I just read a really great article in Psychology Today called, What to Talk About in Therapy. You might ask, “Um, don’t you already know what to talk about in therapy?” Yes, I have a pretty good idea at this point in my career, but the article wasn’t written for counselors, it is written for those who might be seeking counseling. Though I really enjoy this magazine, I have a feeling that most non-mental health folks don’t necessarily subscribe to this one. I was intrigued enough that I wanted to make sure to bring this topic to those of you that have come to trust Restorative Solutions Counseling for help and information. Also, this article reminded me of a comment that I hear frequently in my office, “I don’t know what I’m supposed to talk about.”
This article is divided into four sections, and I’m just going to reference each one in the following paragraphs. What is covered in *therapy? Well, we can talk about whatever you want. However, this kind of broad statement can feel a little overwhelming, especially if someone is coming to therapy for anxiety-related issues. Common reasons that someone may come into counseling: relationship problems, trauma, work problems, mood problems, goals, life changes, intense feelings, and grief. Your counselor is there to talk about anything that is on your mind and important to you, but in the very beginning it is understandable that a person may think, “Where the heck do I start?” The reason for this is because we are complicated creatures, and when things aren’t working, there is rarely a single thing that we can point to and identify as the only problem. Knowing that this is the case, it can feel daunting to figure out where to start. Before we move on to the rest of the article, I’m going to share something with you that I tell clients who say that they don’t know what to talk about: It’s okay. It’s your counselor’s job to help you search for answers, and in the course of doing this we ask a lot of questions. You can come in with an outline if you like, but you can also just come in.
The article* recommends asking yourself a few questions before you come in though, which will help you decide what kinds of things you’d like to address. Ask yourself:
What is the reason I decided to contact this counselor?
Where do I feel stuck?
How do I feel about my relationships and my career?
What would I change in my life right now?
You can also think of your first appointment as your chance to interview your counselor. My view of the first session(s) is that we need to gather some information. I think it’s great if clients think of the first session(s) as their opportunity to figure out if I’m a good fit for them too.
The next section of this article brings up the question of why a therapist might be silent at times. This question is addressed in terms of different therapy styles, and it brings up that treatment methods can range from structured to free-flowing. That’s good for clients to know because there are many different ways to do therapy. If you find that a method isn’t working for you, it might be that this particular therapeutic style or the therapeutic relationship between you and your counselor isn’t good for you, not that therapy won’t work. This question also brings to mind something that I do from time to time, which is to allow some silence for clients to reflect. No, this doesn’t mean that I’m going to start a staring contest with anyone, but sometimes I can tell from the distant look in a client’s eyes that they are thinking something through. When I see this, I want to give that person space to ponder before I ask another question or make another statement. I know that silence can be uncomfortable for some, but it can also offer people an opportunity to think.
The last section is about whether there are things a person shouldn’t say to their counselor. A person might have concerns* that the counselor will either repeat something that has been said in session or that the counselor may judge them. First of all, counselors have to keep their mouths shut about what clients tell them. My family knows to not ask questions about clients because I simply won’t answer those questions. It is an ethical responsibility for us to honor a client’s confidentiality and privacy. There are, however, things that we can’t keep to ourselves. We might have to share what we know if it’s necessary to prevent a client from committing suicide or harming someone else. We are mandated to report abuse or neglect of anyone under the age of 18 or over the age of 65, or a dependent adult. We can also be compelled by a judge to disclose what we have been told by a client. Other than that, we keep things private. As far as judging clients about the things they tell us, a good counselor doesn’t do this. You should expect your counselor to respect your right to keep things to yourself, and you should also know that some discomfort is a necessary part of growth. Your counselor isn’t there to judge you, and in fact, they may help you find peace with decisions from your past. It is a normal fear, but I’ve found that shame only really thrives in the dark. Once it is brought out into the light, shame isn’t as strong.
One main piece of advice that I’d like to leave for anyone who is considering entering therapy is to just go. Yes, it is a scary thing for most people to start. That’s not a bad thing. If we were never scared, we’d never have a chance to be brave. Anything that worries you about starting therapy has probably been a worry that hundreds of our clients have expressed before.
*Psychology Today, January/February 2024 issue: What to Talk About in Therapy.