What to Talk About In Therapy: 21 Ideas To Consider

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22 December 2023

12 Mins

Stepping into therapy for the first time can feel like entering an unknown space, isn't it? At this time, it's totally normal to have a bunch of emotions—curiosity, nervousness, maybe even a little excitement. However, rest assured that therapy is a judgment-free and safe space where you can discuss almost any issue or challenge you face.

While there's no limit to the topics you can explore in therapy, it's common that you feel a bit lost about where to start. If you're wondering what to talk about in therapy or how to get started, this blog will help you figure out what you can discuss, what to expect in your first session, and how to make the most of your time in therapy.

It can be hard to understand what to talk about in therapy when you have never consulted a therapist before. Let the therapist take the lead and help you figure out your inner conflicts for free.

What to Talk About in Therapy - 21 Ideas

If you don't know what to talk about in therapy, think about why you started therapy. What do you want to work on? Is there a lingering issue? What are your current thoughts and feelings? Although thinking about these therapy questions is quite normal, there's no right or wrong way to start; you can share whatever is on your mind with your therapist. But to make it easier for you, here are some things to talk about in therapy to start the conversation:

1. Share your current thoughts and feelings

Ask yourself: How are you feeling today? This basic but important question helps you understand and address your immediate emotions and then you can share the thoughts that have been occupying your mind with your therapist. Whether they revolve around work, relationships, or personal concerns, making sense of your recent musings helps set the stage for a deeper discussion. Hence, sharing your current situation is a good way to break the ice in a therapy conversation.

2. Discuss your reasons for reaching out

One of the things to discuss in therapy is sharing why you want to go for therapy, as it’ll help you identify the root causes a bit more clearly. Whether you had a sudden realization or you've been thinking about getting therapy for a long time, sharing your “why” helps you and your therapist understand your motives and goals.

Think of therapy as a training ground and your goals are the skills you want to master. For example, a goal might be as simple as learning to manage stress better or improving your mental health, so explaining the reason behind your choice lets you both know what priorities and objectives you want to work on in therapy.

discuss your reasons for reaching out

3. Your expectations when you start therapy

When someone starts therapy, they always wonder what to talk about in therapy and get hit with different thoughts and feelings. Some may already have ideas about what it will be like, while others might feel unsure. And most people are really hopeful that therapy will make a big difference for them. So whatever you have in mind, it's completely okay to consider your feelings when you are about to start therapy, as sharing them helps you and your therapist work together better.

4. Your emotional state

Your emotional state means how you feel at a particular moment, which includes a variety of emotions such as happiness, sadness, anger, and fear that can fluctuate over time. If you notice changes in your emotional state, especially between therapy sessions, it is essential to discuss them with your therapist. Sharing these changes will help the therapist understand your symptoms, track progress, and provide guidance tailored to your needs.

Your emotional state

5. Your job or career

Your job or career can have a significant impact on your mental health. Whether your job is a source of stress, a gratifying experience, or if you are moving toward a career change, it is one of the relevant things to discuss in therapy. Issues such as stress in the workplace, conflicts with coworkers, or seeking work-life balance are common topics you may have to address. No matter if you love your job or face challenges, the therapist's questions help you explore and manage the impact of your career on different aspects of your life.

6. Loss or grief

Grief and loss are experiences that often catch us off guard, thereby affecting our mental health. If you have recently suffered a loss that feels overwhelming or if a past loss is still troubling you, therapy provides a safe room to express these feelings. Sometimes, the true impact of a loss only emerges later, and therapy can help you understand and cope with the complex emotions associated with grief.

loss of grief

7. Health history

In therapy, your medical history matters a lot because your physical and emotional health are connected. Positive mental health can benefit your overall health in ways such as better sleep quality, memory, concentration, and decision-making abilities. On the other hand, poor mental health is linked to problems like heart disease, chronic pain, and physical illnesses, which can also affect mental health, leading to stress and depression. Talking about your medical history in therapy helps address both your mental and physical health in-depth.

8. Life ambitions

In therapy, discussing your life goals can provide insight into your aspirations and help set therapy goals to move you in the direction you want. Whether you're seeking clarity on your future or you just have ideas without a clear plan, sharing these aspirations with your therapist can be a valuable part of the therapeutic process.

life ambitions

9. Any trauma

Many people avoid talking about trauma because it is painful and recalling the details can be uncomfortable. In therapy, you have the freedom to share things at your own pace, as you have control over how much or how little you share. If you are hesitant, you can tell your therapist that there is something you want to discuss but are afraid of. A trauma-trained therapist can guide you through the process, making sure you feel comfortable and safe as you work through your traumatic experiences.

10. Childhood experience

Talking about your childhood in therapy might seem like an unnecessary thing, but it's essential. It helps solve complex patterns affecting your life today. Your childhood forms the basis for your behaviors and patterns, and discussing it in therapy gives an understanding of breaking free from unhealthy cycles. For example, you may notice a pattern of avoiding conflicts or becoming anxious in certain situations as an adult. When you explore your childhood experiences, it may reveal that you developed these strategies as a way to cope with stress or challenges.

childhood experiences

11. Hopes and fears

Our hopes are the positive things we want, and our fears are the worries that can hold us back. Hopes are positive plans for good things, and fears can be warnings, but sometimes they stop us from achieving our goals. Let's imagine that you have the hope of starting your own business. Your positive plan may include ideas about what services or products you want to offer. On the other hand, you may fear failure or financial instability, worrying that your business will not be able to take off. Sharing these hopes and fears in therapy allows you to explore both the excitement of your positive aspirations and the challenges posed by your fears.

12. Strengths and weaknesses

Talking about your strengths and weaknesses is an important part of seeking therapy. Weaknesses are things that might make it hard for you to move forward, and strengths are the good qualities and abilities you can use to overcome challenges. For example, if you find it hard to express your feelings but are good at understanding others, that's a strength you can rely on. As you continue with therapy, you might discover more strengths or areas where you can improve.

Strengths and weaknesses

13. Behavioral patterns

Behavioral patterns are the regular ways we do things in our lives, as well as the habits or routines we follow without thinking too much about them. You may have noticed how you deal with different situations, and some of these patterns may be helpful, while others may not be. It is beneficial to share your awareness of these patterns with your therapist. This helps them better understand your experiences and helps you find healthy coping strategies for situations you find challenging.

14. Your relationships

Think about the relationships you currently have in your life. We undergo different types of relationships in life, which are vital in shaping our mental health. Look at your meaningful relationships, from those that bring positivity and peace to those that create more challenges. Then, discuss with your therapist how these relationships impact your wellbeing and mental health.

your relationships

15. Your life events

Life is a journey full of changes and challenges. Some of these changes are accepted with open arms, while others may be met with fear. From happy occasions to more difficult trials, every change leaves a mark on our lives. Think of significant events you have faced – marriage, divorce, the arrival of a new life, farewell, a big move, a change in education or career, ups and downs in health, and any other changes. Among many things to talk about with your therapist, tell them how these experiences have affected you and what impact they have had on your life.

16. Issues related to sex and sexuality

Among things to talk about with your therapist, discussing sex and sexuality is completely appropriate in these sessions. These topics are integral to the human experience and can leave a considerable mark on your mental health. Don't hesitate to talk openly about any aspect related to sex and sexuality that you think took a toll on your wellbeing. In fact, some therapists specialize in addressing issues related to sex and sexuality, so it becomes easier to freely share your experience to get the most benefit out of therapy.

Issues related to sex and sexuality

17. Neglect and abuse

Talking about experiences of abuse and neglect in therapy can be really tough at first. Initially, avoiding these thoughts and memories can help create some emotional distance, but as time goes on, the emotional weight can become disturbing.

It might feel difficult to discuss such personal and painful experiences but when you're ready, start with what you are comfortable sharing, and from there, you can open up about other experiences slowly and steadily. If speaking about it is hard, you can write down your thoughts and share them with your therapist. Don't hesitate to ask your therapist for assistance in talking about what you find difficult. This is a step-by-step process, and your therapist will be there to support you at a pace that feels right for you.

18. Breaking generational patterns

Have you ever noticed similarities in your actions and the actions of your parents or family members? This recognition tells about inherited generational patterns. Most of our early learning about seeing the world comes from watching our parents and family.

Some of these patterns carry positive traditions and valuable intergenerational knowledge, while others may not be as beneficial. Negative behaviors, such as substance abuse, avoidance, perfectionism, and impulsive spending, may also be part of these patterns. If you have noticed such patterns in your behavior, it is okay to share these observations and experiences with your therapist.

breaking generational patterns

19. Milestones

Sharing your milestones in therapy is like telling the important stories of your life. Milestones are special events or achievements that mean a lot to you. They can be things you're proud of or moments that have shaped you. Talking about your milestones helps your therapist understand your journey, so they can guide you in setting new goals and moving forward in life. It's not just you who benefits from this; your therapist also finds joy in celebrating these victories with you.

20. Any previous experience with therapy

It's perfectly fine to talk to your therapist about both the positive and challenging aspects of your past experiences. Share what worked well for you, what you'd like to try again and any aspects of past therapy that you didn't like or wish to avoid.

However, even if your past experiences with therapy weren't beneficial, you now have the opportunity for a positive and successful therapy experience. Each therapy journey is unique, as therapists have different personalities and there are various approaches they use to address different mental health issues.

21. Share updates on your life

You can start your session with some updates on your life, especially if this is your follow-up session. Begin by talking about how things have been since your last therapy session. Share how you're feeling overall and mention any significant changes in your emotions or thoughts. If your therapist gave you tasks or "homework," one of the things to talk about in therapy is how those went to see how they affected you. Don't hesitate to discuss experiences that brought up unexpected or uncomfortable thoughts and feelings. This helps both you and your therapist understand what influences your emotions.

Now that you have gotten clarity on what to talk about in therapy, take full leverage of your free chat with a therapist now.

What to Talk about in Therapy When Things Are Going Well

When things are going well in therapy, it's essential to recollect your progress and celebrate the positive changes. Here are some things to talk about in therapy:

1. What you’ve learned till now

Discuss the insights and lessons you've learned during therapy so far. Think about how this new knowledge has contributed to your personal growth and well-being and share it with your therapist.

2. Your progress so far

When you’re in therapy, it’s vital to share and celebrate your progress and positive changes in life. To understand your achievements better, take a moment to think about the challenges you faced when you started therapy and see how far you've come.

3. Future goals

In therapy sessions, you can talk about your goals and dreams for the future and the steps you can take to keep up your positive momentum and continue growing. It’s important to set new goals, as this will inspire you to engage in therapy for your personal growth and future aspirations.

4. Small victories

Share the small victories and positive moments in your life with your therapist. Even your little achievements are signs of your resilience and progress. Whether it's completing a small task, overcoming a minor challenge, or finding joy in a small victory, these moments matter.

small victories

Final Thoughts

Therapy is a journey to discovering more about yourself, similar to sailing on a big adventure where you get to explore the stories of your own life. To make the most of it, be open and honest about your feelings, find a therapist according to your needs, set clear goals, and take notes between sessions. Your conversations with your therapist will probably touch on various matters, including your life troubles, personal struggles, relationships, or childhood memories.

However, if you ever feel unsure what to talk about in therapy, don't worry; your therapist will guide the conversation by asking therapy questions to help you explore and address relevant topics. This is where Now&Me can help provide a safe and supportive space for the unique aspects of your therapeutic journey. We have experts who can help you through virtual one-on-one sessions at a cost-effective rate, starting at just Rs. 30. For a supportive journey, you can join the Now&Me community and download the app today!


  1. At a Loss for Words? 26 Topics You Can Talk About in Therapy. Published 2023. https://calmerry.com/blog/therapy/at-a-loss-for-words-26-topics-you-can-talk-about-in-therapy/

  2. Not Sure What to Talk About in Therapy? 12 Things to Consider. Published 2022. https://www.healthline.com/health/what-to-talk-about-in-therapy

  3. Unsure What to Talk About in Therapy? Here Are 10 Ideas That Might Help. Published 2022. https://www.goodrx.com/health-topic/mental-health/what-do-i-talk-about-in-therapy

  4. What to Talk About In Therapy: 20 Ideas. Published 2022. https://www.choosingtherapy.com/what-to-talk-about-in-therapy/

  5. What to talk about in therapy. Published 2023. https://www.medicalnewstoday.com/articles/what-to-talk-about-in-therapy

Now&Me articles are written by experienced mental health contributors and are purely based on scientific research and evidence-based practices, which are thoroughly reviewed by experts, including therapists and psychologists with various specialties, to ensure accuracy and alignment with current industry standards.

However, it is important to note that the information provided is not a substitute for professional medical advice, diagnosis, or treatment. Individual circumstances vary, and it is advisable to consult with a qualified mental health professional for personalized advice and guidance.

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