If you’re new to therapy or unsure if you’re getting as much out of it as you can, you might be wondering what exactly you’re supposed to be talking about in your sessions. Well, first of all, you should know there’s no right or wrong topic to broach (or not to broach). Not only are you welcome to use your sessions to talk about whatever’s on your mind, but your therapist is also there to prompt you, often starting with an intake questionnaire before your first session, says Amanda Jurist, L.C.S.W., CEO of The Denham Group. But if you still feel like you need guidance, here are some helpful topics to bring up with your therapist, which can support you on your healing journey.
"Once you understand the basis of these thoughts, you can begin the process of separating yourself from these most often false fear-based and internalized narratives," explains Jurist. "After processing and separating yourself, you begin to have more of a capacity to develop more grounding and fact-based views of self while giving yourself the grace to map out areas of your life you would like to continue developing."
Not sure if you’re really engaging in negative self-talk? Or what your overall self-worth looks like? Hendrix suggests asking yourself questions such as, “Am I hard on myself?” “Can I have compassion for myself when going through a hard time?” or “Do I think I’m good enough?” You can try answering these for yourself or bring them to your next session, so your therapist can help you work through them.
Your Relationships
Here's the thing: Folks frequently bring "unhealed wounds from earlier times in their life" into their relationships as adults, thereby negatively impacting these bonds. But recognizing that this might be the reality is no easy task — and that's why it's a good idea to talk openly about your relationships in therapy. Not only is therapy "an excellent place to develop a secure bond with another person," but it's also a "safe space to unpack what happened to you and how it impacts how you view yourself and the world today," explains McKenna.
In other words, your practitioner can help you piece together any unhealthy patterns that might be at play, and then, together, you two can dig deeper into them to ultimately figure out how to best shift them. “Patterns can be things like getting too close too fast and not being able to notice red flags in others, shutting down and cutting people off because we don’t know how to talk about our feelings and handle conflict, giving too much, not being able to receive,” explains Hendrix.
Anything You'd Hesitate to Share with Others
Some topics that are central to the human experience (think: sex or money) also tend to be fraught with maladaptive beliefs and negative feelings, often making them taboo to discuss vulnerably with friends and family. But in therapy? Pretty much anything goes and you should feel safe and secure in opening up about topics that might otherwise make you feel, say, uncomfortable or embarrassed.
“Generally when something feels really hard to talk about, there’s an emotion that’s difficult to digest in the way of it,” says Jurist. Take, for example, your past experiences with sex: These might “evoke emotions like fear, shame, doubt, anxiety, and in some cases, depression,” thereby making your sexuality something to talk about in therapy, she notes. That’s because your practitioner can help you “learn to tolerate the emotional disruption that comes up when you think of it [and] when you say it out loud [as well as] to learn to be okay with giving it space, while also sorting through the basis of the thought [where it was originally formed],” explains Jurist.
In therapy, you will start to separate what thoughts and feelings are actually yours to keep from those that might've been imposed upon you by, say, society and thus don't serve you. "As we start to peel back these layers, we start to see, 'is this my actual feeling or is this a feeling I adopted based on other people's toxic views of themselves?'" says Jurist. Your therapist will encourage you to feel your feelings, get comfortable with them, understand where they're coming from, and eventually release them — although this process can take a long time.
Any Challenges as of Late
"Discussing recent events, interactions, and the feelings associated with them often leads to the discovery of patterns," says Hendrix. "Once these show up, you can work on these deeper patterns, beliefs, or hurts that are causing you to be upset."
If you draw a blank at the beginning of your sessions, consider this: "I suggest [clients] keep a note for therapy on their phone," says McKenna. "Write down [any] times you have uncomfortable feelings, like anger, jealousy, sadness, anxiety, low self-worth, etc. At the start of therapy, ask to go through the list. You and your therapist can work together to decide which topic to start on during that session."
As you build up a relationship, your therapist should be able to see how your current experiences fit into larger patterns and help you shift how you deal with certain emotions. For example, if receiving negative feedback from your boss sends you into a self-doubting spiral, your therapist can help you reframe your thoughts so that you can see the bigger picture — i.e. you don’t need to be perfect all the time — more clearly. (Up next: How to Know When It’s Okay to Stop Therapy)
