What Should I Talk About in Therapy?

One of the most common concerns people have before starting therapy is surprisingly simple:

"What am I supposed to talk about?"

Many individuals worry that they won't have enough to say, that their concerns aren't "serious enough," or that sessions will feel awkward or unstructured. If you've had this thought, you're not alone. In fact, uncertainty about where to begin is often part of the reason people seek therapy in the first place.

The good news is that you don't need to arrive with a perfectly organized story or a clearly defined problem. Therapy is designed to help you figure that out along the way.

You Don't Need a Major Crisis

Some people begin therapy after a specific life event, such as a breakup, a loss, a career change, or a significant diagnosis. Others come in with a more subtle feeling that something feels off. Both are valid.

Therapy is appropriate for a variety of reasons, including ongoing stress or overwhelm, anxiety or low mood, relationship difficulties, parenting challenges, work-related burnout, identity exploration, difficulty making decisions, and feeling stuck or unmotivated. You don't need a dramatic story. You only need curiosity about your experience and a willingness to explore it.

Start With What's Present

If you're unsure where to begin, try starting with what feels most immediate. Something like: "Work has been draining me lately," or "I've been more irritable than usual," or "My relationship feels tense and I'm not sure why." Day-to-day experiences often reveal deeper patterns over time. Therapy doesn't require jumping straight into your most vulnerable memories unless you're ready.

It's Okay If You Don't Know

Sometimes clients say, "I don't know what's wrong. I just know I don't feel like myself." That's more than enough. Difficulty identifying emotions or needs can be part of the work itself. Therapy helps you develop language for your feelings, notice patterns in behavior, understand your stress responses, and clarify your goals and values. Not knowing where to start isn't a problem — it's information.

Therapy Is Collaborative

You are not responsible for structuring the session on your own. Therapists are trained to guide conversations, ask clarifying questions, and gently help you explore themes that emerge. If something feels unclear, you can say that. If something feels uncomfortable, you can name it. If you're unsure what direction to take, that can become the focus. Therapy is a team effort, and it works best when it's collaborative and flexible.

What If Sessions Feel Like "Venting"?

Many people worry that therapy will turn into repetitive venting. While talking through weekly stressors is often helpful, therapy also provides space to step back and ask deeper questions:

• What patterns keep showing up?

• What beliefs are influencing my reactions?

• What emotions am I avoiding?

• What changes do I actually want to make?

Over time, therapy moves beyond simply describing problems and toward understanding and shifting them.

A Different Way to Think About It

Instead of asking "What should I talk about?" try asking yourself:

• What has felt heavy lately?

• What's been taking up mental space?

• Where do I feel stuck?

You don't need a polished narrative — just a starting thread.

The Bigger Picture

Many clients eventually realize that the fear of "not having enough to say" connects to larger themes, such as minimizing their own needs, feeling undeserving of support, comparing their pain to others, or believing they have to handle everything alone.

Therapy becomes a place to challenge those beliefs, not reinforce them.

The Bottom Line

If you're considering therapy but feel unsure where to begin, you don't need a script. You can show up messy, unsure, quiet, talkative, overwhelmed, or completely blank. There's room for all of it. Because therapy isn't about having the right words — it's about having a space where your experiences can slowly and safely find them.

If you've been thinking about starting therapy but feel hesitant or unsure, our clinicians are here to meet you exactly where you are. Reach out today to connect with someone on our team.

Written by Kelly Sawin, LCPC, CADC

Lincoln Park Psychology Therapy Provider