What to Talk About in Therapy When You Don't Know What to Say

Licensed therapist/counselor offers 6 tips on what to talk about in therapy when you don't know what to say.

If you haven’t been to therapy or counseling, it can be anxiety-provoking to start the process. Not knowing what to say is one of the biggest challenges people face, especially when they're new to counseling. Many people feel so overwhelmed by the whole idea they push it off for months or even years.

Truthfully, taking the first step is going to be hard, especially if it's your first time. Heck, even people who've been to therapy “run out” of things to say, so you're not alone. A big misconception about counseling is that you only benefit from it in a moment of crisis. And once that crisis is resolved, then there’s nothing else to talk about. However, this way of thinking is far from true. Once the problem has been resolved, it's the perfect opportunity to take a deeper look and explore other areas of your life. Remember, your mental health encompasses all parts of your wellness, which includes emotional, psychological, and social well-being. Taking this approach requires that you become comfortable with awkward moments.

However, you don't have to do this alone. If you’re new to therapy, let your counselor know this during the consultation so they can help guide and comfort you through the process. Even if you’ve been to counseling before and still find yourself in this situation, It's still worth mentioning to your counselor.

Luckily, counselors and therapists know this and are willing to assist in the beginning by asking open-ended questions during your intake to better understand you and your needs as their patient and help create a plan for future sessions. Although this can be very helpful, you don't want to leave it all to them. Remember, they don't have a crystal ball in your life, so they will rely on you to tell them what you need help with.

I know, it sounds daunting, right? Well, I’ve got you covered. At Reflection is Healing Counseling, I’ve helped make this process for first-timers and returning clients as smooth as possible. Whether you find yourself not knowing where to begin or just the mere thought of opening up to a stranger sounds horrible. Whatever the situation might be for you, here are a few tips that can make the process a bit smoother.

Here are a few ideas to start the conversation or get your therapy sessions back on track:

1. Start with what brought you to therapy

If you're not sure where to begin, start with what made you schedule the appointment. Was there a specific incident, conversation, or overwhelming feeling that made you call? Start with your most recent stressors, and the conversation will naturally progress as time goes on.

2. Present thoughts, feelings, and behaviors

We’ve all had moments of sadness, anxiousness, and anger, but maybe you’ve noticed those feelings have increased in the last two weeks. Talk about those feelings and what's been driving them to be more intense. Work with your counselor or therapist to improve these feelings over the next couple of weeks.

At Reflection is Healing Counseling, I encourage my clients to keep a journal between therapy sessions. This can be helpful to start conversations and also keep track of patterns. For example, a person may observe throughout their week that feelings of worthlessness keep emerging throughout their different interactions. This would be something to mention and work on.

3. Relationships

Discussing your relationships are great topics to discuss in therapy.

Many of the struggles we face always have something to do with people. Either how we think people perceive us or direct relationships with friends, family, colleagues, or romantic partners. Relationships are an integral part of your mental health, so tell your counselor or therapist about all of your relationships and how they impact you.

4. Explore your past

Now this one may be more challenging to talk about, especially in the first couple of sessions. However, taking a step back in your past could help you resolve unresolved feelings that are impacting your future.

5. Trouble opening-up

If you have a hard time opening up, tell your therapist. Once I had a client tell me, “I didn’t want to come today. I want to get up and leave.” Did she leave? No. Due to her willingness to push through that feeling, we worked through it. Normally, thoughts like this are seldom about the counselor or the client. What’s emerging is the behavior that you have to change.

6. Talk about progress

Reflect on your experiences thus far. Discuss what's worked for you and the progress you've made. Remember, the relationship with your counselor is most important, so don't be afraid to spend some time here.

Simply put, therapy will be uncomfortable at first, but if you continue to push through and work with your counselor or therapist, the benefits will outweigh the uncomfortability in the beginning.

If you are looking for therapy or counseling that is non-judgmental and compassionate about your concerns, then book a consultation with me today. Individual sessions can be covered by your insurance, and our rates are very reasonable and affordable. Get started with your overall well-being by speaking with me by phone, on Zoom, or in person!

Siera Phillips
Licensed clinical professional counselor at Reflection is Healing Counseling Services