What to Talk About in Therapy

It can be difficult to think of what topics to discuss in therapy; especially for those who have never been to counseling before. Therefore, it is important to familiarize yourself with different types of topics that may come up during a session. The following article will discuss various topics that can be explored in therapy, as well as provide helpful tips on how to best approach the conversation.

The Importance of Open Communication

Trust and rapport between the therapist and client are built through dialogue. When you feel comfortable to open up and talk honestly about your experiences, it will help the therapist understand what is going on in your life. This allows them to provide more meaningful insights and advice that are tailored to your specific needs.

The benefits of expressing thoughts and emotions freely in a safe, non-judgmental environment include the following:

• Reduced anxiety and stress
• Improved ability to cope with difficult emotions
• Increased self-awareness and understanding of your behavior patterns
• Better communication skills in all relationships
• Increased feelings of self-acceptance and resilience
  

Licensed psychologist Jonathan Green, PhD notes "Talk about the thing or things you don’t want to talk about. Many times we walk into therapy with something on our mind or that happened during the week that we’d rather not discuss. Maybe it’s embarrassing or something we’re shy about. That’s often the best place to start and the thing that will help us to bring about the greatest amount of change that session."

Identifying Your Goals

It is important to reflect on your personal goals and desired outcomes from therapy. Identify what changes you would like to make and how you can achieve them. Knowing your goals makes it easier for the therapist to design a treatment plan that works for you.

Setting realistic and achievable goals with the help of a therapist involves the following steps:

• Recognize any unhealthy patterns or behaviors that you would like to change.
• Identify actionable steps that will help you move towards your desired outcome.
• Implement an appropriate plan of action.
• Track progress over time and adjust your approach as needed.

Examples of common therapeutic goals include managing anxiety, improving self-esteem, or resolving relationship conflicts. Below are some other areas that could be discussed in therapy:

• Trauma and difficult life experiences
• Grief and loss
• Stress management techniques
• Problem-solving skills
• Coping strategies for challenging emotions
• Dealing with depression or emotional pain

Dr. Green's advice: "At the start of therapy, help your therapist to understand what you’d like to be different in your life. What would you like to be able to do, think, and feel once you’re 'done' with therapy? A classic question therapists will ask here is, 'How will we know when we’re done?'"

Exploring Past Experiences

Past experiences shape your thoughts, behaviors, and emotional well-being through memories, beliefs, expectations, attachments, and values. Exploring these experiences in therapy can be helpful in understanding how they are impacting your current life and behavior. For example, talking about an experience from childhood might help you to identify why certain relationship patterns or thought processes have been difficult to change throughout your adult years.

It's also important to understand the connections between past experiences and present challenges to facilitate healing and personal growth. Therapy should focus on the present as much as the past, and help you develop skills and strategies for managing difficult emotions in your current life. These strategies may include mindfulness, journaling, or positive self-talk.

Emily Maynard, MA, LMFT notes "I encourage people to talk about things that still feel 'sticky' in their mind or disturbing in their body. Often people minimize their hardship or trauma because they feel like it 'wasn't that bad' or they compare their experience to someone who 'had it worse.' But trauma doesn't just go away because you ignore it or can keep it compartmentalized most of the time. Trauma is more about how your body interpreted the experience at the time rather than what happened. Trauma is unique to the person."

Emotions and Emotional Regulation

Exploring and understanding your emotions during therapy is significant because it can help you to better understand how they affect your daily life. To identify and regulate your emotions, you must become aware of what triggers them and how they manifest in your body. It is important to develop a greater understanding of how your thoughts, environment, and relationships contribute to your emotional state.

Common emotions that can be challenging to navigate include anger, sadness, anxiety, or guilt. Below are some tips for managing difficult emotions in a healthy and constructive way:

• Express your feelings in a safe environment.
• Acknowledge the emotion without judgment and let it pass.
• Learn relaxation techniques such as deep breathing or progressive muscle relaxation.
• Exercise or do something creative to help process the emotion.
• Identify ways to respond to the emotion in a productive and healthy way.
• Identify any underlying issues or triggers that may be causing the emotion.
• Develop an action plan for challenging times or situations.
• Use mindfulness exercises or guided imagery to help you stay in the present moment.
• Use journaling to help you process your emotions.
  

Therapy can help you become aware of your emotions, develop healthier coping strategies, and build resilience to manage them more effectively in the future.

Relationships and Interpersonal Dynamics

Relationships have an impact on mental health and overall well-being through communication patterns, dynamics, and interactions. Exploring these factors in therapy can help you to develop healthier relationships and identify patterns of behavior that may be holding you back.

It is important to discuss interpersonal challenges, including family dynamics, romantic relationships, friendships, and workplace interactions during therapy. Doing so can help you to identify potential sources of stress, develop communication and listening skills, and learn to practice empathy in your relationships.

This goes for your relationship with the therapist as well. Dr. Green says, "If you’ve had an odd interaction with your therapist, are feeling uncomfortable, or don’t understand something, talk about it! Talking specifically about the relationship you and your therapist have, especially when things feel off, can be incredibly helpful and can bring about an incredible amount of understanding and change."

As we don't do this in our everyday relationships, it may seem odd to say everything that comes to mind, including thoughts about the person right in front of us, but therapy offers a unique opportunity to explore these important thoughts and feelings we tend to avoid facing more directly.

Self-Reflection and Self-Discovery

Self-reflection can be used as a tool for personal growth and increased self-awareness. It involves reflecting on your thoughts, feelings, behavioral patterns, and reactions to situations.

Therapy can help you to become more aware of your inner dialogue and identify how it is influencing your life. By becoming aware of unhelpful thought patterns or behaviors, you can develop healthier coping strategies for facing challenges in the future.

In addition, exploring your values, beliefs, strengths, and areas for improvement can help you gain a better understanding of yourself and your unique qualities. Therapy can be a safe place to process these experiences without fear of judgment or criticism.

Activities such as journaling, meditation, or engaging in creative outlets can facilitate self-discovery. Below are some other tips for self-reflection and personal growth:

• Set aside time each day to reflect on your thoughts and feelings.
• Reflect on the choices you make in different situations and consider alternative ways of approaching them.
• Notice any patterns in your behavior or emotions that might be holding you back from achieving goals.
• Acknowledge areas for growth and identify steps to make positive changes.
• Listen to your intuition and trust yourself to make decisions that are best for you.
• Challenge yourself with new activities or experiences that can help you learn more about yourself.
• Celebrate your successes and recognize the progress you have made in self-discovery.

Dr. Green identifies one caveat: "If you can, see if you can avoid the 'doorknob comment.' Often times folks will think of something particularly significant just as they’re leaving session. Often times this is something that is particularly uncomfortable that our subconscious mind is trying to avoid discussing, so it gets saved to the end of session so there’s very little time to discuss it."

In summary, therapy is a place to explore and gain an understanding of your thoughts, emotions, and relationships. Through self-reflection, communication skills development, emotional regulation, and more, you can work towards personal growth and improved mental health. By embracing difficult conversations and becoming more aware of yourself in the process, you can create lasting positive changes in your life.