How to Get the Most Out of Psychotherapy, a Series
Part 2: What to Talk About
In the beginning of therapy, we often have so much to say. Usually we’re coming in beyond the point of needing to talk about a thing or several things. And sometimes we’ll have periods in which there is a crisis that we really have to discuss.
What about the other times when there isn’t something urgent? As a therapist, I know people can have anxiety about what to talk about in therapy. It’s a different situation than we’re used to being in socially. Especially if you have anxiety, not knowing what to expect, what is expected of you, or how to do it “right” can be a hurdle in therapy. But it doesn’t have to be.
Unlike a weekly one-on-one we might have with a manager, a therapy session doesn’t have a set agenda and you’re not being evaluated on your performance. And unlike talking with a friend, it doesn’t include taking a turn as a listener while your friend confides in you.
It’s okay to come in with ideas of what you want to talk about and it’s okay to come in without ready ideas. Both can be productive. What you want to avoid is filler. By filler, I mean talking to fill the space as opposed to talking about something that you feel emotionally connected to. A cue that you are using filler is if you have said exactly what you are saying before, to someone else.
There can be many reasons people end up using filler or storytelling in therapy, such as:
an expression of anxiety
a desire to be a good client who is making progress
a fear of or unfamiliarity with emotions
a desire to avoid crying or losing control
fear of content (what might I discover?)
fear of what the therapist might ask/say
Also, some people are temperamentally more chatty. Finding yourself filling time this way isn’t wrong; it’s all additional information about you and how you are in relationships. That’s the kind of information you and your therapist can use to help you gain self-awareness. As a therapist, if I sense we’re in filler territory. I’ll bring it up in a gentle way as something we can be curious about together. I do this because I want you to get the most you can out of our sessions.
Besides wondering about the questions above, there are four tactics I learned as a client in therapy to cutting through the filler:
What can I only talk about here?
You will need to fill your therapist in on history and details– but there is a layer of discussion possible with your therapist that you might not be able to express anywhere else. Often, this layer connects to difficult feelings like shame or embarrassment.Those things, while really challenging to talk about, are exactly what you can bring to therapy. Your therapist is on your side, ready to give you the benefit of the doubt, ready to listen without judging you. Just talking about something shameful with an empathetic person helps to heal and drain the shame.
Return to Goals
While therapy doesn’t have a daily agenda, there are agreed upon goals that you started out with and themes that develop. Returning to those themes and goals or talking with your therapist about where you are in relation to your goals is also a good option when you feel directionless. Goals and priorities naturally shift over time as you make progress or during difficult times.Bring in a Dream
Dream content is a direct link to the unconscious. Dreams, especially our own, can be easy to dismiss, but bringing in a dream can yield a lot of valuable new information. I find that it’s harder to decipher a dream on my own. A person listening will hear different aspects than you do. Dream information is typically something that we do not consciously know already. It’s new information. So, with dreamwork try being intentionally open to discovery instead of reading the dream literally.
Where did we end last session?
Therapy has continuity— sessions aren’t stand alone. You’re not starting over from square one each time; there is a thread connecting all of your sessions and a place where you ended last session. When you are at a loss, you can reflect on what you took away from the last session, where you ended, and potentially pick up there.
It is so much better to tell your therapist that you’re not sure what to talk about than to fill the space talking about something you don’t feel emotionally connected to.
Therapy is a partnership; you don’t have to figure things out alone. It’s always okay to ask for help and talk about how the therapy is going, including if you are feeling awkward, stuck, or unsure of how to move forward. Times when there isn’t a burning topic to discuss are truly opportunities in therapy to get to another layer of discovery.
