What do I talk about in therapy?
This is a short entry.
What you talk about in your session, no matter what it is, has inherent importance. What you don’t talk about in your session has inherent importance. Doesn’t really narrow it down for you, does it?
Talk about your life-- past, present, and future. Often, clients enter therapy due to individual symptoms (like low mood or difficulty concentrating), however symptoms rarely exist in a vacuum. Therapy is your time to explore your current situation, hopes and fears for the future, and importantly, your past.
The classical picture of psychotherapy is someone on the couch, free associating about their childhood. It’s not necessarily what therapy has to be, but turning over these stones is what leads to fuller insight development, and eventually symptom reduction/management.
There’s a chance your therapist does not share your beliefs about politics, spirituality or your general worldview. You can decide whether it’s important to you that they vocalize and share their own beliefs. Most therapists minimize self-disclosure around these ideas; however, your therapy session is your space. The therapist is trained to work within your own framework around these things in order to help you move toward your values.
Exploring your feelings in therapy is probably a given. BUT, it’s harder than you think. Emotions can trickle or explode out of you physically with laughter or tears or wild gesticulation. Your therapist can help you both identify feelings (which can be a struggle for many), sit with difficult feelings, and come up with strategies to manage emotionality that may lead to dysfunction.
Things you never say out loud
There are a lot of things that you walk around thinking that never come out of your mouth. Maybe it’s because you don’t have anyone with whom you feel you can talk. Usually, it’s because once something leaves your head and goes out into the world, you have to face it.
A note on honesty: Therapy works well when you’re open and honest because the therapist can attempt to make more accurate interpretations and you’re hearing your own truths. When you’re not so open and honest, your therapist may trip over their analyses, the content of the session may not resonate, and you walk away dissatisfied. However, if you’re in a place where you need to remain closed, this is also good information. When are other times in your life that you may have sabotaged yourself like this? Development of vulnerability inside of a session will track growth.
Things you wrote down during the week to talk about in therapy
There are many times that you may sit down for your session and have nothing to talk about. Things happened during the week. And the things that happen during the week connect to your core self, your life history, etc… It’s all fodder for exploration. It could help to write it down! And then you’ll know what you want to talk about! Why not. Hey, it’s a form of journaling, which we’ve explored previously here.
In therapy, you can play out potential issues in your life. You can weigh pros and cons and engage in decision making with someone who is working to move you toward making values-based decisions (your values). There’s a chance that you’ll be able to live with the outcome of your life’s difficulties if the decisions you make when you’re at a crossroads lies within the context of your own values.
Therapy is a place where you can go ahead and spin out about anxiety provoking situations. You can talk about all the terrible things that could happen! And then you and your therapist can reel you back in to the here-and-now.
Some therapists are specifically trained to work with dreams, dream symbols and free association. Even if your therapist does not have that specific training, dreams are still a pretty interesting landscape to explore. Even if we take the perspective that dreams are just random firings of neurons, they can often be incredibly emotionally affective upon waking (though emotionality often dissipates throughout the day which is how emotions work!). You and your therapist can talk about feelings or memories evoked from dreams. Therapists can also aid in nightmare reduction/management through various interventions.
What is your point of view? Are you flirting with conspiracy theories? So what? Bring it up. Want to talk about the way you perceive your neighbors? Do it. You can also explore the way you think others are perceiving you or situations. This is especially helpful as your perceptions of other perceptions take your own temperature around thoughts and feelings in different situations. If the way you perceive any given circumstance is causing you significant distress, your therapist can help you look at all sides in order to determine your best course of action.
Therapy itself can aid in stress management. Simply having a scheduled time and place to vent can decrease that stress-induced discomfort. Moreover, working with a therapist with whom you have a good working relationship can be even more beneficial. Often, we don’t share our stress with friends and loved ones in an attempt to keep them from feeling stressed themselves. Guess what-- it’s your therapist’s job to take in that information.
Often, talking about your interests is a way to build rapport with your therapist. Especially if there’s an interest that the two of you share. Did you binge a show this week? Talk about it. There’s a good chance that if it resonates with you, there may be connections to your life or in the least, you may have gained insight from it.
Your relationship with the therapist
Depending on your therapist’s theoretical orientation, your thoughts and feelings about your therapist could potentially be the most important thing to talk about. If your therapist is oriented in such a way, if you say something like, “I thought you would be offended if I… so I did…” you and the therapist can dissect your automatic thoughts, defenses used, etc… in the context of treatment’s safe space. It’s like a relationship lab. The relationship between you and the therapist can be used to represent all of your relationships and the way you move about the world.
Additionally, if you are uncomfortable with something that happened in therapy, or if you have a question about your therapist or therapy, you should talk to your therapist! It’s difficult to be vulnerable in a space when you have questions or concerns around the person who is providing the space.
I always ask about previous therapy with potential clients. I want to know what worked and what didn’t work with a client’s previous therapist. It’s a quick way to both identify interpersonal patterns and note a client’s satisfaction with the process. It’s also beneficial to bring to the session what you have learned about yourself in former treatment so that growth can continue.
I told you, you can talk about anything. The little things that happen during your day aren’t necessarily of some grand importance, but maybe they are. Even if they’re not, building a relationship with your therapist is important and sharing the way you brush your teeth strengthens the relationship, believe it or not.
What is the therapist’s role?
As briefly explored above, the therapist can have many roles both depending on their theoretical orientation, but also your level of need. The therapist may prompt you with questions and statements. The therapist can validate your emotions. The therapist may analyze and interpret a situation that you bring forth or attempt to make connections with you. The therapist may troubleshoot with you when working out a challenge.
When you’re really struggling to talk or draw or dance (whatever your sessions look like), sitting in silence is an important part of therapy, and it’s your therapist’s job to sit there with you. This is an incredibly powerful, vulnerable, and potentially healing way of holding space that can be just as important as any of the ideas listed above.
Now that you’ve read some ideas, go ahead and reach out.