What to Talk About in Therapy: Helpful Conversation Topics

What to Talk About in Therapy: Making the Most of Your Sessions

Starting therapy can be intimidating. You may wonder what exactly you should discuss with your therapist or how much you should open up. While the possibilities may seem endless, having some guidance can help you get the most out of each session.

Current Issues and Recent Events

Therapy works best when focused on what's happening in your life right now. Come prepared to talk about any pressing issues, challenges you’re facing, or significant events from the past week. This provides your therapist recent examples to understand what you’re going through.

For instance, share about stressful interactions at work, a fight with your partner, trouble sleeping, or feeling lonely. Your therapist can then offer support, coping strategies, and insights tailored to your current situation.

Thoughts, Feelings, and Behaviors

Don’t just describe what happened - dig into how you reacted, what you thought and felt, and how you behaved. For example, if you felt overwhelmed at work, explain your thought process, emotions, and actions.

Were you unable to focus? Did you feel anxious or sad? Did you snap at co-workers or make errors? These details help your therapist pinpoint unhelpful patterns to shift.

Triggers and Stressors

Take note of what seems to trigger your symptoms or make you feel worse. For example, does checking your work email on weekends heighten your anxiety? Do you feel depressed after spending time with critical family members?

Discussing these stressors with your therapist allows them to help you establish healthy boundaries, manage exposure, and cope ahead of time.

Goals and Motivations

Talk about what you hope to accomplish in therapy and in life. Do you want to manage anxiety before a job interview? Improve your marriage? Be less judgmental toward others?

Setting goals gives your treatment direction. As you make progress, you can refine your goals. Always keep your deeper motivations in mind.

Past Experiences

While therapy focuses on the present, looking to the past can provide insight. Talk about impactful experiences, especially ones you’ve never addressed. These may include deaths, divorce, trauma, failure, rejection, or family dynamics.

Exploring formative events with your therapist’s guidance can help you resolve pain, gain perspective, and see yourself more clearly.

Mental and Physical Health History

Your therapist needs to understand your mental health background, including:

• Past diagnoses like anxiety, depression, OCD, PTSD
• Previous therapists or treatment approaches
• Medications and side effects
• Substance use
• Hospitalizations

Physical health issues like chronic pain, autoimmune disorders, headaches, and sleep difficulties can also interplay with mental health. Providing this background helps your therapist support you.

Family Background and Childhood

Family experiences often influence our emotional patterns, beliefs, and relationships. Opening up about your childhood allows your therapist insight into family dynamics that still affect you today.

You may discuss relationship patterns like conflict, distance, criticism, addictions, mental illness, or abuse. Even subtle dynamics like roles you played or emotional needs that went unmet can have lasting impacts.

Identity and Social Relationships

Our identity and relationships profoundly shape our wellbeing. Discuss who you are as a person - your values, interests, personality traits, worldview. Share about gender identity, sexual orientation, culture, and important communities or groups you belong to.

Likewise, talk about how you relate to others - your social style, communication patterns, and friendship or relationship dynamics. This provides insight into personal struggles.

Self-Reflections

Therapy is a chance to reflect deeply on yourself with guidance. Come ready to explore questions like:

• What are my core beliefs and assumptions?
• Do I accept myself or am I self-critical?
• How do I typically handle emotions?
• What roles do I play in relationships?
• How do I respond to adversity or conflict?

Examining your inner world often brings buried feelings and beliefs to light. Discuss these openings with your therapist to grow.

Daydreams and Thought Patterns

Notice when your mind wanders and share those thoughts with your therapist. Do you replay arguments? Daydream about success? Worry over the future? Obsess about your flaws?

These passing thoughts usually reveal deeper issues perfect for discussion. Talk through them instead of suppressing them.

Weaknesses and Pain Points

Everyone has areas for growth - tendencies we’re ashamed of or would rather ignore. But acknowledging weaknesses and pain points with your therapist creates opportunities for healing.

Are you quick to anger? Prone to jealousy? Passive aggressive? Avoidant? Self-centered? Perfectionistic? Feelings this vulnerable takes courage but lays the groundwork for lasting change.

What You Want to Change

Make sure to discuss:

• Attitudes you want to adjust
• Behaviors you want to stop or start
• Skills you want to build
• New ways you’d like to handle situations

You might want to communicate more calmly with your partner, stop procrastinating, better manage conflict, or establish healthier habits. Voicing your desired changes helps focus treatment.

Small Improvements and Victories

As therapy progresses, share any small wins and improvements you notice. Which new coping strategies or thought patterns feel helpful? What progress have you made toward goals?

Noticing growth motivates further positive steps. Even small victories validate that you’re on the right track.

Setbacks and Roadblocks

Change isn’t linear, so inevitably you’ll run into setbacks. When you slip into old habits or thinking, get stuck in a problem, or feel therapy isn’t working, bring it up.

Working through roadblocks with your therapist gets you back on track. Setbacks allow you both to adjust treatment approaches as needed.

What You Dislike or Want Changed

If some aspect of therapy feels off or unhelpful, immediately discuss it with your therapist. For instance, tell them if:

• You feel judged or misunderstood
• Exercises don't make sense or seem irrelevant
• Their style feels too cold, pushy, passive, or rigid
• Sessions drift off track too much

Giving candid feedback allows your therapist to adjust and improve. You deserve to feel safe and understood.

Overall Impressions

Periodically step back and summarize how you feel therapy is going overall. Do you feel understood, challenged, and supported? Has your thinking or behavior shifted at all? Are you addressing your goals?

Voicing what works well reassures you’re on the right path. Constructive criticism helps refine your therapist’s approach to maximize your growth.

Unsure Where to Start?

If you’re unsure what to talk about, ask your therapist to guide the discussion or use prompts like:

• What's been on your mind lately?
• What are your hopes for our session today?
• What would you like to get out of therapy?

Simply discussing how you feel about therapy itself can be a valuable start. The more you open up, the more natural it becomes.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.