If you’ve never tried therapy before, you may wonder what people usually talk about in therapy. You might feel at a loss for what to talk about, or instead feel like there are too many options for potential topics. How can you figure out what to prioritize? 

From working through recurring patterns and anxieties to processing the seemingly mundane day-to-day, therapy can provide a space for transformational reflection and growth. 

What do most people talk about in therapy? 

In therapy, conversations can revolve around many different topics, from past traumas to current stressors. Here are some of the most common topics that come up in therapy sessions.

Recurring patterns and behaviors

Many people repeat the same unhelpful patterns over and over again, or use unhealthy strategies to deal with their problems, like avoidance, self-sabotage, or people-pleasing. Through therapy, you can learn to identify these patterns, understand their origins, and get support in breaking the patterns.

Thoughts and feelings

Therapy sessions provide a safe space for clients to explore a variety of thoughts and emotions, including anxiety, depression, anger, sadness, and joy. In therapy, you can openly express your thoughts and feelings without fear of judgment, practice re-working unhelpful thinking patterns, and find a release for distressing emotions. 

Relationship dynamics 

In therapy, clients may explore their relationships with family members, friends, romantic partners, and colleagues. Therapy can help you gain insights into your communication patterns, boundaries, and relational conflicts. Whether focusing on previous childhood experiences with an absent parent or issues in a current romantic relationship, therapy can be a helpful place to explore and better understand many different kinds of relationship dynamics.

Coping mechanisms 

Many people turn to unhealthy coping mechanisms to manage stress, anxiety, or trauma. These coping strategies may include things like substance use, self-harm, avoidance, or excessive work. In therapy, clients can confront these maladaptive patterns, understand their underlying triggers, and develop healthier coping strategies. 

A loved one’s untreated mental illness 

Having a loved one with untreated mental illness or substance abuse can be incredibly distressing and can take a significant toll on your own mental health. Through open dialogue and reflection, therapy provides a space to unpack these emotions, set boundaries, and explore strategies for maintaining a healthy relationship dynamic. 

Where to begin when you have a lot to say

If you feel overwhelmed by the number of things you could talk about in therapy or aren’t sure where to begin, here are some ways you can figure out where to start:

• Start with what’s most pressing: Identify the topic that is top of mind, like a recent event that triggered strong feelings or a recurring issue that's been impacting you. By addressing the most pressing concern first, you can work to alleviate immediate distress and create a foundation for deeper exploration later on.

• Consider what’s impacting your day-to-day: Look for patterns of behaviors, thoughts, or emotions that interfere with your work, relationships, or overall well-being. Perhaps you find yourself stuck in spirals of anxiety or feel overwhelmed by intrusive thoughts. By focusing on topics that have a tangible impact on your daily life, you can work towards practical solutions and positive changes.

• Listen to your gut: Pay attention to your emotional reactions when considering different topics. Are there particular issues that evoke strong feelings of sadness, anger, or anxiety? Emotions often serve as valuable indicators of underlying needs or unresolved issues. Trusting your emotional intuition can guide you towards topics that would benefit from exploration and healing.

• Lean on your therapist: Don’t be afraid to work with your therapist to figure out where to begin. Therapy is a collaborative process and having a conversation with your therapist can help you figure out where to begin. Share your thoughts and concerns about what topics to prioritize, and trust your therapist's expertise in helping you navigate your journey. 

Once you begin, your therapist will help you create goals to determine what you want to accomplish in therapy. Once those goals are created, it gets easier to know what to talk about each session.

Is there anything that’s ‘too small’ to discuss in therapy?

No, no topic is too small or trivial to bring up in therapy. Even seemingly minor issues can hold significant meaning and provide valuable insights into your thoughts, emotions, and behaviors. Things that seem small can also have a big impact, especially if they trigger past traumas or represent a recurring pattern.

Even with topics that seem superficial, the process of exploration and discovery in therapy extends beyond the surface level. Therapists are trained to listen attentively, ask probing questions, and help clients explore the significance of even the smallest details. Whether it's a fleeting thought, a recurring annoyance, or a seemingly inconsequential event, these details can offer valuable clues about underlying patterns or emotions and reveal opportunities to put solutions into play.

Addressing "small" issues in therapy can also prevent them from escalating into larger problems over time. By addressing concerns proactively, therapy can help you develop healthier coping mechanisms, improve communication skills, and cultivate greater self-awareness.

Ready to start therapy? Octave has over 1,500 therapists who have been carefully selected to meet your mental health needs.