Nervous about what to talk about in Therapy? 5 ideas to get you started

5 Conversation Ideas To Help Ease Nervousness In Therapy Sessions

You have been thinking about getting therapy for a while- you finally get to the point of doing your research, looking for a good therapist, reading reviews and seeing if they are a good fit for you and can help you.

Starting therapy can feel like a huge step—one that’s equal parts exciting and nerve-wracking. You book the first session and It’s a mix of hope, relief, and then…panic? Suddenly, you’re wondering, “What am I even going to talk about?” You may know what you want to talk about but probably don’t know how to articulate it. Or you may have several things to talk about but don’t know where to start from. It’s okay to feel nervous, but you don’t need to have it all figured out.

Here’s the thing: you don’t need to have everything figured out. In fact, the beauty of therapy is that you don’t have to walk in with a neatly wrapped agenda. But, if you’re someone who likes to be a little prepared, here are five ways to get started:

1) The Presenting Problem :

Even if you’re not entirely sure what’s bothering you, chances are something brought you to this point. Maybe it’s stress, relationship issues, or just feeling “off.” You can simply start by saying what’s on your mind. Don’t worry about making it sound perfect – therapy is a judgment-free zone, so there’s no right or wrong way to do this.

For Example – You start by telling your therapist, “I’ve been feeling anxious a lot lately. Sometimes, it’s just this sense of dread that comes out of nowhere. I don’t even know if it’s something specific, but it’s been making it hard to focus at work or relax at home.”

Your therapist might dig deeper into when this feeling started or what might be triggering it. Even if you don’t have all the answers, acknowledging the anxiety is a good place to start.

2) Recent Life Events :

Recent life events—whether big or small—can shake up your emotional balance. Have you experienced a change in your job, a relationship shift, or the loss of a loved one? Even positive changes, like moving to a new city or getting a promotion, can bring up stress or anxiety. Talking about these events helps your therapist understand how your current circumstances might be affecting you.

For Example: You might say, “I recently switched jobs and I feel this constant pressure to prove myself. I’m always worried I’m going to mess up, and it’s making me anxious all the time.” These life changes, whether joyful or challenging, often come with unexpected emotional baggage. By discussing them, your therapist can help you process what’s happening and how you’re feeling about it.

3) Physiological state and Daily Routine :

Sometimes, it’s not just your thoughts that need attention—your body may be telling a story, too. Do you feel tense? Are you clenching your jaw or having trouble sleeping? Maybe your heart races when certain topics come up. These physical cues can offer valuable insight during therapy, and it’s worth paying attention to how your body reacts.

example: You might say,”I’ve noticed that every time I talk about work, I feel my shoulders tensing up, and my stomach gets tight.I didn’t realize how much stress it’s causing me physically until now.”

Your therapist can help you connect the dots between your emotional and physical responses, which is often the first step in understanding how deeply certain stressors or emotions are affecting you. You may also explore ways to release that tension, whether through mindfulness, relaxation techniques, or addressing the underlying issue.

4) Goals in Therapy :

When you go for therapy, you know what you want help with. You can have certain goals in mind. Do you want to feel less anxious? More confident? Better equipped to deal with everyday stress? Sharing these small goals can give your therapist a starting point to guide the sessions.

Example : This can be as simple as saying, “I just want to stop feeling like I’m constantly on edge,” or “I’d like to be more emotionally regulated.’’ Your therapist and you can collaboratively work on those goals and develop an action plan to achieve them.

5) Be Honest about feeling Unsure:

You can simply start by stating that you’re unsure about this. If you walk in and say, “I’m not even sure what I’m doing here,” that’s completely okay! Your therapist is there to help you figure it out, and being open about feeling confused or uncertain is a great place to start. You don’t need to have a clear direction on day one. You can talk about anything under the sun, there are no seemingly big or small issues from the lens of therapy.

Whether you come in with a clear issue or just a general sense of unease, the key is to start talking. Your therapist is there to help you make sense of it all, and with time, you’ll begin to understand more about yourself and what you need to feel better. It’s all about taking that first step and trusting that the rest will unfold.

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