What to Talk About in Therapy?

Natalie Buchwald, LMHCTherapy

By Natalie Buchwald, LMHC | Last Updated: May 22nd, 2023
Reviewed by Steven Buchwald

Whether you are going to therapy for the first time or switching therapists, you might be wondering what you and your therapist will talk about. How can you share your feelings with a stranger when you don’t completely understand them yourself? How are you going to fill a whole hour?

If you’re feeling daunted, you are not alone. Many people do not feel comfortable sharing their thoughts and feelings with others. Fortunately, whether you come in with a specific problem or a general sense that you need help getting on track, there are no right or wrong topics in therapy.

Your therapist is a trained professional who will guide the conversation in a way that is helpful for you.

The key to any therapy session is to let your emotions, feelings, and concerns take the lead.

Truly, therapy is the place to say what you feel. If you don’t exactly know what you feel, that is a talking point in and of itself!

How Are You?

We all know the standard format: Someone says “hello” and asks us how we are. We say we’re “fine” or even “great!” – even when we’re not.

When your therapist asks you how you are, it’s different.

Your therapist wants to know how you really are. What are you troubled by right now?

Are you feeling frustrated, sad, anxious, angry, or something else?

Be honest in your response. Your therapist isn’t looking for a polite response: they are looking for an honest one.

If you are struggling to identify how you are feeling, just talk about what is present with you at this moment.

Sharing what’s alive now is the path to discovering more deeply rooted issues.

Let what’s alive right now, the most intense emotion (frustration, anger, depression, you name it), have the mic!

Whatever answer you give to “how are you,” your therapist will probably ask you to explore it further: What triggered the feelings you’re experiencing right now?

Don’t worry if it seems small or trivial. If you’re having an uncomfortable response, there is something to be curious about.

The Past is Prologue

Oftentimes, our emotional responses to difficult moments in the present are rooted in our experiences in the past. Our pasts are always with us.

For example, you may know that your current job isn’t a great fit, but you are reluctant to take the necessary steps to find a new one. You may feel frustrated about your perceived lack of momentum.

When you share these feelings with your therapist, they might ask questions to uncover the reasons you’re not sending out your resume. Therapy is about finding out why we feel the way we do. Those reasons are often deeply-rooted in older – sometimes even half-forgotten – life experiences.

Once we recognize the connections between past and present, we can evaluate them. What assumptions have we been making about certain situations? Are these assumptions reasonable in the present? Are they useful? If not, how can we replace them with new, more realistic ones?

What NOT to Talk About in Therapy

Your time with your therapist is valuable. After all, you are in a judgment-free zone where the sole focus is officially on you and how you’re feeling.

Make the most of the experience and talk. Talk about anything that’s present in the moment.

Share whatever is in your heart, soul, and mind, even if it takes you to difficult and unexpected places.

Your therapist is there to help you, not judge you. Therapists are trained to be with your experience fully and meet you where you are. No topic is off-limits.

Nothing you say is too strange, dark, or shameful for your therapist to hear.

In fact, shame and guilt are two of the human mind’s most powerful and destructive forces. We have to recognize them and deal with them to move forward in our lives.

The only thing not to talk about in therapy is nothing! Superficial chitchat is not going to lead you to the kinds of realizations you need to become whole and move forward in your life.

Honesty and the courage to explore how you feel and why you react the way you do are essential to healing and becoming whole.

Get Started

Starting therapy can feel overwhelming, but you have made the first difficult step in making your appointment. At Manhattan Health Counseling, we offer easy, affordable and high-quality therapy. Our therapists can help you take the next step forward for your mental health. Contact us today by calling 212-960-8626.