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Not sure what to talk about in therapy? A guide for 13 things to work in therapy

Not sure what to talk about in therapy? Here is a list of 13 things to talk about in therapy to help you dive deeper

therapy couch, therapist's office

You've been thinking about starting therapy but you're not sure what to talk about in therapy sessions or is therapy worth it. In this blog post we'll help you understand some common talking points that many clients start explore when they're starting therapy so you can decide if therapy might be a good fit for you.

Seeking therapy is a courageous step toward self-awareness, personal growth, and emotional well-being. Let's delve into the common emotional struggles that many of us face, and discuss a variety of topics that you might decide to explore with your therapist. Let's get started!

1. What to talk about in your first session

Therapy should be a warm and welcoming environment, where you can express your thoughts and emotions freely without feeling judged. Trust is the cornerstone of the therapeutic relationship. As a result when you start working with a new therapist you'll start to work on building rapport and a therapeutic alliance. During your first session, your therapist will probably begin with an initial assessment to better understand the work that you'll be doing together.

During the first session you'll mostly be discussing your mental health symptoms, medical history, past mental health treatment, family history, significant changes you've recently experienced, and start to develop a treatment plan. Together, with your therapist you'll start to explore your concerns and work collaboratively to develop coping skills to start to make positive changes. The therapeutic process is a journey of self-discovery, where you can gain insights into your inner world and develop coping strategies to face life's challenges.

therapist in San Jose, CA

2. Current Mental Health and Emotional Struggles

Many people start therapy sessions because they're struggling with their mental health. Many clients discuss their symptoms and negative behaviors related to their anxiety or depression.

Discussing depression or anxiety and anxious thoughts in therapy can be a transformative and healing experience. Therapy offers a safe and compassionate space to explore the underlying causes of anxiety or depression, identify triggers, and gain insights into how it affects various aspects of your life. Through open conversations, you can learn to recognize the patterns of anxious thoughts and their impact on your emotions and behaviors.

A therapist can help you develop coping mechanisms and skills, such as mindfulness techniques and cognitive restructuring, to challenge and manage anxious and depressive thoughts. In addition, you will work towards building resilience, understanding the root causes of your anxiety, and developing a greater sense of self-compassion. By talking about your mental health struggles in therapy, you can cultivate a deeper understanding of yourself and navigate the journey towards a calmer, more empowered, and emotionally balanced life.

3. Don't sweat the small stuff, but don't leave it out

Discussing the "small stuff" in therapy can be just as impactful as addressing major life challenges. Often, we may minimize or dismiss everyday concerns, believing they are insignificant or unworthy of attention. However, therapy provides a safe and supportive space to explore these seemingly trivial issues that may hold more significance than we realize.

These "small stuff" discussions can offer valuable insights into patterns of thinking and emotional responses that shape our daily lives. By examining these seemingly smaller concerns, we may be able to uncover deeper emotional layers and unresolved issues that contribute to our overall well-being.

Therapists can help us recognize how seemingly inconsequential events may be linked to larger themes and assist us in developing healthy coping skills for managing the subtler aspects of life. Embracing these discussions can lead to transformative self-awareness and personal growth, fostering a more profound understanding of ourselves and our emotions, ultimately paving the way for a more balanced and authentic life.

doom-and-gloom radio

4. Rumination - the doom-and-gloom radio

Another topic that is common to talk about in therapy is rumination so you can understand and address this common cognitive pattern. Rumination refers to the repetitive and intrusive thoughts that constantly replay in our minds, often centered around negative experiences, past decisions, worries, or regrets. The doom-and-gloom radio that plays on repeat in our minds often starts to impact our behaviors and feelings in our day to day life.

Constant rumination often makes people feel stuck and like they can't move forward. Through open conversations with your therapist you can gain insights into the origins of rumination and how it's impacting your emotional well-being. Your therapist can provide a supportive environment to explore the triggers and underlying emotions associated with rumination, to help you recognize your patterns to start to turn the volume down on the doom-and-gloom radio and your negative thoughts.

5. Current relationships and Relationship Patterns

Whether it's a romantic partner, family members, or friend, relationships can be a source of both comfort and conflict. Relationship issues are a common topic to talk about in therapy since we're social beings our relationships often impact our emotional health. Many people want to improve their relationship dynamics with their loved ones, but changing long-standing relationship patterns often is complex.

By working with a licensed therapist you can help you gain insight about possible patterns that are reoccurring in your relationships. You can also talk about in therapy communication barriers and work on building effective ways to express your needs, improve communication skills, and learn to actively listen with empathy. Trust and intimacy are essential for healthy relationships, and therapy can be a nurturing ground to cultivate these qualities.

couples counseling

6. Self-Identity and Self-Esteem

Embracing your true self and cultivating self-esteem is a beautiful journey. Many people reach out to a mental health professional due to self doubt and wanting to have a safe space to be completely honest about what they're struggling with.

Most of us (therapists included!) have an inner critic who makes us question if we're doing the right or wrong thing. As a result, talking about your self doubt in therapy can help you gain clarity about how you actually talk to your self and if it is causing a negative impact on you.

Often when you open up about your self doubt you can start to learn concrete tools to improve your self esteem and practice self acceptance. Together with your therapist you can explore the various facets of your identity and work on building self-confidence. Weekly sessions with the right therapist can empower you to challenge self-doubt and embrace your uniqueness, allowing you to shine like the beautiful soul you are.

7. Life Transition and Major Changes

Life is ever-changing, and sometimes the uncertainty that comes along with these transitions can be overwhelming. Whether it's a new job, a move to a different city, or a significant loss, therapy can be a comforting space to navigate through these shifts. It is perfectly normal to struggle when life throws you a curveball and you're not sure how to handle such life changes.

If you're not sure what to talk about in therapy, you can start to explore any life transitions that you've experienced and how you've dealt with them. With your therapist you can develop strategies to adapt and thrive in the face of life changes, empowering you to see transitions as opportunities for growth.

8. Traumatic Experiences and Healing

Unhealed trauma from childhood experiences or from your past can cast a long shadow on our lives. Past trauma is often one of the most difficult things to start talking about since it can bring up strong emotions and difficult memories. Working with a therapist who specializes in trauma can help you process your past so you can build resilience and coping mechanisms, fostering a path to healing and renewal.

9. Behavioral Patterns Related to Your Past and childhood experiences

Many of us have adopted behavioral or thought patterns from our families which we were much younger, we often assumed every other family acted and operated like ours. Talk therapy can help you dig a little deeper and understand how our past experiences can influence our present behaviors in profound ways .

By starting to talk about such generational patterns and deepening your self awareness you can gain clarity as to why you might has some of these behavioral patterns or core beliefs. With your therapist you can take a compassionate look at these patterns, identifying those that no longer serving you and work on building healthier coping strategies. Embracing these insights allows you to break free from old patterns and create a more fulfilling and empowered future. generational patterns

inner compass

10. Clarify your core values

Many people feel stuck and want to gain clarity about their purpose through practicing self reflection and starting therapy. If you're feeling lost about what to talk about in therapy, a good therapist can help you start to understand how you want to show up in the world and what's most important to you.

The therapy experience offers a transformative space where you can delve deep into your inner self, helping you clarify your core values so you can start to align your actions with those values. Core values can often serve as a map so we can better understand where we're going and what we want to stand for as a person. Through introspective exploration and open dialogue with a skilled therapist, you gain valuable information about your core values and insights into what truly matters to you and what you hold dear.

As you identify your core values, you begin to understand how they influence your thoughts, emotions, and behaviors. Leveraging this self-awareness, therapy guides you in making conscious choices that align with your values, fostering a sense of authenticity and purpose in your actions. With each session, you embark on a journey of personal growth, learning to live in harmony with your beliefs and paving the way for a more fulfilling and authentic life.

11. Your personal strengths to make positive changes

Many times what you may talk about in therapy might be related to your struggles and challenges, however it is also important to gain a deeper understanding of your unique strengths and capabilities. Therapy provides a nurturing space for you to explore your accomplishments and challenges, uncovering the inherent strengths that have helped you navigate through life's ups and downs (and everything in between!) Often, we tend to underestimate or minimize our own abilities and resilience, but through the therapeutic relationship, you'll learn to recognize and appreciate your innate strengths.

Therapy also involves highlighting your strengths in the context of your current challenges and goals. By examining how you have successfully coped with difficulties in the past, you can apply those strategies to your present circumstances, empowering you to overcome obstacles more effectively. This process allows you to build a personalized toolkit of coping skills, empowering you to face life's challenges with resilience and integrity.


12. Let's talk about treatment goals

Therapy can serve as a powerful catalyst for personal growth and transformation, aiding you in developing clear and meaningful goals that align with your core values. One of the most important things to talk about in therapy is what you want to get out therapy and how you hope to change your life. Therapy requires the client to do the work, possibly explore topics they've previously avoided, and sometimes feel uncomfortable. On the flip side before you run away from the discomfort, it's important to understand how therapy can serve you and and help you make progress on your struggles and new challenges.

Through open-hearted and honest discussions with your therapist, you gain insights into what truly matters to you. By clarifying your values and aspirations so you can develop a treatment plan that can positively impact your life. Therapy can empower you to set specific and achievable goals that reflect the life you envision, guiding you towards a path of fulfillment and authenticity. Your therapist will collaborate with you, offering support and guidance as you break down larger aspirations into actionable steps that previously may have seemed like they were off limits.

As you work towards these goals, therapy provides a safe and encouraging space to address challenges and celebrate victories, nurturing your self-trust and motivation. With each milestone achieved, you'll move closer to a life that resonates with your deepest values, fostering a sense of purpose, joy, and genuine contentment.

13. You've made progress and you're thinking about ending therapy

Deciding when to end therapy is a significant step in the therapeutic journey and should be carefully considered and talked about in your therapy sessions. Clients graduate from therapy for a variety of reasons. Firstly, when you have achieved your goals related to why you started therapy and feel that you have made significant progress in addressing the initial concerns that brought you to therapy, it may be a sign that you are ready to move forward independently. Secondly, if you and your therapist mutually agree that you have reached a point of stability and have developed effective coping strategies, this can be an indicator that therapy has served its purpose.

Additionally, some clients may choose to end therapy when they feel they have gained sufficient self-awareness and have the tools to continue their personal growth outside of therapy. Ultimately, the decision to end mental health treatment should be made collaboratively between you and your therapist, ensuring that it is the right time for your unique circumstances and that you leave therapy feeling empowered and equipped to navigate life's challenges with newfound strength and resilience.

pre-therapy notes

Get started with the things to work on in therapy

Therapy is a powerful tool that can empower you to navigate life's challenges with grace and embark on a path of personal growth and well-being. Embrace this opportunity to embark on a journey of self-discovery and healing, and remember, you are never alone on this path - a compassionate therapist is ready to walk beside you every step of the way.

Learning more about starting therapy, developing coping skills, and regaining balance in your life can lead to improved life satisfaction. Connecting with a therapist in San Jose, CA or San Juan, PR who can support you often benefits your own mental health as well as your help you navigate life's challenges. Reach out to Living Openhearted Therapy and Wellness to book a free consultation and learn more about online therapy to get the support you need.

***The ideas, concepts, and opinions expressed in all Living Openhearted posts are intended to be used for educational purposes only. The author and publisher are not rendering medical or mental health advice of any kind, nor are intended to replace medical advice, nor to diagnose, prescribe, or treat any disease, condition, illness, or injury. Authors and publisher claim no responsibility to any person or entity for any liability, loss, or damage as a result of the use, application, or interpretation of the material.



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