Lost for words in therapy? Some useful tips

So, you've finally plucked up the courage to begin therapy, but you don’t have a clue where to start. It may be that you’ve taken the next step and you're sitting opposite your counsellor, who is ready to listen, but your mind draws a blank.


This can be frustrating, and nerve-wracking, and can make you wonder if counselling is right for you. You're not alone in feeling this way; many people struggle with knowing what to say in therapy. The pressure to open up and discuss your deepest thoughts can be daunting, but rest assured, it's a common experience. In this article, we'll explore ways to help you find your voice when you're unsure of what to talk about in therapy.

Acknowledge the feelings of uncertainty

It can be reassuring to recognise that the initial step into therapy doesn't always come with a clear understanding of the issues at hand. Sometimes, it's a vague sense that something isn't quite right, that you can’t quite put your finger on. This uncertainty is often a natural part of the therapeutic process. As you embark on this journey, it can help to embrace the unknown. Acknowledge the feelings of uncertainty and understand that it's okay not to have all the answers right from the start.

Therapy offers a unique space for exploration. Your counsellor is not there to pressure you into immediate revelations but to assist you in navigating through these initial unknowns. Take your time and be patient with yourself. The fact that you have decided to start therapy is a huge positive step, so give yourself a pat on the back for taking those first steps to seek help.

Start small

If you're unsure where to begin, it can help to start small. Consider sharing what happened during your week, your recent thoughts, or anything that comes to mind. This can help you to feel more comfortable opening up to your counsellor and help to build up a therapeutic relationship.

Your therapist is experienced in creating a supportive environment that encourages open exploration, offering a space where you can delve deeper into your experiences. This aligns well with person-centred therapy, which emphasises self-exploration without the immediate need for specific goals. You're not required to have a roadmap; the journey unfolds organically.

Focus on what you want to change

If identifying a specific issue seems challenging, consider focusing on what led you to therapy in the first place. What aspects of your life cause distress or dissatisfaction? What thoughts stay with you when you’re trying to sleep? What is it that you wish you didn’t have to deal with in day-to-day life? Again, you don’t need to have all of the answers to these questions; instead, it's an invitation to begin to explore your feelings and desires.

Therapy is a space to uncover and understand, allowing for a gradual revelation of the issues that may be impacting your well-being. A therapist with a solution-focused approach can be helpful in this instance when you want to make changes without delving too deep into past events.

Consider recent changes

Consider any recent changes in your daily routine. Our brains, wired for predictability and consistency, often resist change. So, when there are changes, big or small, it can impact our emotions and well-being. Have you altered your sleep patterns, switched up your daily activities, or done something different in your usual routine? These can all be helpful conversation starters when you are struggling with what to say.

Exploring changes in routine can help you understand your feelings better. Our brains are creatures of habit, and when those habits change, it can shake things up emotionally.

Embrace the uncomfortable

Feel free to discuss the discomfort you may be experiencing within the therapy itself. If you're feeling stuck or uneasy, share these concerns with your counsellor. They are trained to adjust their approach to suit your needs.

This openness can create a collaborative and trusting therapeutic relationship, which is a cornerstone for effective therapy. For instance, you might say, "I find it challenging to open up about personal matters. Can we explore strategies to help me become more comfortable sharing my thoughts and feelings?" This type of conversation not only addresses the immediate discomfort but also contributes to the overall progress of your therapy.

Put pen to paper

Between therapy sessions, keeping a journal can be a powerful tool. Write down your thoughts and feelings, even if they seem disconnected or unclear. Over time, patterns may emerge, providing valuable insights for your therapy discussions.

If articulating emotions verbally proves challenging during sessions, your therapist can help interpret the patterns in your journal, encouraging you to explore these feelings further. Journaling also promotes self-reflection, enhancing your ability to communicate effectively in therapy. Some journaling prompts to get started with could be: “How do I feel today?” “What do I wish I could change?” “Did anything happen today that could be contributing to how I feel right now?”

Reflect on the past

Consider if you've experienced similar feelings in the past. Have there been instances in your life where you felt uncertain, anxious, or overwhelmed? What was happening in your life at that time? How did you get past this? Reflecting on past experiences can provide context and insights into recurring patterns or triggers. Again, journalling can be very effective in working out any long-standing issues that you may want to work on.

Assess your general well-being

Evaluate your general well-being, including sleep patterns, relaxation time, and physical health. Changes in these areas can significantly impact your emotional state.

Are you getting enough rest? Do you allow yourself time to relax and unwind? How is your physical health? Discussing these aspects can offer a holistic view of your well-being and contribute to understanding your current emotional state.

Understand physical sensations

Sometimes, your body may be expressing what your words cannot. Physical symptoms such as a tight jaw, shoulder tension, headaches, or digestive issues can be indicative of underlying stress, anxiety, or emotional distress. Listen to your body and consider discussing these physical manifestations with your therapist. They can provide valuable clues to the emotions you may be struggling to put into words.

Consider alternative approaches

If traditional talking therapy doesn't resonate with you, consider alternative therapeutic approaches. Art therapy, for instance, allows you to express yourself through various art forms, providing a non-verbal outlet for emotions. Somatic therapy, focusing on the mind-body connection, addresses physical manifestations of stress and trauma. Walk-and-talk therapy can offer a sense of freedom that comes with being outdoors, which can help the conversation flow more naturally than in a therapy room for some people.

There are many other approaches, such as animal-assisted or mindfulness-based therapy, and further creative modalities, working with drama, music or writing.

Remember, finding your voice in therapy is a process, a journey that requires patience, self-compassion, and a willingness to explore the unknown. Your therapist is there to support you every step of the way. Whether you're uncertain about a specific issue or find it challenging to express yourself verbally, therapy is a space where you can navigate these uncertainties and foster personal growth.

By acknowledging your feelings, exploring your current situation, and considering alternative approaches, you can empower yourself to find your voice and make the most of your therapeutic journey. The path to self-discovery and personal growth is unique to each individual. Embrace this opportunity, and you'll find that therapy can be a powerful tool for healing, growth, and self-discovery.

If you resonate with the insights shared here and would like further support, I'm here to help you. Feel free to get in touch by clicking the ‘email me’ button below. Together, we can work at your own pace to find how therapy can be a transformative experience for you.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Widnes, Cheshire, WA8
Written by Abigail Holman, MBACP
Widnes, Cheshire, WA8

Hey there, I get it – sifting through therapist profiles can be a bit of a maze, so I’ll try my best to keep this simple. I'm a qualified counsellor who's worn a few different hats in the field of well-being. I worked in the corporate world of occupational health for over 5 years, I̵...

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