategies for moving forward.
8. Creative Endeavors
If you engage in any creative activity, talking about your work can be a way to express yourself and convey difficult topics. As a therapist, I enjoy engaging with clients about their artwork because it is often a way of expressing ideas that are difficult to put into words.
9. Personal Strengths
Usually, we think that therapy has to be about what we struggle with, but discussing our strengths is also valable. Having a deeper understanding of your strengths allows you and your therapist to process ways to build on them.
10. Current Coping Strategies
Coping strategies can be healthy or unhealthy, though most fall somewhere in the middle. When you discuss the ways you typically deal with stressors, let your therapist know how well you think they work for you, too. Learning new, healthy ways to cope is typically a major part of therapy.
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11. Trigger Points
What causes you to react inappropriately with rage, panic, or disgust? Are there noises, smells, or feelings that cause you to immediately feel overwhelmed? All of these could be considered triggers. You may know where the triggers come from, but you also may have no idea why a certain thing bothers you. A therapist can help you identify triggers and learn ways to manage your reactions.
12. Major Life Transitions
A move, graduation, birth, death, job change, or any other life transition can cause inner turmoil. Even a positive change is inherently stressful on your body and mind. Therapy during life transitions gives you a way to process the feelings that come with change. Talking about past transitions can also highlight patterns and old wounds.
13. Grief
While grief is a common experience, it’s often pushed aside. While it certainly applies to the loss of a loved one, people also experience grief in a number of other circumstances including divorce, aging, and during medical diagnoses. A professional clinician will be able to walk you through the grieving process in a healthy way.
14. Childhood Experiences
The inflection points of childhood set the stage for continued patterns. Talking about your childhood in therapy may seem cliché, but it is a way to highlight and untangle the complicated patterns that keep us in unhealthy situations.
15. Abuse/Neglect/Violence In Your Past
Due in part to trauma and isolation, any history of abuse, neglect, or violence is important to discuss in therapy. Therapists, especially those skilled in trauma-informed care, are trained to help you manage the effects of those events.
16. Generational Patterns
When you look at your family tree, what kind of patterns do you see? Generational patterns of addiction, suicide, violence, and/or hospitalizations are important for a thearpist to be aware of. Patterns of relationship issues in prior generations can also help shed light on potential risk factors.
17. Medical History
While most therapists aren’t medical professionals, medical history does play a major factor in your mental health. If you have had a major medical crisis, you may be experiencing a trauma reaction. Certain medical diagnoses also have higher risk factors for depression or anxiety. Talking about your medical history and your experiences with the medical establishment may shed light on certain patterns or reactions.
18. Fears About the Future
Discussing your fears and anxieties about the future may seem obvious, but many people feel like they can only talk about things that are problematic in the present or past. Talking about your fears for the future can help you make a plan.
19. Hopes For the Future
Not all therapy sessions have to be about negative, difficult issues. By exploring your hopes and dreams for the future in therapy, you can set intentions while also learning and incorporating healthy strategies to allow you to achieve those dreams.
20. That Thing You’re Avoiding Talking About
You probably don’t want to talk about whatever it is that you’re avoiding, but you should probably find a way to bring it up. You may need to email your therapist if it’s easier to write than speak. Or let them know that there’s something on your mind, but you’re not sure how to mention it. The things we avoid are usually the keys to unlock future healing.
What to Talk About When Things Are Going Well
If things are going well and you’re not in crisis that doesn’t mean that there aren’t important things to discuss. It’s important to talk about what specifically is helping and how you are feeling about the positive things in your life. This can help you plan for what to do if life throws a curveball. It’s also important to process any concerns that things may go awry.
Things going well can also be a sign that therapy is at its end. If you are at a point where you feel that life is good, bring this up with your therapist! Ending a therapeutic relationship intentionally allows both you and the therapist to assess your progress, discuss any lingering concerns, and, most importantly, experience the ending of a relationship in a healthy way.
It’s also important to remember that pausing or ending therapy can be “for now” and does not have to be forever.
How to Find a Therapist
If you’re interested in starting therapy, finding a therapist can be tricky. Referrals from your insurance company or a medical provider can connect you with someone who will be in-network. Also, ask other people who have had good experiences in therapy to direct you toward the right clinicians. Alternatively, you can start your search in an online therapist directory.
Make sure to schedule an initial consultation or phone call with a prospective therapist. Ask them questions about their experience with the types of issues you are struggling with; assess not only their answers, but also how comfortable you feel talking with them.
Research shows that the strength of the therapeutic alliance is a stronger predictor of outcomes than the modality of treatment.1 Simply put, a strong relationship with your therapist matters more than the kind of therapy you engage in.
Final Thoughts On Topics to Talk About in Therapy
Therapy can be difficult, but it’s often healing. While you can (and should) rely on your therapist to work with you to make your experience worthwhile, knowing what is appropriate/common to discuss and how to bring it up can help reduce stress and increase efficiency. Good luck!
For Further Reading
Here are additional resources:
- National Alliance on Mental Illness (NAMI)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- The National Suicide Prevention Lifeline at 1-800-273-8255.
- Mental Health America
- National Alliance on Mental Health
- MentalHealth.gov
What to Talk About in Therapy Infographics
