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What to Do When You Don’t Know What to Talk About in Therapy



If you consistently have trouble speaking up in therapy, this can be an opportunity to check-in about the process and whether your therapist is a good fit. There are also different therapeutic styles, so it’s possible that you may do better with a different approach. Your therapist can work to tailor their methods to you or help you find someone else that you might like working with better. “I’m not the right therapist for everyone,” Dr. Pirutinsky says. He recalls one client who wasn’t engaged during their sessions. Eventually, Dr. Pirutinsky broached this with the individual, learned the person preferred working with a therapist who was Black, and helped his patient find a new therapist.

Dr. Johnson agrees that it’s really useful for her to know when someone is struggling with their sessions. “That really helps me understand, ‘OK I think what we need to do at this moment is explore that more. I need to ask more digging questions rather than very broad surface-level questions,” she says.

Oftentimes, people begin therapy when they have a lot going on. But once you’ve worked through some specific events (for example, managing work stress) you may feel like you have nothing to talk about. That can be a good opportunity to explore and process deeper areas, such as having self-esteem issues or previous traumas. “As a therapist, I can be like, ‘Well, this is something that you’ve wanted to talk about, but you’ve had a lot going on. I wonder if now is a time when you have more resilience to talk about that,’” Dr. Johnson says. To this end, your therapist might ask about past experiences so you can reflect on patterns or gain insight into how prior events affect your outlook and behavior now.

A “quiet” session can also be a chance to create or re-evaluate goals, both experts say. “Sometimes, silence indicates that you’ve accomplished some things. Either it’s time to focus on new goals or integrate new methods to accomplish your goals,” Dr. Pirutinsky says. Depending on your particular situation, you and your therapist might decide to adopt a new strategy for your sessions or discuss if you want to continue with therapy at all.

“Sometimes I might say, ‘It sounds like you are at a place where therapy is not something that you need right now,”’ Dr. Johnson says. “That can be a scary thing for someone, especially if you’ve gotten a lot out of therapy.” If you don’t feel ready to give up therapy completely, then you may just go less often.

Experiment with ways to stimulate conversation in therapy.

There are no rules for going to therapy, but there are ways to feel like you’re being more thoughtful in your sessions. One way to do that is by preparing for your meeting. Throughout the week, keep track of things that happen so you don’t forget and then bring that list to therapy. These situations don’t have to feel very big either—they can include a misunderstanding you had with a friend, waking up feeling irritable one day, or listening to a particular song on repeat. (You can do this informally on your notes app.)


Bringing in props, such as family photos, a poem you wrote, or a song that resonates with you can help get things going, too, Dr. Pirutinsky says. “Human beings are so multifactorial and complex, and there are many, many ways of getting to know someone,” Dr. Pirutinsky explains. For example, exploring why you can’t stop listening to a certain song can be insightful. Similarly, talking about photos can help people remember details more vividly and is helpful when talking about painful memories (with a little questioning and guidance from your therapist).

Whenever you’re feeling stuck in the middle of a session, try to take that moment to yourself and do a brief body scan, Dr. Johnson says. You can even say something like, “I don’t know what to talk about, so I’m going to take a brief moment to reflect on how I’m feeling.” Then, close your eyes and tune into how your body feels in that moment—and if you’re holding onto any tension—and discuss whatever feelings you notice with your therapist.

Remember that progress isn’t immediate. Some sessions may just feel uneventful, and it can take some time before you notice any changes or feel like you’ve gained insight. “Sometimes it can feel like a session was really helpful, and we feel really good about those sessions. It’s normal for some sessions to not seem super productive,” Dr. Johnson says. “Therapy is a process.”


Source: Self


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