Therapy works when you know where to begin. Here are deeply effective things to talk about in therapy—from hidden emotional patterns to the roles you never chose but still carry.
Here’s the truth: there’s no “right” way to start therapy—but there are things to talk about in therapy that cut deeper, heal faster, and create clarity where confusion once lived. This isn’t a surface-level checklist. These are real, research-backed topics that help you finally get somewhere in therapy—whether you’re navigating anxiety, trauma, relationships, burnout, or grief.
Things to Talk About in Therapy
You walk into the therapist’s office.
You sit down.
And suddenly, your mind goes blank.
You thought you had so much to say—but now you’re second-guessing everything.
What’s too small to mention?
What’s too heavy to start with?
What if you sound dramatic, or worse, broken?
1. The Story You Tell Yourself About Who You Are
This isn’t just about what happened to you.
It’s about how you’ve internalized it.
Talk about the identity you’ve built around pain—like:
- “I’m the one who always gets left.”
- “I have to earn love.”
- “I’m too much or not enough.”
Psychologist Dr. Dan Siegel, clinical professor at UCLA School of Medicine, calls this your “narrative self.” He states, “If we don’t make sense of our story, our story controls us.” Therapy helps you rewrite it—on your terms.
Example: One woman realized she always introduced herself as “independent to a fault”—but in therapy, she explored how that phrase masked a deep mistrust of depending on others because of childhood abandonment.
2. The Patterns You Keep Repeating
Therapy gets powerful when you stop obsessing over what happened and start exploring why it keeps happening again.
Ask yourself:
- Why do I chase emotionally unavailable people?
- Why do I shut down when someone gets close?
- Why do I always feel like the problem?
Bring those patterns into the room. Not just the outcome—but the loop.
3. How You Were Loved (Or Not) as a Child
Attachment wounds run deeper than people admit.
They shape how you deal with closeness, rejection, trust, and self-worth.
Talk about:
- How your caregivers responded when you were upset
- Whether love felt conditional or safe
- If you had to parent yourself early
4. Your Relationship With Anger
Anger isn’t a “bad emotion.” It’s a compass.
If you suppress it, it becomes depression. If you fear it, it turns inward.
In therapy, talk about:
- What anger looks like for you
- How your family treated anger
- Where you store your rage—body, voice, or silence?
A man once realized in therapy that he never raised his voice—not because he was “calm,” but because he was terrified of turning into his aggressive father.
5. Your Relationship With Your Body
Your body holds more memory than your mind.
Talk about:
- How you feel in your skin
- Where you feel anxiety, shame, or numbness
- Times you dissociate or disconnect
6. The Things You Don’t Say Out Loud
Therapy isn’t small talk.
It’s the space where you say what you’ve never said before—even to yourself.
This could be:
- “I’m scared I’ll never be okay.”
- “I don’t think I love my partner anymore.”
- “I feel numb when I’m with my kids.”
These confessions are not shameful—they’re signposts pointing to buried pain. Saying them in therapy is a turning point.
7. What You Want From Life (Even If It Feels Selfish)
Goals aren’t just career plans. They’re emotional anchors.
Discuss:
- What you secretly want
- Why you don’t let yourself want it
- What you think will happen if you get what you want
8. Your Habits and Coping Mechanisms
Talk about the behaviors that help and hurt you:
- Doom scrolling at night
- Drinking to feel social
- Overworking to avoid intimacy
Don’t judge them—study them. These habits are adaptations. Therapy helps you understand the need behind them so you can choose differently.
9. Your Relationship With Control
Some people micromanage every detail. Others avoid decisions completely. Both are trauma responses.
In therapy, explore:
- Where you over-function or under-function
- If control gives you safety or makes you rigid
- Where you resist vulnerability
Control is often the shield protecting your most scared parts. Let therapy help you put the shield down.
10. Your Experience With Grief or Loss
Grief isn’t just death. It’s any loss:
- A friendship that faded
- A future that didn’t happen
- The version of you that existed before trauma
Talk about grief in therapy so it doesn’t settle inside you like fog.
11. How You Talk To Yourself
Self-talk is a running script.
In therapy, read it out loud. Listen to it. Re-write it.
Explore:
- The tone of your inner voice
- If you repeat phrases you heard growing up
- Whether you’d speak to a friend the way you speak to yourself
12. What Triggers You and Why
Triggers aren’t “overreactions.” They’re echoes.
In therapy, track:
- What situations set you off
- What emotion came up fast
- What memory it connects to
Knowing your triggers helps you regain your power.
13. How You Handle Conflict
Conflict reveals emotional wiring.
Do you:
- Go silent?
- Become sarcastic?
- Cry and apologize even when you’re not wrong?
Therapy helps you break those default modes. It teaches assertiveness, boundary-setting, and emotional regulation so conflict doesn’t become chaos.
14. The Roles You’ve Been Forced to Play
Maybe you were “the strong one.”
Or “the fixer.”
Or “the peacemaker.”
Roles you didn’t choose become cages.
Therapy helps you step out of those performances and figure out who you really are—without the pressure of carrying everyone else’s emotional weight.
15. What Safety Means to You Now
This is the most important question you’ll answer.
- Who feels safe?
- What situations feel unsafe?
- When do you feel most grounded?
Your therapist is trained to listen for safety—not just storylines. Once you understand your own nervous system, your healing becomes non-negotiable.
The hardest part isn’t talking.
It’s knowing what to talk about.
This list isn’t exhaustive—but it gives you a place to start. A direction. A thread to pull.
The most powerful things to talk about in therapy are the ones that feel raw, tender, and unfinished. Bring those pieces in. Let your therapist witness them without trying to fix them.
You don’t need a perfect narrative. You need honesty.
Not for their sake—but for your own.
This is your space. Use it.
