 Many people consider starting therapy but feel unsure about what to say once they’re in the room. It’s a common concern: “What if I don’t know what to talk about?” or “What if I just sit in silence?” Therapy doesn’t come with a script, and there are countless meaningful paths of conversation. The most important part is showing up with openness and honesty. This article will guide you through topics that are helpful to bring up in therapy, why they matter, and how they can help you move toward your goals. Whether you’re starting therapy for the first time or returning after a break, understanding what you can talk about may ease the anxiety of beginning the process. Why It’s Normal to Feel Unsure About What to Say When meeting a therapist, you might worry about being judged, saying the “wrong” thing, or not having anything “serious enough” to discuss. These thoughts are normal. Therapy is different from most conversations. It is private, non-judgmental, and focused entirely on you. Your therapist isn’t expecting perfection. They do expect honesty, curiosity, and sometimes even confusion. Not knowing where to start is part of the process, and talking about not knowing what to talk about can actually be a powerful entry point. Topics That Often Come Up in Therapy 1. Your Current Symptoms or Stressors Many people begin therapy because of symptoms like anxiety, sadness, irritability, or sleep difficulties. Bringing these up directly helps your therapist understand your situation.
Even if you feel vague discomfort like being “stuck” or “not yourself, that’s worth mentioning. 2. Life Events and Transitions Major changes often lead people to therapy. Examples include:
Transitions can stir up emotions, even when they are positive. Therapy offers a space to reflect, adapt, and grow through change. 3. Past Experiences Sometimes our past shapes the way we think and act today. If certain memories, family dynamics, or earlier experiences come to mind, bringing them up can be important.
Your therapist won’t push you to share more than you’re ready for, but when you choose to explore the past, it often sheds light on current patterns. 4. Relationships Romantic, family, friendships, or work-related relationships are central to emotional health. In therapy, you can discuss:
Talking about how you relate to others can help you better understand yourself and improve those connections. 5. Thoughts and Beliefs Therapy is a place to explore how your thoughts influence your emotions and actions. You might notice:
Your therapist can help you reframe unhelpful thinking patterns and build a healthier mindset. 6. Coping Skills Some patients come to therapy because their current coping strategies aren’t working, or they feel unhealthy (such as overeating, drinking, or avoiding responsibilities). Therapy helps you explore new strategies to manage stress more effectively. 7. Goals and Aspirations Therapy isn’t only about problems. It’s also about growth. You might want to discuss:
Setting and tracking goals in therapy can provide structure and a sense of progress. 8. Self-Understanding Many people use therapy as a tool for self-discovery. Questions like “Who am I?” or “What do I really want?” are valuable to explore. Your therapist can guide you in understanding your identity, values, and priorities. 9. Emotions You Don’t Understand Sometimes feelings surface without clear reasons. You may notice sudden sadness, anger, or anxiety. Bringing these to therapy, even if they seem “irrational,” can uncover deeper insights about yourself. 10. Patterns of Behavior Do you notice yourself repeating certain cycles? Maybe you push people away when they get close, procrastinate until the last minute, or sabotage your own success. Therapy can help identify patterns and change them. How to Decide What to Bring Up Here are some strategies to prepare for sessions:
What If You Don’t Know What to Say? This is a common situation, especially at the beginning. Some options include:
Remember: you don’t need to prepare a script. Therapy is about showing up as you are. Sensitive Topics You Can Bring Up You may hesitate to discuss certain issues, but therapy is designed for openness. Topics often include:
Your therapist’s role is to support, not judge. The Role of Trust in Choosing What to Talk About At first, you might not feel comfortable sharing everything. That’s normal. As trust builds, you’ll likely find it easier to bring up sensitive or vulnerable topics. Therapy is a journey, and what you share may evolve over time. Examples of First-Session Topics If you’re starting therapy and wondering what to say in the very first session, here are useful entry points:
The first session is about laying the groundwork. You don’t need to tell your entire life story right away. Why Talking Matters Therapy works because it provides a structured, safe space to explore thoughts and emotions. Research consistently shows that talking about difficulties like naming them out loud reduces distress and improves clarity. By verbalizing your experience, you can:
When Therapy Feels Stuck Sometimes you may feel therapy isn’t moving forward. If that happens:
Open communication keeps therapy effective. Therapy as a Collaborative Process What you talk about is your choice, but therapy is most powerful when it’s collaborative. Your therapist will listen, ask questions, and sometimes challenge you. The combination of your openness and your therapist’s guidance creates change. The question “What should I talk about in therapy?” doesn’t have one single answer. You can talk about your feelings, relationships, past experiences, future goals, or even your uncertainty about what to say. The important part is showing up honestly and being willing to explore. Therapy is not about being “interesting” or “perfect”. It’s about being real. Over time, you’ll find that the process naturally guides you toward the conversations you need most. 
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