On What to Discuss When You’re New to Therapy
Many therapy clients come to us never having been in therapy before. These new clients are usually excited to begin but also feel intimidated, uncertain, and unknowing of what to expect. Understandably, starting therapy can bring up a complex mixture of emotions! One question we frequently get from clients new to therapy is “What should I talk about in therapy?” Read on for common subjects you can explore with your new therapist and get some jumping-off points to discuss to help you feel more equipped as you embark on your therapy journey.
What to discuss in therapy?
Firstly, a big congratulations to you for taking the leap to start therapy! We talk to many prospective clients and hear more often than not that they’ve considered starting therapy for a long time but never felt fully ready to do so. So this is a big deal! Good for you!
What to expect in a first therapy session?
When you’re working with a new therapist, they will likely ask you many questions in your first few sessions to help get to know you better and understand why you’ve chosen to start therapy at this time. Some of these questions might be:
“What’s bringing you to therapy at this time?”
“Has something happened recently that you need support around?”
“How does it feel to be sitting with me today?”
“Tell me a little about what your life looks like right now.”
“Can you introduce me to your family/your close relationships so I can get to know you better?” “What are you hoping to work on in therapy?”
“How will you know if therapy is successful? What would be different for you?”
“What are you hoping for from your new therapist?”
“Is there anything I can do to help you feel more comfortable here?”
“Is there anything you’re worried or concerned about in starting therapy?”
“What is important for me to know about your childhood or any significant events in your life?”
“What else feels important for me to know about you?”
Initial topics to discuss in therapy while you’re getting to know your therapist
After starting to get acclimated to your therapist and answering the questions they have for you, you might find yourself wondering how best to use your session time and what is valuable to talk about. Know that it’s common to feel unready to fully open up with a new therapist and that it takes time to build comfort and security in a therapeutic relationship. If you don’t feel ready to dive into topics that feel very vulnerable and difficult for you to talk about. Some common smaller topics that can help you ease in and start to build safety with your therapist are:
Recapping recent events and conversations that have occurred since you’ve last seen your therapist
Discussing work/your career and any recent issues you’re having in your workplace
Smaller conflicts with your family, friends, and/or partner
World events that are impacting you but may feel less personal to explore
Hopes, goals, behavior changes, and directions you’d like to move toward as therapy progresses
Activities you enjoy and movies, tv shows, podcasts, etc, that speak to you
Relationships that you feel supported by or other things in your life that feel like they’re going well right now
Your relationship with the therapist and what you need to start building more safety and trust to share more vulnerably
As you can see, not all therapy sessions need to only explore topics or areas of your life that are challenging or distressing. Some of my most connected therapy sessions have been joyful and had many moments of levity where I'm connecting with clients about a recent tv show we’ve both watched! Nothing is off the table in therapy, really.
Current Feelings & Challenges
Once you start to feel a bit more comfortable with your therapist, you will likely find yourself wanting to share a bit more and start to go a little deeper. A good place to start is how you’re feeling right now in the therapeutic relationship–what’s going well. How have you been feeling supported and understood by your therapist and also, are there any moments that have occurred where you would have liked them to respond differently? Explore together how it feels to sit with them and share with them.
Similarly, you can start to discuss how you’re feeling generally in your life and on a day to day basis. If you’re regularly feeling anxious or depressed, what are some factors that you think may be contributing to this? How are you wanting to feel in your day-to-day life and what do you imagine would need to change to start to feel differently and routinely experience less distress or discomfort? To explore these topics together, you don’t actually have to go into detail about what’s distressing if you don’t feel ready, you can still have very meaningful conversations merely by discussing what this feels like for you and how you’d like it to change. Of course, if you feel ready to share more, no need to hold back!
Your Patterns & Behaviors that You’d Like to Change
We all have things we do that we wish we didn’t, right?! Another medium-level subject to discuss in therapy is sharing about the behaviors you engage in that leave you feeling regretful or you dislike about yourself. This helps your therapist better understand the direction you’re headed in together and this can help them think about where therapy is headed and what subjects you need to explore together to help you meet your therapeutic goals.
I know that one of the common concerns for new therapy clients is worrying about feeling judged or shamed when sharing about patterns you engage in that you’re not proud of. Ideally, you should never feel judged or shamed by your therapist! Our job as therapists is to help you see and better understand areas where you can make changes to get more of what you’re wanting from your life, but in a way that is compassionate and caring. If you find that you’re regularly feeling judged by your therapist, i encourage you to try to discuss this with them but if that doesn’t work, it may be time to consider if this is the best therapeutic fit for you.
Discussing Relationships in Therapy
As relational therapists, our team at Kindman & Co. specializes in helping our clients to better understand and improve the quality of their relationships. Because humans are social creatures, a significant amount of our lives is devoted to making and fostering relationships. Relationships are also a common cause for human distress!
There’s a lot to explore with your therapist about your relationships–who do you feel most supported and understood by in your life? How do those people show up that helps you feel this way? Who do you tend to have the most conflict with and similarly, how do those people show up that contribute to your distress? When you’re experiencing relationship conflict, how do you behave and are there ways you’d like to see this change? What do you need from your relationships to feel you can be authentic and how can you go about advocating for these needs?
Your therapist can help you have more understanding of what relationship dynamics work well for you and which are most challenging. They can also help you to build tools and skills to more effectively manage and nurture your relationships, like communication skills, identifying your unmet needs, managing your feelings when you’re experiencing relationship conflict, ways to build more community into your life, etc. We want our clients to have thriving relationships and feel as connected as possible!
Talking About Life Transitions
Part of being human is frequently experiencing change. While many changes and life transitions can be exciting, they often bring up a lot of emotions and connect us to previous experiences of transition that we’ve had to navigate. For many of us, change is hard, distressing, and overwhelming.
There are many kinds of life transitions to explore with your therapist, like moving cities, navigating the loss of a loved one and resulting grief, beginning a new relationship with a partner, getting married, starting a family, losing a job, getting a new job, etc. You can discuss any form of transition that you’re navigating with a therapist and they can support you to hold space for whatever feelings are coming up as you’re managing this change and also help you learn tools to manage it with more confidence and ease. If you’re interested, you can read more about the kinds of life transitions our team can help you with.
Managing Big Feelings
Our team specializes in working with folks who are emotional, sensitive, and often feel like they’re too much. We know how hard it is to feel like you walk through the world carrying your heart on your sleeve and frequently feel overcome with emotion. To be clear, there’s nothing wrong with you! Being sensitive is a strength and helps you to have significant empathy and compassion for yourself, others, and the world around you. That being said, it can be anxiety-provoking to feel too raw and that big feelings are lurking around every corner. Discussing how big feelings show up for you, what happens in your body when you feel them, the ways that big feelings are a strength and a burden, and tools to help you cope in moments where they feel unmanageable are all things you can explore in therapy.
Mental Health Diagnoses & Symptoms
While we don’t regularly diagnose in our practice, many clients come to us with a previous mental health diagnosis or are seeking one for insurance coverage and/or to better understand their experience. You and your therapist can explore the symptoms you regularly experience related to a mental health diagnosis, like generalized anxiety disorder, major depressive disorder, adjustment disorder, obsessive-compulsive disorder, ADHD, etc. and how these symptoms impact your daily life. You can identify skills to help you better cope with symptoms when they arise and learn more about diagnoses together to help you better understand what’s happening as well as to learn how to explain to your family and loved ones about the impact a mental health diagnosis has on you and how they can better support you.
Past Traumas & Challenging Life Events
Now we’re getting into some of the heaviest hitters. Most of us have experienced significant life events that have caused great distress, pain and hurt. For some, these experiences have gotten stored in our bodies and minds as traumatic events, often because we didn’t have enough support at the time to navigate them without becoming too overwhelmed. Sometimes this is also because the people involved have been our primary caregivers or loved ones who instead of supporting us, were actually hurting us at the time.
I won’t go too into trauma here, if you want to learn more about trauma, we have many blogs about trauma. Just know that trauma and emotionally challenging events deeply impact us and shape how safe we feel in our relationships and in the world. When you feel like you have enough safety and comfort in your relationship with your therapist, it is important to start to gently explore these pain points so that you can begin to heal from them to lessen the anxiety and distress you may be experiencing currently.
Do I have to talk about my childhood in therapy?
The short answer is well, yes and no. We know that many people find it incredibly painful to remember childhood experiences and that many of our clients would prefer to center their therapeutic sessions around present challenges. Your therapist should never force you to discuss something that you’re too uncomfortable or not ready to discuss. The safety and success of the therapeutic relationship depends on therapy being uniquely customized to you and this means, going at a pace that you’re comfortable with. That being said, if you were my client and you didn’t want to discuss your childhood, I’d hope to explore with you about what fears or concerns you have about what might come up and/or how you’d feel talking about it to better understand your hesitation and if there’s anyway that we can tailor therapy to help you feel more comfortable and resilient to exploring your past.
At some point, when you’re ready, it is generally valuable to discuss your childhood and your experiences with your parents/primary caregivers as these do tend to impact your emotions, behaviors, relationships, and symptoms in the present. Your childhood lays a foundation for your attachment style and your nervous system response to stressful situations, which absolutely impact how you feel now. Your relationship with your family both historically and at present, is a significant part of your story and in part, how you’ve become who you are today.
Other Topics to Discuss in Therapy that May Feel Uncomfortable
Everyone has parts of themself that they may feel ashamed of or are uncomfortable talking about and often, society and families of origin have reinforced these feelings and beliefs. Similarly, there are many topics and experiences that we may have received messaging that we’re not “supposed to talk about” or are seen as taboo. Some topics that are important to explore in therapy and if you have a safe and secure relationship with your therapist, should be welcomed to explore are:
Sex–Kinks, fetishes, desires, use of porn, masturbation, feelings of shame related to sex and sexuality, all of these are fair game and valuable to explore!
Embodiment–American society privileges thought over body. We know it’s hugely important to better understand our nervous system and body sensations, increase our tolerance for being connected to our bodies, as well as body image, physical touch and intimacy, and our self-concept (how we see ourselves)
Chronic illness and Disability–if you’re experiencing ongoing health concerns, physical pain, or disability, this hugely impacts your life and your relationships. Your therapist should help you explore your relationship to illness and health
Social Injustice & Your Relationship to Your Environment–Discussing feelings and values you have around political events, systemic oppression, racial trauma, climate change and related climate anxiety, etc. deeply impact your sense of safety and wellbeing.
Identity, Queerness & LGTBQIA+ Related Issues–We know that in many parts of the world and this country, it is unsafe to explore these topics, though it shouldn’t be this way. Exploring your sexual and gender orientation, feelings about coming out, traumatic experiences with queerphobia, etc. are essential to supporting you to be who you are and feeling seen and loved for who you are
Adoption–many adoptees or parents of adopted children/parents considering adoption have felt stigmatized or less than. My hope is that you will feel safe enough in therapy to discuss how your experience with adoption impacts you and that you will be met with compassion and curiosity.
Estrangement from Family Members–Many folks have been taught that things that happen in your family should stay there and shouldn’t be discussed with outsiders. Family strain and estrangement can often feel like a source of shame or that there’s something wrong with you. In fact, in many circumstances, estrangement from your family may be the safest and healthiest option for you and is absolutely something you can expect to receive support from your therapist for.
I hope that you’ve found this article helpful and that you now have some key topics that you feel you can discuss in therapy. Remember, you’re welcome to discuss whatever you feel like in therapy and nothing is too big or taboo to do so. After all, your therapist has likely heard it all!
Kaitlin Kindman, is a co-founder of Kindman & Co., is disabled, an activist, and a feminist. Her purpose is to help her clients come to believe that they are not alone, they belong, AND they inspire—they have the power to bring about change. She works with her clients to feel more connected, so that they take actions that improve their relationships and the world.
Kaitlin is deeply committed to providing socially just and anti-oppressive therapy. She really loves working with couples to improve their relationships and deepen intimacy, with other therapists and healers, as well as entrepreneurs and other business owners. Kaitlin finds true enjoyment in cuddling with animals, a just-right temperature cup of tea, feeling the sun on her face, and dancing in supermarket aisles.
GET HELP NOW
If you are interested in therapy with Kindman & Co. and would like to learn more about the services we have to help you, follow these quick & easy steps:
Schedule a free 20-minute phone consultation with our Care Coordinator.
Get matched with the therapist who’s right for you.
Start feeling more supported and fulfilled in your life and relationships!
THERAPY SERVICES AT KINDMAN & CO.
We are here for your diverse counseling needs. Our team of therapists provides lgbtqia+ affirmative therapy, couples therapy & premarital counseling, grief & loss counseling, group therapy, and more. We have specialists in trauma, women's issues, depression & anxiety, substance use, mindfulness & embodiment, and support for creatives. For therapists and practice owners, we also provide consultation and supervision services! We look forward to welcoming you for therapy in Highland Park and online.