What to Talk About in Therapy

Talk to your therapist about their approach

Far too many people continue attending therapy feeling that they’ve hit a standstill, but being afraid to speak up about it. Again, this is understandable. After all, the therapist is the one with all the education, training, and experience; they must know what they’re doing. Right?

Wrong.

Along with finding the right therapist and ensuring that they use evidence-based approaches, being an active participant in your own growth is the best way to help yourself achieve your goals for therapy.

Even effective, well-intentioned therapists can be unsure of how to help their clients, especially when communication is evaporating into avoidance. Many people report that they go through the same experience of continually discussing the events that transpired between sessions without making any progress. If you find this is your situation, tell your therapist that it’s time for them to help you steer the conversation back towards your goals and progress.

If you’re just showing up, going with your therapist’s flow, hoping that it works out, you won’t be able to make the progress you deserve. Speaking up, advocating for yourself, and providing your therapist with feedback and even criticism when appropriate is the best way to make sure that your needs are being met.

Good therapists utilize a number of different approaches depending on your unique needs and unique scenarios. Some people respond better to certain approaches than others. Part of moving your therapy in the right direction involves you and your therapist getting on the same page about what feels helpful and what doesn’t. For this to happen, you’ll need to speak up.

Feel free to go ahead and tell your therapist, “It doesn’t feel helpful when you simply ask me about how my week was,” for example.

At the same time, you can tell your therapist when you particularly like some approach they’re taking and encourage them to use that approach more.

It is your right to speak up if you feel that your sessions are unproductive. No therapeutic path is right for everyone, and you’re not doing something wrong if something isn’t working for you.

Tell your therapist how you feel about them

In addition to providing your therapist with feedback about what’s helpful and not helpful to you, it’s important to tell your therapist how you feel about them, especially if you’re having feelings of avoidance, irritation, or embarrassment. I know this sounds cringey, but trust me — this is where the action is, and can lead to hugely powerful growth moments for you. 

If you’re worrying that your therapist will be annoyed with you, or dismissive of you if you ask for what you need, tell them! Your therapist is there to help you heal and to develop self-esteem, not to judge you, and if you’re holding things back from them out of feel, you won’t be able to make as much progress as you otherwise could.

Be fearless, and say how you feel. We need to know! But even more importantly, speaking up assertively and authentically with your therapist about how you’re feeling in your relationship with them IS THE WORK. It’s basically training wheels for being able to be assertive and have healthy boundaries with people in other parts of your life.

Also, if your therapist has said something that rubbed you the wrong way, or felt invalidating, or minimizing, or hurt your feelings, it’s vital to share that openly. We’re humans, and we say the wrong things sometimes! We’re also trying to have a real relationship with you that is devoted to your growth. Telling us how you feel about us can be not just good for your work in therapy, it can be a really powerful growth experience that leads to positive changes and greater security in your other relationships too.

Consider this: The way you unconsciously relate to your therapist can be the way you relate to people in general. Issues you have with us are going to feel familiar. But working through these feelings with us is how to change your patterns in all of your relationships.

If you need therapy, it’s likely that your therapist is one of the most non-judgmental and unconditionally accepting and supportive people in your life. Having emotionally safe relationships with people is what we do! So your therapist is a safe person for you to practice being authentic and assertive with, and it also gives you a chance to gain awareness about your patterns.

Furthermore, telling your therapist about how you feel about them allows you to understand how you habitually feel in many of your relationships. For example, if you worry that your therapist is going to judge you, or reject you, or become angry with you, or dislike you — say that to them. It can shed a lot of light on your attachment patterns and other ingrained styles of relating.

I have clients who have had huge breakthroughs in their personal growth work when they’ve had the courage to tell me that they were afraid of my reactions to them, and that it was keeping them from being fully honest with me. Once they did, and we could talk through it, it helped them understand that they were projecting (on to me) the fears that they have with many people in their lives — and how their assumptions are often untrue. It also allowed them to become more honest with me, and more vulnerable in our relationship. They could then open up about aspects of their experience that they’d formerly felt a lot of shame around, and this was really healing for them. 

Your relationship with your therapist is a professional relationship with unique boundaries, but it’s still a real relationship. When you and your therapist can address the relationship you have together, openly and honestly, it can lead to incredibly powerful growth work.

Talk to your therapist about your boundaries

It may sound contradictory after emphasizing goals and progress, but there are some cases in which therapists may push their clients to move past feelings they’re not ready to move past yet. Especially when grief and loss are involved, the real value of a therapy setting might be its function as a “container” or “safe space.”

Many people who’ve lost loved ones, for example, find it difficult or frustrating to talk about their loss with close friends and family members. They may simply want someone to listen and be there, but often, other people don’t know how to help and try their best to give practical, productive advice. Then, if they go to therapy seeking a container space where they can sit and feel their loss and the therapist also starts trying to “fix” and “resolve their symptoms,” the frustration and helplessness are multiplied.

Just like it’s okay to ask your therapist to provide you with a more structured or active approach, it’s also okay to say, “What I need from you today is just to sit and listen while I talk through some things. Please help me process this.” 

If you’re in any situation in therapy where your therapist is trying to push you to make progress but you’re simply not ready, tell them!