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Therapy is a space for healing, growth and self-discovery. But sometimes, knowing what to talk about can feel overwhelming. Whether you’re new to therapy or have been attending sessions for a while, this guide offers 15 meaningful topics to explore. Each one is designed to help you open up, gain insight and make the most of your time with your therapist. If you’re looking for professional support, explore the range of services offered by Citizen Advocates.

1. Your present feelings and emotions

Your present emotions are a window into your mental health. Discussing how you feel right now helps your therapist understand your internal world and identify patterns. Whether you’re experiencing anxiety, joy or frustration, naming these emotions is the first step toward healing.

• Name specific emotions you’ve felt this week (e.g., anxiety, joy, anger, frustration)
• Explore the physical sensations that accompany these emotions in your body.
• Discuss the situations or triggers that brought up these strong feelings.
• Identify any emotions you find difficult to express or understand.

2. Your relationships and interpersonal issues

Relationships shape our emotional well-being. Therapy is a safe place to explore how you connect with others, resolve conflicts and set boundaries. Whether you’re navigating family dynamics or feeling isolated, these conversations can lead to healthier connections.

• Describe communication patterns with your partner, family or friends.
• Talk about a specific recent conflict or misunderstanding.
• Explore feelings of loneliness, connection or social anxiety.
• Discuss your expectations and boundaries in your most important relationships.

3. Recurring patterns and behaviors

We all have patterns—ways we react to stress, conflict or uncertainty. Therapy helps you recognize these behaviors and understand their roots. By identifying what no longer serves you, you can begin to make intentional changes.

• Identify recurring reactions you have to stress or conflict.
• Discuss habits you want to change (e.g., procrastination, people-pleasing, avoidance).
• Explore any self-sabotaging behaviors you’ve noticed in your career or personal life.
• Note any repeated themes in your thoughts, worries or dreams.

4. Your self-esteem and self-image

Self-esteem influences how you show up in the world. Therapy is a space to challenge your inner critic, explore your strengths and reshape your self-image. This work can lead to greater confidence and self-compassion.

• Talk about your “inner critic” and the content of your negative self-talk.
• Explore how you perceive your body and overall appearance.
• Discuss your perceived strengths, weaknesses and sense of self-worth.
• Identify past experiences that may have shaped your self-image.

5. Past experiences and traumas

Trauma and past experiences often linger in the background of our lives. Therapy allows you to process these memories at your own pace. You are always in control, and a skilled therapist will guide you with care and sensitivity. EMDR (Eye Movement Desensitization Reprocessing) therapy for trauma is one approach that can help you safely reprocess traumatic memories.

• Share memories or experiences that still impact you today, at your own pace.
• Discuss how past events might affect your current fears, triggers and behaviors.
• Explore feelings of guilt, shame or anger related to past events.
• Remember that you are in control; a good therapist will not force you to discuss anything you’re not ready for.

6. Life challenges and transitions

Life transitions—like starting a new job, moving or entering a new relationship—can bring both excitement and stress. Therapy helps you navigate these changes, process your emotions, and build resilience for the future.

• Talk about the stress of a new job, a recent move or a change in relationship status.
• Explore feelings of uncertainty, excitement or grief about the future.
• Discuss the challenges of major life events like marriage, parenting, illness or loss.
• Identify what kind of support you need to navigate this new phase of life.

7. Your coping mechanisms

Coping mechanisms are the tools we use to manage stress. Some are helpful, others less so. Therapy helps you evaluate your current strategies and develop healthier ways to cope with life’s challenges.

• Identify your go-to strategies for dealing with stress, both healthy and unhealthy.
• Discuss unhealthy coping mechanisms you’d like to change (e.g., substance use, overeating, social withdrawal).
• Explore where and when you learned these coping skills.
• Brainstorm new, healthier strategies with your therapist.

8. Thoughts and conflicts you tend to avoid

Avoidance is often a sign of deeper emotional conflict. Therapy is a judgment-free space where you can explore difficult thoughts, fears and decisions. Naming what feels scary is a powerful step toward healing.

• Mention a topic that feels “off-limits” or scary to bring up.
• Talk about your fears of judgment from others or even yourself.
• Explore internal conflicts or difficult decisions you’re struggling to make.
• Acknowledge things you feel guilty or ashamed about in a non-judgmental space.

9. The ‘small’ issues that bother you

Even small irritations can reveal important emotional patterns. Therapy helps you unpack why a minor event triggered a strong reaction, offering insight into your deeper beliefs and needs.

• Describe a minor annoyance from your week that has stuck with you.
• Understand that “small” issues often point to larger underlying patterns or beliefs.
• Explore why a seemingly insignificant event caused a strong emotional reaction.
• Use minor issues as a low-stakes starting point when you don’t know what else to say.

3 Things to Talk About in Your First Therapy Sessi

1. Your personal history and background

Your personal history provides context for your current challenges. Sharing your background, family dynamics and past experiences helps your therapist understand your story and tailor support to your needs. Mental health assessments and evaluations can help you begin this process.

• Give a brief overview of your family dynamics and upbringing.
• Mention any significant life events, milestones or previous experiences with therapy.
• Share your educational or career path if it feels relevant.
• You don’t need to tell your whole life story; just provide the context for what brought you here.

2. Your goals for therapy

Setting goals gives therapy direction. Whether you want to reduce anxiety, improve relationships or gain clarity, sharing your intentions helps your therapist support your progress.

• Answer the core question: “What brought you to therapy at this specific time?”
• Describe what you hope to achieve, change or understand through the process.
• Mention specific outcomes you’d like to see in your life (e.g., “I want to feel less anxious in social situations”).
• Discuss your expectations of the therapist and the therapeutic relationship.

3. Your current challenges and stressors

Current stressors—like work pressure, family conflict or health concerns—can impact your mood and relationships. Therapy helps you unpack these challenges and find new ways to cope.

• Describe the primary issues, symptoms or feelings causing you distress.
• Talk about the main sources of stress in your life right now (e.g., work, family, health).
• Explain how these challenges are impacting your daily life, mood and relationships.
• Share what you’ve already tried to do to solve the problem on your own.

What If I Feel Like I Have Nothing to Talk About in Therapy?

1. The feeling of having nothing to say

Feeling like you have nothing to say in therapy is common—and meaningful. This “blankness” can signal avoidance, fear or simply a need for rest. Naming it can lead to deeper insight and connection. Peer support services may also help you feel less alone.

• The feeling of “stuckness” is a valid and important therapeutic topic in itself.
• It can sometimes reveal a subconscious resistance or avoidance of a deeper issue.
• Your therapist can help you explore what this “blankness” might mean in a curious way.
• Being honest about it builds trust and authenticity in the session.

2. Discomfort or trouble opening up

Opening up in therapy can feel vulnerable. It’s okay to name your discomfort, fear of judgment or uncertainty. These conversations build trust and deepen the therapeutic relationship. Group counseling options can also provide a supportive environment.

• Express any feelings of nervousness, awkwardness or fear of judgment in the therapy room.
• Talk about the general difficulty of being vulnerable.
• Explore if the silence is related to the therapeutic relationship itself.
• Ask your therapist directly for guidance: “I’m not sure where to start today, can you help?”

3. A review of your progress and setbacks

Therapy is a journey. Reviewing your progress, setbacks and insights helps you stay grounded and adjust your goals. It’s a chance to celebrate growth and recommit to your healing.

• Reflect on what has changed for you since you started therapy.
• Discuss specific strategies, insights or “aha” moments that have been helpful.
• Identify any recent setbacks, recurring challenges or times you fell back into old patterns.
• Revisit your initial therapy goals to see if they are still relevant or need to be updated.

How much do you need to share?

You are always in control of what you share and when you share it. Therapy is a process of building trust; it’s natural to share more as you feel safer. A therapist’s role is to create a safe space, not to force confessions. Keep in mind that being more open often leads to more effective and transformative therapy.

Are there off-limit topics?

Generally, no topic is off-limits. Therapy is a confidential space for all your thoughts and feelings. The main legal and ethical exceptions relate to breaking confidentiality if there is a clear, imminent threat of harm to yourself or an identifiable person. Your therapist can explain these limits to you clearly in your first session. If you are unsure, it’s always okay to ask your therapist, “Can I talk about something and have it remain confidential?”

What to do if therapy isn’t working

Bring this feeling up directly and honestly with your therapist. Try to identify what isn’t working—is it the therapeutic approach, the personal connection or your own expectations? An open conversation can lead to a productive shift in strategy or help clarify misunderstandings. Remember, it’s perfectly okay to seek a different therapist if you’ve discussed the issue and still feel the fit isn’t right.

Conclusion

Therapy is a powerful tool for self-discovery, healing and growth. Whether you’re navigating major life transitions or simply feeling stuck, there is always something valuable to explore in therapy. You don’t need to have the perfect words—just a willingness to show up and be curious about your inner world.

Ready to begin your journey? Click here to find the Citizen Advocates clinic nearest you and schedule an appointment.

Frequently Asked Questions

How should I prepare for a therapy session?

Reflect on your recent experiences, emotions and any specific challenges you’d like to discuss.

What if I don’t feel connected to my therapist?

It’s okay to bring this up in session. A good therapist will welcome honest feedback and explore ways to improve the relationship.

Can I talk about the therapy process itself?

Absolutely. Discussing how therapy feels, what’s working and what’s not is part of the healing process.

How do I know when it’s time to end therapy?

When you’ve met your goals or feel ready to transition, talk with your therapist about next steps.

Is it okay to cry in therapy?

Yes. Crying is a natural emotional release and is welcomed in the therapy space.