What to Talk About in Therapy, According to a Therapist

Congratulations, you’ve decided to start going to therapy. It’s a big, often scary step and you should be proud of yourself for prioritizing your mental wellbeing. Now that you’ve found a provider and your appointment is scheduled, though, you’re wondering what to even talk about during a session. No worries, that’s totally normal. Luckily, many first therapy appointments follow a similar formula. “The therapist will typically guide the first session in order to conduct an intake evaluation,” says Michele Goldman, Psychologist and Hope for Depression Research Foundation media advisor. “This session might include information about your work, platonic and romantic relationships, medical history, family history and mental health history, etc.

As for what to talk about once the basics have been covered, Goldman tells us that there’s really no right or wrong thing to bring up. “The time is yours, so you choose how you use it. If you feel a desire to talk about something, then that is something you should talk about. There is no topic that is off limits.”

Still, because this is a brand-new experience and it can feel overwhelming to talk about yourself and your feelings to a complete stranger, we asked Goldman for a few jumping-off points. From the things that have stopped you from going to therapy in the past to your goals for your time in therapy, here are six things to talk about.

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1. What prompted you to make the appointment

You likely didn’t wake up one day, out of the blue, and think I’m going to make an appointment to see a therapist. “Something prompted you to reach out to a therapist at this point in time,” Goldman tells us. “Start there. Talk about the reason you are in therapy and perhaps what has kept you from therapy in the past. As much as you’re comfortable, go into the details of whatever is bringing you in.

2. What you want to see change during your time in therapy

Goldman tells us that this might be related to what brings you into therapy, but it also might not be. “If you think about therapy being really successful, in four to six months what do you envision would be different?” This might be a helpful thing to discuss, he tells us, because it helps to align the client with the provider. “Identifying objectives might allow for the therapist and client to be working in the same direction with a shared goal.” So whether you’re getting out of a long relationship and are looking for guidance on how to trust people moving forward or you feel stuck in your life and are hoping to find ways to propel yourself forward, let your provider know what you’re hoping to get out of your time together.

3. Points of stress in your life

“There are many things that we might need to talk through with a non-biased, third party,” Goldman reveals. “It can be useful to vent and get things off our chest, but also might be useful to problem solve around various stressors. It is possible that there are ways to approach certain stressors differently.” It’s way less daunting to open with an anecdote about how stressed your mom makes you that to launch directly into an analysis of all the ways your relationship has shaped who you are as a person.

4. Topics that you hesitate to share with others

You adore your partner and you lean on your friends like nobody’s business. Even so, there are certain things you’re wary to share even with the people closest to you. That’s where your therapist comes in. This can be questions you have about a topic that you’re embarrassed to ask, something you feel shame around or a painful topic from the past. “If we’re avoiding talking about it for some reason, that might be something we want to lean into in therapy,” Goldstein notes.

5. Events from the past that continue to impact you today

No matter who we are or what we’ve been through, we all have events from the past that shaped us or impacted us. Goldstein tells us that if you still find yourself thinking about these past events, it might be helpful to talk about further in therapy. “Talking about the past could help with unresolved feelings, but it might also help to shine light on issues you’re having in the present.”

6. Fears that are holding you back

It’s normal to occasionally have feelings of inadequacy or fears that we are not competent in some way (hello, imposter syndrome). “A lot of us have fears that hold us back from living the life we want to be living,” Goldstein reveals. “Perhaps it’s a fear of being vulnerable or a fear of tapping into emotions, fear of talking about the past and opening up old wounds, fear of being ‘seen’ by someone else or fear of being unhappy in the future because of decisions being made in the present.” There are all great topics to explore in therapy.

sarah stiefvater

Wellness Director

Sarah Stiefvater is PureWow's Wellness Director. She's been at PureWow for ten years, and in that time has written and edited stories across all categories, but currently focuses...