When you’re stuck for words in therapy, don’t give up. Simply use these tips to gain clarity on what you want to say…

It’s hard to know where to begin when you start therapy. Some people may arrive with a specific issue to discuss, and the session may go by in a flash, but, often, we find ourselves unsure of what to say.

“Many people struggle to know exactly what to talk about, or where to start,” says Laura Greenwood, a cognitive behavioural psychotherapist. “It’s natural to be nervous. You may be talking about intimate experiences, which you may not have told anyone before. Often, these nerves settle once you feel safe with the therapist. Once you begin talking, and your therapist is listening and eager to support you, the words flow.”

To help ease you into things if you’re unsure of what to talk about, here are some things to consider when entering the therapy room.

Talk about why you’re there

It’s common to have an introductory session, so your therapist can better understand your needs. It can be helpful to write down any thoughts, worries, or feelings beforehand so you can refer back to them.

“In an initial appointment, I explore the key reasons for seeking therapy, and what you might be struggling with,” says Laura. “Giving as much information as possible helps your therapist to devise a support plan that is going to be beneficial and personalised for you.”

Talk about your goals

It’s a common misconception that you should always bring a specific ‘problem’ to therapy, but you can also focus on goals. You may want to build your self-confidence at work, reduce stress, plan for early retirement, or find strategies for menopause-related anxiety – whatever reasons you have are valid.

“We might seek therapy because something doesn’t feel right, or we’re struggling,” says Laura. “Therapists are also eager to know what it is you would like to change about your struggles, and what your goals are.”

Talk about life challenges

If something is occupying your thoughts or stirring your emotions, it’s important to talk about it – whether it’s a change in living arrangements, relationship conflicts, a shift in workload, or caring for an elderly relative. Often, these challenges are ripe with potential for self-growth.

“Life challenges or recurring patterns that feel hard to break – and even fleeting or seemingly insignificant emotions – can all lead to valuable insights that facilitate healing,” says psychologist Amanda Charles.

Talk about trauma

Talking about a traumatic experience can be a crucial step in processing it, but it can feel overwhelming. Remember that you are in control of what, how, and when you share. You may want to approach the subject in layers, by discussing how the event has affected you generally, before moving on to specifics.

“Start with what feels manageable, even if it’s just mentioning that something is hard to talk about,” says Amanda. “This gives your therapist a cue to guide the conversation, without pressuring you to get into the details right away.

“Therapists are trained to help you explore at a pace that feels safe. Therapy isn’t about reliving your pain, but about understanding, processing, and releasing it in a way that feels empowering.”

Delving into the past can help us understand the roots of current struggles. Even things that feel ‘minor’ could help explain why you’re struggling today. It takes time to feel comfortable enough to open up with a therapist. And remember, finding the right one is key – so don’t feel afraid to find a new one.

Talk about your relationships

“Therapy is your space to explore your feelings, thoughts, and experiences,” says Amanda. “Talking about a relationship in therapy isn’t about criticising the other person. It’s about understanding how the relationship is affecting you, and exploring how you can navigate challenges.”

Feelings of guilt are common, but it’s important to remember that your intention isn’t to hurt your loved one. Your therapist will be able to help you gain insight and develop the tools to address issues thoughtfully. “It helps you develop emotional intelligence and self-awareness, enabling you to communicate your feelings in ways that foster connection,” she adds.

Talk about the good things

Therapy is also a space to celebrate wins, explore your strengths, and reflect on moments of joy, says Amanda. “Discussing positive experiences, achievements, or relationships can deepen your understanding of what fulfills and energises you, which is essential for creating a fulfilling life,” she says.

Healing isn’t just about working through what’s wrong – it’s also about recognising and nurturing what’s going right. “Reflecting on times when you felt confident, connected, or proud can help you reconnect with that energy, and use it as a foundation for further growth,” says Amanda.