What Should I Talk about in Therapy?

People new to psychotherapy often wonder, what should I talk about in therapy? Should I come to each session with an agenda? Do I need to bring a list of things that have been bothering me?

In short, there’s no one correct answer to this question. Every person who comes to therapy is wonderfully unique, and every therapist approaches this topic somewhat differently. 

Sometimes it makes sense to start by simply discussing what’s bothering you. At other times, it’s most helpful to talk about whatever at the moment comes to mind.

Beginning Therapy
Generally, when your therapist begins working with you, he or she will ask lots of questions to gain a clearer understanding of your background and the issues and symptoms you’re struggling with. He should also orient you to the type of therapy he practices, such as psychoanalytic, psychodynamic, relational, or cognitive behavioral therapy, and explain how he works with patients.

Exploring the Unconscious

In my practice, I help individuals process issues related to current and past relationships, experiences that are causing them problems or distress, and past traumas. I encourage them to discuss a variety of topics in therapy to gain insight into themselves and their behavior, in part, by exploring their unconscious.

Over many decades, therapists have successfully demonstrated that exploring the unconscious mind fosters self-awareness and healing. 

The unconscious is where all of our memories, feelings, and beliefs about ourselves and the world are stored. While most of this is beneath our level of awareness, there are proven ways of tapping into it.

Remember that your therapist is there to help guide you. Rest assured, those of us who work with the unconscious undergo intensive training to learn various methods and techniques to access it.

Expressing Your Thoughts Freely

When you freely express your thoughts, you tap into a rich reservoir of self-understanding!

Sigmund Freud originated the concept of free association to explore the unconscious. Free association helps us express thoughts and memories, which can reveal patterns and emotions that are not normally available to us on a conscious level. This has been expanded upon by the interpersonal and relational traditions of psychotherapy. 

This is why I generally would not encourage someone to bring an agenda or a list to therapy when working with me. This does not mean that you should never come in with something specific to discuss or process. Many people come to therapy burdened by an issue or problem that they want to work through. In fact, this is why many people begin therapy in the first place! There is absolutely nothing wrong with doing this when needed. It is often a great starting point. However, good therapy doesn’t generally end there.

If you’re afraid you won’t have anything important to talk about when going into a therapy session, please don’t feel bad. That can actually be a good thing; in fact, my experience has been that those are often some of the best sessions. The unconscious has a remarkable way of working between sessions to bring your most pressing concerns to the surface during your next therapy session.

Exploring Your Dreams

Many therapists, myself included, occasionally also work with dreams, which is another way the unconscious communicates with us. Our dreams often offer a look into unresolved conflicts, memories, fears, and desires. For these reasons, dreams have been referred to as the “royal road to the unconscious.”

Developing a Safe, Supportive, and Trusting Relationship with Your Therapist

The more relaxed you are in therapy, the more easily your unconscious mind can express itself. Your therapist should work with you to create a safe, supportive, and trusting relationship where you can be relaxed and talk about anything on your mind. In fact, therapy is one of the few places where you can talk freely about absolutely anything without being judged.

Studies consistently show that the quality of the relationship with one’s therapist is inextricably linked to successful treatment outcomes. An article in Psychology Today notes that “this relationship, often called the therapeutic alliance, is a partnership between the therapist and client for the purpose of achieving the goals of treatment. It requires mutual trust and honest communication.”

Different Ways of Working

I should note that while my primary orientation as a therapist is to help those I work with heal through greater insight and awareness, this is not the only way I work. I tailor therapy sessions to meet the unique needs of each individual and draw from various theoretical frameworks, which, in addition to working with the unconscious, include somatic, mindfulness, and cognitive-behavioral therapy (CBT) techniques. 

Ultimately, therapy's primary goals are to promote self-awareness, improve coping, and, perhaps most importantly, relieve suffering and lead to a more joyful and fulfilling life.

Chris Haley Therapy

If you live in New York State and are looking for a therapist, I invite you to contact me for a no-obligation consultation. I strive to create a warm, safe, and supportive environment to discuss anything causing you distress. You can always bring your whole self to therapy with me.