What to Talk About in Therapy? 22 Topics to Consider

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Mental health is an important aspect of everyday life. Back in the day, it was not promoted as something important.

Many people overlook their mental health and emotional well-being as a result, including those with mental disorders who need treatment.

The unwillingness came from the social stigma associated with mental illness. You risk getting criticized or called insane if you dare mention seeing a therapist or mental health counselor.

Fortunately, things have changed tremendously. More people are open to psychotherapy and appreciate the value of talking with a therapist.

Once you’ve decided to explore psychotherapy, the next thing is to identify what to talk about in therapy. Getting a clear idea of your mental health needs is a good starting point. This can serve as a guide to deciding what to discuss with a licensed therapist.

Before scheduling an appointment, take a few minutes to learn what is therapy, the types of therapists to choose from, and the benefits of therapy. Next, we’ll run through a list of therapy topics to consider and matters to address during your therapy sessions.

What Is Therapy?

Psychotherapy, also called therapy, talk therapy, or counseling, is a type of mental health treatment. It primarily involves discussing and addressing mental and emotional health concerns with a licensed therapist.

The therapist is trained to set up a treatment plan to help meet the patient’s individual needs. The overall goal of therapy is to provide patients with coping skills to make behavioral changes.

The changes can help them to overcome certain mental health challenges.

As a patient, you can meet for one-on-one or group sessions with your therapist. Although therapy is an alternative to medication, some doctors may recommend it alongside medical treatments.

What are the Benefits of Therapy?

Therapists are required to follow evidence-based therapies and guidelines to match the needs of patients. Each patient’s experience and result are unique. Regardless of your specific diagnosis, therapy can help in the following ways:

  • Help you discover unhealthy behavior patterns
  • Give you an opportunity to talk about your thoughts, feelings, and experiences in a non-judgmental setting
  • Provide tools for shifting to a positive or growth mindset
  • Learn healthy communication skills for resolving conflict
  • Improve family and romantic relationships
  • Develop skills to cope with everyday challenges and mental health conditions
  • Cope with and heal from emotional and childhood trauma
  • Assist you in overcoming fear, shame, or guilt linked to various negative life events
  • Live healthier, happier, and more motivated
  • Improve physical health

Types of Therapists and Techniques

Psychiatrists, psychologists, psychotherapists, and mental health counselors play fundamental roles in the area of mental health. They are trained and certified to evaluate clients and provide the appropriate treatment or therapy.

Some mental health professionals are authorized to prescribe medication alongside evidence-based therapies.

The appropriate mental health professional and treatment techniques will depend on your needs. Below are the top in-demand therapists who can provide coping strategies:

  • Marriage and Family Therapists
  • Behavioral Therapists
  • Trauma Therapist
  • Grief and Loss Therapist
  • Motivational therapist
  • Sex Therapist
  • Attachment Therapist

Common Psychotherapy Techniques

variety of treatment techniques are available to assist patients in overcoming their difficulties. Depending on your needs, your therapist may recommend the following techniques after diagnosing your symptoms:

  • Family therapy for improving communication and resolving conflicts
  • Cognitive Behavioral Therapy (CBT) for changing core beliefs that create personal challenges
  • Motivational Enhancement Therapy (MET) for increasing the patient’s willingness to change their behavior
  • Breathing and relaxation techniques for anxiety and phobias
  • Mindfulness techniques to combat stress, worry, anxiety, and negative thoughts
  • Exposure Therapy for confronting fear and other symptoms related to phobias
  • Eye Movement Desensitization And Reprocessing Therapy (EMDR): Used mainly for treating PTSD symptoms
  • Psychodynamic Psychotherapy for coping mainly with social anxiety and depression
  • Grief and Loss Therapy for assisting individuals in overcoming death or loss of a loved one or pet

Common Reasons for Seeing a Therapist

A general physician usually recommends seeing a therapist after evaluating your symptoms at your checkup. Referrals are typically provided for the following common complaints, symptoms, and disorders:

  • Severe or chronic stress
  • Self-defeating thoughts
  • Substance abuse
  • Eating disorders
  • Traumatic events, e.g., the death of a loved one and childhood abuse
  • Insomniaor trouble sleeping for a prolonged period
  • Anxiety disorder symptoms, e.g., strong feelings of fear, dread, or panic
  • Depressionsymptoms, e.g., loss of interest in everyday activities
  • Behavioral disorders, e.g., attention-deficit hyperactivity disorder (ADHD), bipolar disorder, and borderline personality disorder (BPD)
  • Suicidal thoughtsor ideations

22 Ideas on What to Talk About in Therapy

The main goal of therapy is to teach you skills to cope with common life problems. These include behavior issues, traumatic events, sexuality, and mental health disorders. Your therapist will engage you based on your diagnosed mental health needs.

Even though you’re seeking treatment for one aspect of your mental health, you may have unrelated concerns.

They won’t know what you’re going through unless you provide information and ask questions for clarity. Some therapists give prompts, while others may wait for you to broach a subject matter or ask questions.

Therapy is done in a non-judgmental setting, so there’s no “wrong” or “stupid” question. Your therapist is here to listen and help you make sense of your experiences, thoughts feelings, and behavior.

They also provide guidance and strategies on how to cope and help you accomplish the overall treatment goals.

Below is a list of things you can bring up before you start therapy or before your next session. You can zoom in on the ones that apply to your circumstances.

Childhood Trauma

Unresolved childhood trauma happens when the brain suppresses overwhelming or traumatic events as a child. The brain does this to protect you from emotional pain you’re too young to handle.

The trauma may lead to emotional detachment and trouble regulating emotions. A trauma therapist can provide an environment for you to discuss the following traumatic childhood events.

1. Parental neglect or abandonment

Neglect or partial abandonment by a parent occurs when a child does not get their physical and emotional needs met. In some cases, the parent leaves the home leading to total child abandonment.

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Victims of childhood abuse do not easily open up about their experiences out of fear, shame, and guilt.

Not only is this devastating for you as a child, you’re only able to make sense of it as an adult.

Try opening up to your therapist about strong trust or abandonment issues, social avoidance, anxiety, and low self-esteem. These symptoms are related to neglect and abandonment.

2. Childhood abuse

Abuse in childhood can happen by witnessing violence in the home. Being subject to physical or sexual assault is also abuse in childhood. Victims do not easily open up about their experiences out of fear, shame, and guilt.

The therapy environment is a safe haven for you to freely discuss these traumatic childhood experiences.

3. Parental death

The death of a parent in your childhood is similar to parental abandonment. The devastation of the loss leads to severe emotional trauma that goes on into adulthood.

The trauma often leads to mental health disorders, e.g., anxiety, mood disorders, substance abuse, or low-life success. Your therapist can help determine if your symptoms have to do with the trauma of parental loss.

Relationships and Family

A licensed Marriage & Family Therapist, LMFT, works with couples and families to help them work through relationships, marriage, or family challenges. Therapy is geared toward helping clients build happy healthy relationships.

4. Blended family

Two families coming together to live under the same roof is considered a major life event. Usually, this happens after marriage. Parents and children can find it stressful and difficult to deal with the changes.

Different parenting styles are a common source of conflict in blended families. Discussing the life transition openly and expressing your feelings is a healthy way to cope.

5. Generational patterns

Mental health conditions and behavioral patterns can pass from one generation to the next through genetics. Consider informing your therapist about patterns such as addiction, domestic violence, depression, or suicide.

Together, you can discuss the signs you may be at risk and ways to break the pattern.

6. Attachment styles

Some therapists specialize in attachment styles therapy. They can help if you express your struggles in building healthy relationships. Attachment therapy helps you trace back to childhood experiences that caused you to develop insecure attachment styles.

During your sessions, you can explore ways to create healthy and a secure attachment style. A secure attachment style is essential for building meaningful relationships.

7. Boundaries

Establishing healthy boundaries is an area many of us struggle with. However, setting up healthy boundaries protects you from behavior by others that can impact your mental health. Let your therapist know about your difficulties in this area.

They’ll help you understand how personality traits, such as being empathic or a people-pleaser, can cause others to use you. They can also provide the right tools and approach for building healthy boundaries.

8. Emotional abuse

You may have to deal with a narcissistic or other type of controlling individual who treats you in an emotionally abusive way. This can be at home, work, or in a romantic relationship. Explain what is happening to your therapist.

They can assess your symptoms to determine if emotional abuse is taking a toll on your emotional health.

Everyday Issues

These are things a cognitive, behavioral, or motivational therapist can help with. Motivational therapists help patients find motivation from within themselves to make positive behavior changes.

Consider whether you’re “what to talk about in therapy” list should include any of the following concerns.

9. Anger problems

Do you have uncontrollable anger that gets in the way of job and relationship success? Your therapist may not know this simply by looking at you.

Inform them of your anger tendency and struggles to manage it. Some behavioral therapists are trained to provide anger management skills to their clients.

10. Problems at work

The way your narcissistic boss or co-workers behave towards you can turn your workplace into a hostile environment. You may experience anxiety or depression or think of quitting.

Discuss your workplace dynamics to see if your therapist can assist you in navigating those challenges.

11. Emotional triggers

Have you noticed your reactions in certain settings often go overboard but can’t explain why? For example, triggers like noise, certain smells, or even a baby crying can cause you to feel overwhelmed, angry, sad, or anxious.

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Low self-esteem can arise in adults who did not receive the essential love and care needed in childhood.

Your therapist can help you explore what triggers reactions that are not proportionate to the situation. Additionally, they can provide tools to help you manage those triggers.

12. Low self-esteem

Low self-esteem can arise in adults who did not receive the essential love and care needed in childhood. Explore feelings of unworthiness, negative self-image, poor boundaries, or sensitivity to criticism with your therapist.

They may ask you about other symptoms, such as difficulty asking for help and people-pleasing. Based on your responses, they can tell if you may benefit from therapy for low self-esteem.

13. Frequent drinking or drug use

Therapy can be helpful before problems get out of control or become a disorder. Raising the issue in therapy can save you from substance abuse, dependency, or addiction. A therapist can stage what’s called a “brief intervention.” 

Intervention can involve helping you to understand the consequences of substance use. Other strategies include encouraging you to try nonuse to quit on your own or attending a twelve-step program.

14. Negative thought patterns

Changing thinking patterns can help relieve issues such as rumination and catastrophizing. These unhelpful thinking patterns may be an underlying reason for anxiety and depression.

A cognitive behavioral therapist can use the cognitive restructuring technique designed to help patients replace negative thoughts with positive ones.

15. Sexual orientation

Too many people continue to struggle with their sexual orientation despite widespread societal acceptance of LBGTQA++. If you struggle with shame or low self-esteem, you can discuss your feelings with your therapist.

You may have difficulty informing loved ones about your sexual orientation due to strong fears of rejection or condemnation. Ask your therapist if they can provide tools to build confidence and cope with potential negative feedback.

Mental Health Disorders or Conditions

19.86% of adults were living with a mental illness in 2022, according to research data provided by Mental Health America.

Anxiety disorders are the most prevalent followed by major depressive disorder, PTSD, bipolar disorder, and borderline personality disorder, in that order.

Untreated mental illness is problematic because it is often the cause of missed work or school, substance abuse, and relationship conflicts.

In short, the symptoms can affect your overall quality of life on a long-term basis if you fail to receive the treatment needed.

16. Anxiety symptoms

People develop chronic anxiety due to long-term fears about various things. Common sources of anxiety are socializing, memories of traumatic events, sickness, death, and uncertainties about the future.

Discussing what triggers fear, worry, or nervousness brings it to your awareness. From there, your therapist can decide what anxiety disorder treatment may work for you.

17. Depression symptoms

Ongoing depressive symptoms or major depressive disorder (MDD) often interfere with daily functioning. Work and academic performance may decline. Relationships in the home or with your partner can be affected. 

Don’t be afraid to let your therapist know what’s happening in your inner world. They are there to assist you in managing the symptoms or refer you to a professional who specializes in depression psychotherapy.

18. Borderline personality disorder (BPD)

An individual may suspect they suffer from BPD based on their dysfunctional behavior. However, they are afraid to tell anyone out of fear of being called ‘crazy’.

This is something you can share with your therapist without fear of judgment.

They are trained to evaluate the symptoms of mental health disorders and provide behavioral therapy. Dialectical behavioral therapy (DBT) is a specialized treatment for BPD.

19. PTSD symptoms

Those who experienced or witnessed a traumatic event such as an accident, death of a loved one, or war, may develop PTSD: Posttraumatic stress disorder (PTSD) is a psychiatric disorder.

Ask your doctor why you have intense and disturbing thoughts, flashbacks, or nightmares about the past emotional trauma months or years later. These are all common symptoms of PTSD.

Grief and Loss

Grief counseling is a type of therapy designed to help patients cope with negative emotions in various stages of recovering from a loss. This type of therapy can work for grief related to death and divorce.

20. Stages of grief

Grief is a set of complex emotions and feelings experienced after the death or loss of a loved human or pet.

These emotions, such as intense anger, guilt, sadness, numbness, and denial, are considered natural responses. You may wish to learn more about the stages a bereaved person goes through.

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Ongoing depressive symptoms or major depressive disorder often interfere with daily functioning.

Perhaps, you’re confused as to why you swing back and forth to the different stages. Your therapist can explain why and provide reassurance that grief normally comes to an end.

21. Long-term grief

The average timeline for acute grief to resolve is six months to one year. You may wish to find out why you still feel devastated after more than a year. Getting stuck in the stages of grief for longer than 12 months is considered complicated grief.

Your therapist can shed light on how accepting the loss is a powerful method to alleviate persistent grief symptoms.

22. Divorce loss and grief

Relationship breakups and divorce cause grief symptoms similar to when a loved one passes away. The grief stages are also similar. While grief is a natural reaction, taking longer than normal to recover can interfere with everyday life.

A therapist can provide the tools to cope with the symptoms of grief as well as setbacks related to the divorce process. The ultimate treatment goal is to help you come to terms with the loss and see that there’s a bright and happy future after divorce.

Final Thoughts on What to Talk About in Therapy

The idea of going to therapy can be scary, especially if it’s your first time, and you don’t know what to expect.

Don’t worry, you’ll be meeting with professionals trained to engage you with compassion and empathy. They are equipped with the knowledge and tools to help you cope with and manage your challenges.

All there is to do now is to work up the courage to ask questions, raise topics, and express yourself. The success of therapy depends mostly on your mindset.

Being open to doing the work to facilitate the behavioral changes and life transitions you seek can lead to a successful outcome

If you’re in search of a therapist, look online for the type of therapist near you using your zip code.

Here’s a link to resources to locate a therapist in your area. With Telehealth making virtual therapy sessions possible, you may not need to physically go to your therapist’s office.

Many patients find it easier to decide what to talk about in therapy because they feel more comfortable doing virtual sessions. Before you go, be sure to learn the difference between Psychologist VS Psychiatrist: How to Choose between Each Option.

And if you want more articles about mental health, be sure to read the following articles:

Finally, if you want to identify YOUR personality type, then take one of these 11 personality tests to better understand what makes you tick.

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