Nothing is off-limits in therapy. However, sometimes people find it hard to know what to say. Going over some common topics or reflecting on why a person chose to seek therapy can be a good place to start.
A person can talk about whatever they want in therapy. There are no strict rules on what is appropriate to discuss.
That said, different therapists may direct the discussion in different ways, depending on their preferred style and the form of therapy. Some may encourage free association, which means thinking of whatever comes to mind, while others may want to focus on a particular issue. However, the client always has the final say on what they feel comfortable talking about.
This article will provide some ideas for what to talk about in therapy and cover some common questions about what to expect from a therapy session.
There are no right or wrong topics to talk about in therapy. People can bring up whatever is on their minds.
Possible topics
If a person is unsure, the following subjects can be good starting points:
- how the client’s day or week is going
- how they feel right now
- what is going on in their family or household
- any difficult recent moments or ongoing situations
Starting with these topics can be enough to get the conversation flowing. However, if there is a lull or silence, that is also okay. Sometimes, silences can give therapists helpful information or allow the client’s mind to wander onto topics they did not even know they wanted to discuss.
It is common for people to feel nervous about therapy, but the therapist will also be there to guide the conversation and offer reassurance. Some topics they may eventually want to ask about include a person’s:
- childhood
- past experiences
- dreams
- relationships
- career
- patterns of behavior
- symptoms, if they have a specific mental health diagnosis
- physical health
The first session with a therapist can be a little different from later sessions. This is a chance for both people to introduce themselves and get to know the basics about each other.
For the client, this may mean explaining:
- a little about themselves
- why they are seeking therapy
- what they hope to gain from therapy
For the therapist, it
- their approach to therapy
- what they can or cannot help with
- practical considerations, such as appointment availability or prices
A person will also have the opportunity to ask any questions they have.
No, not necessarily. Therapy does not have to involve delving into big questions or challenging topics every session.
If a person has a specific event or concern they want to address, it may be necessary to discuss deep thoughts or feelings eventually. A person can do this whenever they like.
However, sometimes talking about the “smaller” things can be just as beneficial, as they can reveal something to the client or therapist that they were not expecting about how the client experiences daily life.
There can be several reasons a person feels they have nothing to say in a therapy session. Understanding the cause of this feeling may help with figuring out a way forward.
For example, the client may feel:
- They are doing well: If a person has been feeling better recently, this could be an opportunity to reflect on what has changed since they started therapy. Not all sessions need to focus on problems – they can focus on wins, too.
- They feel like nothing interesting has happened: If a person has had an “ordinary” day or week, they can talk about this. A therapist might be curious about what an ordinary day looks like for the client and how they feel about it. For example, one person could find an uneventful week boring, while another may find it fulfilling.
- They feel their problems are unimportant: A person may be experiencing difficulties or feel distressed about something but write these concerns off as insignificant or trivial. Alternatively, they may feel pressure to make progress, meaning they do not report when they are feeling bad. Both are things a therapist will be interested to know about.
- Their mind goes blank: This can be a result of the “freeze” response, which occurs due to stress. If a person feels anxious during a session for any reason, it may be hard for them to think. Again, telling a therapist about this can be beneficial and may lead to better sessions.
It is important to note that therapy does not have to follow the structure of a typical conversation. It is okay if a person wants to stop talking, change the topic, or ask the therapist for their input.
There are no topics people must always avoid in therapy. Ideally, a person will feel comfortable discussing whatever they need with their therapist.
However, if a person feels highly uncomfortable or unsafe discussing a certain topic, this may be a sign that they are not ready to explore it yet. It may take some time for them to feel safe enough to do so.
Some minor discomfort can be necessary to make progress in therapy. However, if a person experiences any of the following, it is important they tell the therapist how they are feeling:
- intense anxiety
- flashbacks
- dissociation, which is when a person feels disconnected from reality, themselves, or their environment
These can be signs that a person may need to return to this topic later when it feels more manageable.
People can stop therapy whenever they want to. There can be several reasons for doing this, such as:
- finishing a treatment program with a specific end date
- meeting the goals a person had when they started
- feeling consistently much better than before having therapy
- not feeling they are benefitting from the type of therapy or therapist
- difficulty getting to or scheduling sessions
- financial or insurance issues
However, there is no rule that people have to stop seeing a therapist when they feel better or reach their initial goals. They may discover new goals they want to work toward or feel they simply benefit from having someone to talk with.
People may also use therapy sessions as a preventive measure to address emotional concerns or symptoms of strain on their mental health before they become more significant.
A person can talk about anything they want in therapy. Therapists may ask about a person’s family, childhood, relationships, or career. Some may also be interested in a person’s dreams. However, it is up to the client to decide what they want to discuss and when.
Talking about what has happened during the week or how a person currently feels can get the conversation started. If a person feels anxious or their mind often goes blank in sessions, and they are unsure what to say, it may be best if they mention this to the therapist. The therapist can help them explore what may be causing these feelings.