What to Talk About in Therapy: An Easy Guide

Whether you’re going to your first therapy session ever, you’re returning to it after taking a long break, or you’ve been in therapy for years, it’s possible you may be asking yourself, “What should I talk about in therapy?”

You may wonder where to start or what’s appropriate to bring up, or you may be afraid that something that’s on your mind isn’t a “big enough” problem or “too big” of a problem to even be worth bringing up with a therapist. 

The truth is, you can talk about anything in therapy. If it is causing you distress or contributing to what brings you to therapy, it’s fair game. You might enter therapy for one reason and then other things come up that you need help processing. 

Understanding what to talk about in therapy can be daunting, especially for those new to the experience, but this guide is meant to help alleviate some of that uncertainty or anxiety.

Things to talk about in therapy

Therapy is something that should be personalized to you, so when thinking about what to talk about in therapy, you can feel comfortable talking about anything, and you don’t have to be in crisis for it to be a helpful tool. To help give you some places to start and normalize some of what might be on your mind, here are some topics that you can cover in therapy:

Your feelings around being in therapy 

When starting therapy, you may be asking yourself what to talk to a therapist about as it relates to your experience in therapy. This is a common challenge, but remember that therapy is your safe space designed for openness, exploration, and personal growth. Each thought that crosses your mind is something you can discuss. Consider the following areas that focus on a specific experience or emotion around being in therapy:

• Your hesitation or skepticism about being in therapy 
• Your previous therapy experiences
• Your beliefs about therapy 
• Not knowing what to say in a first session or follow-up sessions
• Feeling unsure about what’s bringing you to therapy 
• Wondering how long therapy takes to work

Your relationships

Different people have different things to work on in therapy, but a lot of people talk about their relationships — whether they’re causing problems or not. Your interactions with the people in your life are rich areas for exploration regarding what to talk about with your therapist. Here are some issues and areas regarding relationships you might wish to delve into:

• Important people in your life
• Frustrating people in your life
• People you miss
• What you wish people would do more of
• What you wish people would do less of
• How to set boundaries 
• Your family and friends

Your emotions

In the journey of self-discovery and healing, emotions are undoubtedly among the crucial things to talk about with your therapist. Discussing how your mood has shifted over time can also provide insight into your mental health and overall well-being. Here are some emotion-focused topics that you might find beneficial to explore:

• What makes you laugh 
• What makes you angry
• What makes you cry
• What scares you
• How your mood has changed

Your thoughts

Your thought patterns and concerns are one of the key things to talk to your therapist about. Recognizing irrational or intrusive thoughts can also be good for self-awareness and healing. Below are some thought-focused topics to consider discussing in counseling:

• Patterns you find yourself repeating
• Memories you think about a lot
• What worries you
• Irrational thoughts
• Intrusive thoughts
• Your thoughts about yourself

Your everyday life

When wondering what you talk about in therapy, don't overlook the seemingly mundane aspects of your everyday life. Daily experiences and routines can help your therapist understand more about you and your circumstances.. Here are some everyday life topics that could be beneficial to address in your therapy sessions:

• What makes you feel stress
• Where you feel stuck
• What you want to change
• What you want to stay the same 
• Things that bother you
• What goals you want to set
• How you cope or what gets you through hard times

This list of what to talk about in therapy is nowhere near exhaustive, but it can serve as a starting place if you’re feeling at a loss with what to talk to your therapist about in any given session — even if you’ve been in therapy for years.

How therapy works

Therapy is a process, and it takes time to see results. However, if you are willing to put in the work, therapy can be a very effective way to improve your mental health.

Therapy has a lot of benefits. It can help you:

• Understand your thoughts, feelings, and behaviors
• Change your thoughts, feelings, and behaviors
• Improve your relationships
• Manage stress and anxiety
• Cope with difficult emotions
• Achieve your personal goals

How to get the most out of therapy

Therapy is different for everyone. What works for one person may not work for someone else. Now that you have a sense of what you can talk about in therapy, there are a few tips and tricks that can help us all make the most of it.

Don’t obsess over being polite.

You can ask questions. You are allowed to disagree with your therapist. And if something doesn’t make sense to you, say so. No amount of advanced training in psychology or years of study will ever invalidate your feelings. Speak up if something feels off.

Don’t keep things to yourself.

The best way for your therapist to get to know the real you (and to help you!) is for you to be completely honest about what you’re thinking. If you’re worried about feeling judged, remember that a good therapist isn’t there to make judgments.

Be your most authentic self.

If the very idea of being authentic is confusing or feels unnatural, tell your therapist. That is valuable information for the work ahead. If you’re struggling to describe or articulate how you really feel, say so. Honesty is the best way to get to the root of what you’re struggling with and how you’re really feeling.

Let your emotions show.

Therapy is one place you don’t have to bottle up your emotions. If something comes up that makes you angry or sad, let those emotions out. Every therapist has heard a variation of someone saying, “Sorry, I don’t know why I’m crying.” Part of therapy is helping you navigate those emotions.

Try not to focus solely on symptom relief.

As an example, say you want to stop having panic attacks. A therapist aids you in mitigating those attacks, but they also want to get to the root of why you’re having those attacks in the first place. It’s like taking ibuprofen for pain. It alleviates the pain, but you still need to figure out what’s causing the pain in the first place.

Set boundaries around therapy.

It can feel natural to discuss new therapy with a significant other or family, but try to create thoughtful parameters around how you speak about it. There may come a time when you don’t feel comfortable sharing what happened in therapy. It’s wise not to set up expectations that you’ll always share. Plus, sometimes other people's thoughts and opinions can be more destructive than valuable.

Keep a journal.

The work is not done when the therapy hour is done. Whatever you covered in your last session will come up in your next session. Throughout the week, try to practice what you learned in therapy. Keep an eye out for what emotions come up and what new challenges you may face.

The best way to keep track of how you feel between therapy sessions is to keep a journal. It can be a notebook or even just a private Google doc where you scribble your thoughts. It’s perfectly okay to refer to this doc in therapy — your therapist will probably appreciate the work you’re willing to put in.

Establish a process for check-ins.

It's useful to plan in advance how you can reach your therapist between sessions. Sometimes doing the work results in feeling emotional, overwhelmed, and lost, and you may want to email or call your therapist for a quick reflection on how to manage these emotions. Your therapist should have a protocol for contacting them between sessions. If you’re in therapy with Two Chairs, you have mental health check-ins built into your experience to help you reflect on how you’re feeling week-to-week.

Expect to drag your feet sometimes.

Sometimes we just don’t feel like going to therapy. Be cognizant of this feeling and why you may be feeling it. Is it time to find a different therapist? Or are you working through something really challenging?

Therapy is similar to exercising in that way: we might want to veg out instead of working out, but we usually feel better if we exercise.

Get business out of the way.

Start each session with scheduling questions, payment, and other administrative duties. It helps to get this out of the way so you’re not interrupting the emotional work at the end of the session.

Don’t worry about the clock.

Your therapist will be the one keeping an eye on the time. Do your best to turn off devices and be present. Therapy is typically only 50 minutes — try to dedicate that time to yourself.

Try to schedule therapy at a good time.

Sometimes we can’t be choosy with the timing of our therapy hour, but if you can, it’s best to schedule it when you can have some time to reflect after the session is over. It’s easier to be fully emotionally available when you don’t have to be back at work immediately after.

Don't expect your therapist to tell you what to do.

Therapy is less about advice and more about helping you make decisions that serve you. It can be tempting to ask a therapist to just tell you what to do, but try not to hold this as an expectation. 

Be patient.

Therapy is hard work. Positive changes take time. It can be frustrating, and that’s okay. If you get frustrated, it’s perfectly acceptable to talk about it with your therapist. 

Whatever it is for you, know that therapy is your space, and you should feel comfortable and safe talking about anything you need to. This is why working with the right therapist is so important in figuring out what to talk about in therapy.

The first step in beginning therapy with Two Chairs is a matching appointment, which ensures that our clients are paired with the most suitable therapist for them. You can read more about what to expect during a matching appointment here. If you’re ready to let us find the right therapist for you, book a matching appointment today.