What should I talk about in therapy?

You don’t feel right, something’s amiss. You may or may not know the cause, but you do know that you need to talk to someone. It’s good to talk, they say! But you arrive at your session, and you don’t know what to say.

You may be relieved to know that the feeling of not knowing what to talk about in therapy is a very common concern.

Maybe a part of you is wondering whether you should even be there because you don’t have a good enough reason; you believe that because you haven’t been through a really challenging life experience, then you shouldn’t be in therapy.

Meanwhile, deep down, the other part knows what you want to say but it just seems way too difficult, so you desperately search for something that’s easier to talk about, less vulnerable and exposing, in the hope that the therapy will happen anyway.

Your experience will probably be entirely different because you are you, and you are unique. And it is your uniqueness that needs to be seen, heard, honoured and treasured. This is how we grow and heal.

The good news is that you don’t have to know what to say. You don’t have to have your thoughts, ideas and concerns ready to articulate, and you don’t have to worry about whether what you say is relevant, interesting, good (or bad) enough. I appreciate that this is easier said than done. Often, the belief that we need to be a certain way is difficult to shed; such beliefs feel deeply ingrained. They might even be symptomatic of the reason you sought therapy in the first place.

What will be helpful, however, is to approach your therapy with openness, willingness, curiosity and honesty. What does this look like in the counselling session? It’s a commitment to being upfront about what’s happening in the here and now. Ask yourself, what is it like to arrive at your session feeling that you don’t know what to talk about? Is it that I don’t know what to say, or is that my feelings feel too difficult to articulate? Such questions are ripe for exploration alongside your therapist and may prove to be an insightful part of your work together.

Not only will sharing this struggle give you something to talk about, but opening up a conversation about the here-and-now therapeutic relationship between the two of you generally leads to a deepening of the trust you’re trying to build. This might involve saying something like, “I find it really hard to know what to say when I’m sat here with you.”

Exploring this difficulty is the work of therapy. Making a commitment to yourself that you will approach your sessions with openness, willingness, curiosity, and honesty could just crank the effectiveness of your therapy up a gear. And, just to clarify, making this commitment does not mean forcing yourself to disclose something that feels too difficult for you. It simply means being honest about how difficult it is to talk and allowing yourself to be curious about your struggle with your therapist by your side.

Perhaps this sounds rather scary. If so, then maybe think about what it was that made you choose your therapist. Whilst scrolling through the directory pages, did you view their profile picture and think, ‘Oh she looks like a kindly mother figure who will metaphorically wrap me up and make everything OK?’ Or did you go for someone you thought looked like a learned, scholarly type who would be able to provide you with answers? Perhaps you just thought, ‘They look nice!’ or something else entirely.

Either way, you’re likely to have some preconceived ideas about this person and how you should relate and connect with them. Usually, these ideas are not in our conscious awareness because they are rooted in our childhood and modelled on our earliest experience of relationships.

Sometimes this is useful — for example, if you had a close, supportive relationship with your mother, then seeking counselling from someone who closely aligns with this role is likely to make the formation of a trusting relationship easier for you. However, maybe you want to talk about your sex life and now you feel that this could be difficult. If you opted for the academic, maybe you’re comforted and reassured that they know what they’re doing, but alongside this is a, perhaps subconscious, concern that you’re being judged, marked, or ranked, as though you were back at school.

These are just some examples of the roles and presumptions that we attach to every relationship, including our therapists, that can make communication challenging – sometimes more so than it needs to be.

How do you view your therapist? It may be helpful to remind yourself that regardless of what they look like, or any other aspects of their identity, they are a fallible human, just like you. They will have had counselling themselves as part of their training, so they will know what it is like to be on the receiving end of therapy. They are trained and prepared to meet your struggle in a way that is supportive.

Having said this, it can be really hard to accept empathy, genuine caring and acceptance from another person if we’re not used to being on the receiving end of it. If we’ve missed out, our experience of being in the world makes it difficult to trust others and feel close enough to share our most vulnerable parts.

Part of my motivation for doing the job that I do is because I am so cross with the unfairness of this paradox: that the very reason most of my clients seek therapy, is the same one that prohibits them from accessing it with freedom and ease. Therapy is hard, so be kind to yourself.