Help! I Have No Idea What to Talk About in Therapy: An A to Z Guide
I remember when I first started therapy, I was so nervous about what I was supposed to talk about. I thought I needed to come in with a big list of problems or life-changing insights, and on the weeks when nothing major was happening, I’d start to worry about sitting there in an awkward silence…
If you’ve ever felt this way too, you’re not alone. The truth is, therapy isn’t just about processing crises; it’s also a space for exploration, reflection, and growth. And if you’re not sure where to start, that’s okay!
As a therapist, I completely understand this feeling, which is why when my own clients come in and don’t know what to talk about that day, I actually get excited. Those are often the sessions where we can go deeper - exploring things that haven’t been fully processed yet or uncovering patterns that might otherwise go unnoticed. Sometimes, I’ll use those moments to review progress with goals and set new ones, finally address the things that may have been left on the back burner during times of crisis, or explore different areas of life that haven’t been discussed as much. These sessions can end up being some of the most meaningful, leading to insights that might not have surfaced otherwise.
To help you get started, I’ve put together an ABC list of topics you can explore in therapy when you’re feeling stuck:
A - Attachment
Attachment refers to the emotional bonds we form with others, often shaped by early experiences. Exploring your attachment style (secure, anxious, avoidant, or disorganized) can help you understand your relationship patterns and work toward more secure connections.
B - Boundaries
Boundaries define what is and isn’t acceptable in how others treat you. Learning to set and maintain healthy boundaries can improve relationships, reduce resentment, and protect your emotional well-being.
C - Communication
Communication is the way we share thoughts, feelings, and needs with others. Effective communication—both listening and expressing ourselves—is vital for healthy relationships. Therapy can help you explore your communication style, improve how you express yourself, and learn strategies for more constructive conversations, especially during conflict.
D - Defensiveness
Defensiveness often arises when we feel attacked, misunderstood, or vulnerable. It can create barriers in communication and prevent us from hearing others' perspectives. Exploring defensiveness in therapy can help you understand its roots and develop healthier ways to respond to criticism or conflict.
E - Emotions
Emotions are an integral part of our experience, guiding us and signaling how we relate to the world. Therapy helps you identify, understand, and regulate your emotions, ensuring they are expressed healthily and constructively.
F - Family Dynamics
Family dynamics refer to the patterns of behavior, roles, and relationships within your family. These dynamics often influence how we see ourselves, others, and how we engage in future relationships. Therapy can help you explore family dynamics to understand how they impact your current emotional well-being and relationship patterns.
G - Grief
Grief is the deep sorrow we feel from loss, which could be a person, identity, or life phase. It’s a natural response to change, yet it often goes unprocessed.Therapy provides a space to process grief, honor what was lost, and find ways to move forward.
H - Habits
Our habits shape our daily lives, sometimes without us realizing it. Examining both helpful and harmful habits in therapy can help you break cycles that no longer serve you and create new, healthier routines.
I - Identity
Who are you outside of your roles, relationships, or expectations from others? Exploring identity in therapy can help you embrace your authentic self and build confidence in who you are becoming.
J - Judgment
Judgment, whether directed toward yourself or others, often stems from critical thoughts and can block connection and growth. Exploring judgment in therapy helps you recognize where it’s limiting your ability to be compassionate toward yourself and others.
K - Kindness
Kindness is the ability to show compassion and care toward others—and yourself. Exploring self-kindness in therapy can help you reduce self-criticism, perfectionism, and guilt. Cultivating kindness can make space for self-acceptance and emotional healing.
L - Limiting Beliefs
Limiting beliefs are deeply held negative thoughts about yourself that hinder your full potential, such as “I’m not good enough” or “I can’t succeed.” Therapy helps you identify these beliefs, understand their origin, and work on replacing them with empowering, positive beliefs.
M - Mindfulness
Mindfulness is the practice of staying present in the moment, observing thoughts and feelings without judgment. Incorporating mindfulness into therapy can help reduce anxiety, manage stress, and increase emotional regulation.
N - Needs
Many people struggle with identifying and advocating for their needs. Therapy can help you understand what you truly need emotionally, physically, and mentally—and how to communicate those needs effectively.
O - Overthinking
Overthinking can keep you stuck in cycles of worry and indecision. Therapy can help you break free from analysis paralysis and develop healthier ways of processing your thoughts.
P - Purpose
A sense of purpose can bring meaning and direction to life. Therapy can help you explore your passions, values, and goals to create a life that feels fulfilling and aligned with who you are.
Q - Quality of Life
Quality of life refers to the overall sense of fulfillment, happiness, and balance you feel in your life. Exploring your quality of life in therapy can help you identify areas where you may feel unfulfilled or stressed and develop strategies to improve your well-being and satisfaction. If you're feeling disconnected from your passions or overwhelmed by your daily routine, therapy can help you explore what changes can be made to bring more joy, meaning, and balance into your life.
R - Regret
Regret can stem from past decisions that we wish we had handled differently. Therapy helps you explore these feelings, understand the lessons learned, and find ways to forgive yourself, ultimately allowing you to move forward without being held back by the past.
S - Self-Worth
Struggling with self-worth can affect every aspect of life. Therapy can help you unpack negative beliefs, challenge self-doubt, and develop a stronger sense of confidence and self-acceptance.
T - Trauma
Past trauma can continue to impact thoughts, emotions, and behaviors in the present. Processing trauma in therapy can help you heal, regain control, and move forward in a healthier way.
U - Uncertainty
Life is full of uncertainty, which can trigger anxiety and fear. Therapy can help you develop resilience, flexibility, and coping skills to navigate the unknown with more ease.
V - Vulnerability
Many people fear vulnerability because it feels risky, but it’s also the key to deep connection and authenticity. Therapy can help you build the courage to be vulnerable in safe and meaningful ways.
W - Work-Life Balance
Balancing work and personal life is essential for long-term health and happiness. Therapy helps you explore how to manage stress, set boundaries, and prioritize self-care, leading to greater fulfillment in both work and life.
X - eXpectations
Unrealistic expectations—whether self-imposed or external—can lead to frustration and disappointment. Therapy can help you set healthier, more realistic expectations that align with your well-being.
Y - Yearning
What do you deeply long for? Whether it’s connection, change, or personal growth, exploring your desires in therapy can help you clarify what truly matters to you.
Z - Zeal
Zeal is the passion and enthusiasm we feel for life, our goals, or our interests. Exploring what sparks your zeal in therapy can help you reconnect with what excites you, cultivating a sense of purpose and motivation to move toward your aspirations.
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As you explore these topics in therapy, remember that this process is personal and unique to you. There’s no “right” way to navigate therapy, whether you’re working through deep emotions, uncovering limiting beliefs, or simply gaining clarity, every step you take is part of your growth journey.
If you’re feeling unsure about where to start or what to focus on in therapy, you're not alone. Reach out to our client care coordinator today to find a therapist who is the right fit for you.
Happy exploring!
Kalie Pham, AMFT
