I Want Therapy, But I Don’t Know What to Talk About
Maybe you’ve been thinking about therapy for a while. You know something doesn’t feel right. Maybe you’re anxious more often than you’d like to admit, you’re exhausted from overthinking, something from your past still bothers you, or your relationships keep bringing up the same feelings. Maybe you just don’t feel like yourself lately.
You’ve even thought, Maybe I should talk to someone.
And then your brain immediately follows that up with: But what would I even talk about?
Maybe you imagine sitting across from a therapist while she waits for you to explain your entire life, and suddenly you can’t remember a single thing that has ever happened to you. Very convenient, brain.
Or maybe you know there’s a lot there, but you have no idea where to begin.
Here’s what I want you to know: you do not need to know exactly what to talk about before starting therapy. You can show up with a feeling, a recent situation, something from your past, a pattern you keep noticing, a relationship that’s been weighing on you, or simply:
“I don’t really know where to start. I just know I don’t want to keep feeling like this.”
We can start there.
What Do I Talk About in Therapy If I Don’t Know Where to Start?
You don’t need a perfectly organized explanation of what’s wrong. And you definitely don’t need a PowerPoint presentation covering everything that has happened to you since childhood.
Part of therapy is figuring things out together, including what’s been happening, what’s hurting, the patterns you’ve noticed, what you want to better understand about yourself, and what you’d like to feel different moving forward.
Sometimes people come to therapy knowing exactly what they want to work on. Other times, they come in saying things like:
“I’ve been overwhelmed lately and I don’t really know why.”
“I keep getting into the same kind of relationships.”
“I thought I was over what happened, but apparently I’m not.”
“I’m tired of overthinking everything.”
“I don’t know why setting boundaries makes me feel so guilty.”
“Everybody thinks I’m doing fine, but I don’t feel fine.”
“I don’t even know what I need. I just know something needs to change.”
Those are all places we can begin. You don’t have to understand the entire story before you tell someone the first sentence.
What If My Problems Aren’t Serious Enough for Therapy?
This is one of the biggest ways people talk themselves out of asking for help. You may tell yourself, Other people have been through worse. I’m still functioning. It’s not that serious. I should be able to handle this myself.
And because you’re still getting up, going to work, taking care of responsibilities, and showing up for other people, you may convince yourself that whatever you’re carrying doesn’t “count.”
But functioning and feeling okay are not the same thing. You can be getting everything done and still feel anxious, disconnected, overwhelmed, lonely, angry, exhausted, or emotionally drained underneath it all.
If you’ve been wondering whether what you’re experiencing is “enough” for therapy, I wrote more about this in I’ve Been Pushing Through for Years. How Do I Know When It’s Time to Start Therapy?
Therapy isn’t reserved for the moment when everything finally falls apart. Sometimes you start because you’re tired of waiting for it to get that far.
What If I Sit There and Have Nothing to Say?
This fear makes sense, especially if you’re not used to talking about yourself. Maybe you’re normally the listener. Maybe you’re the person other people call when they need something. Maybe when someone asks how you’re doing, your automatic response is “I’m good,” and depending on the day, you may even convince yourself that’s true.
So sitting in a space where the conversation is actually about you can feel unfamiliar.
You might worry there will be an awkward silence and your therapist will stare at you while you desperately search your brain for something interesting enough to say. That isn’t how therapy has to work.
I’m not expecting you to walk into a session with an agenda and three discussion topics prepared. We can talk about what happened that week, something you’ve been thinking about, a conversation that bothered you more than you expected, something you keep avoiding, a feeling you don’t understand, or a decision you’re struggling with.
Sometimes we may even start with “I don’t know what I want to talk about today” and see where we go from there. Silence can happen in therapy too. You don’t have to fill every second.
This isn’t a performance.
What If I Start Crying and Can’t Stop?
You’re allowed to cry in therapy. You’re also allowed not to cry. There isn’t a correct emotional response you’re supposed to have.
Some women have spent years trying to keep their emotions contained because letting themselves feel everything seemed unsafe, inconvenient, uncomfortable, or simply impossible. You may have learned to hold it together because somebody had to.
So when you finally have a space where you don’t have to do that, emotions may show up. That doesn’t mean you’re doing therapy wrong. And if you’re someone who rarely cries, that doesn’t mean you’re doing it wrong either.
Your healing doesn’t have to look dramatic to be meaningful.
What If I’m Not Ready to Talk About Everything?
Then we don’t talk about everything.
Seriously.
Starting therapy does not mean handing over every painful experience you’ve ever had during the first session. You get to have boundaries in therapy too.
Trauma-informed therapy isn’t about forcing you to tell your story before you feel safe enough to tell it. It’s also not about digging into painful memories simply because they exist. Sometimes the first part of the work is building trust. Sometimes it’s understanding what happens in your mind and body when you become overwhelmed. Sometimes it’s learning how to feel safer in the present before spending much time talking about the past.
And sometimes you may simply say, “There’s something I think I want to talk about eventually, but I’m not ready yet.”
That is information I can work with. You are allowed to move at a pace that feels manageable.
What If I Don’t Know What My Therapy Goals Are?
You don’t have to arrive saying, “My three measurable therapeutic objectives are...”
Please don’t put that kind of pressure on yourself.
Your goal might initially be I want to stop overthinking everything. I want to feel more confident. I want to understand why I keep choosing relationships that hurt me. I want to stop feeling guilty every time I say no. I want to process what happened to me. I want to feel like myself again.
Or maybe it’s simply: I honestly don’t know. I just know I don’t want to keep living like this.
That last one counts too.
As we work together and understand more about what’s happening, your goals can become clearer. They can also change. Therapy is collaborative. You don’t have to arrive knowing the destination before we’ve even looked at the map.
What If I Feel Guilty Talking About Myself?
This is another one I want to name because sometimes the discomfort isn’t actually “I don’t know what to talk about.”
Sometimes it’s: I’m not used to taking up this much space.
If you’re accustomed to being the listener, caretaker, helper, dependable one, or person who figures things out herself, having an hour centered around what you feel and need may bring up guilt.
You may worry that you’re complaining. Being selfish. Making too big a deal out of something. Or spending time and money on yourself when you “should” be able to handle things on your own.
That guilt can show up outside therapy too. You rest and feel like you should be doing something. You say no and immediately want to explain yourself. You choose what you need and start worrying about how everyone else feels about it.
If guilt tends to show up whenever you rest, set a boundary, ask for help, or choose yourself, download my free guilt worksheet to start noticing where that guilt comes from and how it may be keeping you stuck.
You don’t have to eliminate guilt before you start choosing yourself differently.
What If My Therapist Judges Me?
This fear can be especially strong when what you’re carrying involves shame. Maybe there are things you haven’t told anyone, choices you regret, relationships you stayed in longer than you think you “should” have, feelings toward people you’re “supposed” to love, or parts of your story you’re afraid someone else won’t understand.
Maybe things happened to you that you somehow learned to blame yourself for.
If you’ve spent years worrying that nobody will believe you, understand you, or really listen to you, opening up to a therapist can feel like a huge risk. That’s why the therapeutic relationship matters.
You deserve a space where you can be curious about your experiences without feeling like you have to defend them. That doesn’t mean I’ll agree with every thought you have or tell you everything you do is wonderful. Sometimes therapy includes noticing patterns, asking uncomfortable questions, and gently challenging things that may be keeping you stuck.
But challenge and judgment are not the same thing.
The goal isn’t for me to decide who you should be. It’s to help you understand yourself more deeply so you can make choices that feel more aligned with who you want to be.
What Actually Happens If I Say, “I Don’t Know Where to Start”?
We start there.
I might ask what made you decide to reach out now. Maybe something recently happened. Maybe nothing dramatic happened, but you’ve noticed that you’re tired of feeling the way you’ve been feeling.
We may talk about what life looks like right now, what feels hardest, what you’ve already tried, what your relationships are like, or what you wish could feel different. I may notice something you say and ask, “Can we stay there for a second?” Or, “You said that like it wasn’t a big deal. Does it feel like one?”
And sometimes we may realize that something you thought was completely unrelated connects to a pattern you’ve been experiencing for years.
You don’t have to connect all those dots by yourself before coming in.
That’s part of what we’re doing together.
Therapy Isn’t an Interview You Have to Pass
Sometimes starting therapy can feel like one more situation where you have to get things “right.” Say the right thing. Explain yourself correctly. Be vulnerable enough, but not too vulnerable. Have good goals. Make progress quickly. Be a “good” therapy client.
Nope.
You don’t need to impress me. You don’t need to tell your story in chronological order. You don’t have to remember every detail. You don’t have to make what happened sound worse so that I take it seriously, and you don’t have to minimize it so that I don’t think you’re being dramatic.
You get to show up as you are.
Confused counts. Nervous counts. Unsure counts.
I don’t know where to start counts.
You Don’t Have to Figure It Out Before You Ask for Help
If you’ve been waiting to start therapy until you can clearly explain what’s wrong, know exactly what you want to work on, or finally feel “ready,” you could be waiting a long time.
Sometimes clarity comes after you finally have somewhere safe enough to slow down and listen to yourself.
You may discover that the anxiety isn’t as random as you thought. That the guilt you feel when setting boundaries has a history. That the way you talk to yourself sounds a lot like someone who used to talk to you. That the relationship pattern you keep repeating makes more sense when you understand what you learned to expect from love.
Or you may realize you’ve spent so much time taking care of everybody else that you genuinely haven’t had much space to ask yourself what you need.
If you’ve been functioning on the outside while privately feeling exhausted, overwhelmed, or unlike yourself, you may also relate to I Look Fine on the Outside, So Why Am I Struggling So Much Inside?
You don’t have to know what the whole journey will look like.
You just need somewhere to begin.
Ready to See What Therapy Could Look Like for You?
If you’ve been thinking about therapy but keep stopping yourself because you don’t know what you’d say, you can bring that uncertainty with you. You don’t need a perfectly organized story, you don’t need to know exactly what’s wrong, and you don’t need to have your goals figured out.
You can literally start with: “I don’t really know where to begin. I just know I’m tired of feeling like this.”
My approach is trauma-informed, collaborative, laidback, and direct when it needs to be. I think of therapy a little like a road trip. You’re the driver. I’m not taking over the steering wheel. I’m there beside you, helping you notice patterns, offering another perspective, and navigating with you when the road gets confusing.
I provide virtual individual therapy for adult women navigating trauma, grief, anxiety, depression, self-worth concerns, difficult relationships, and life transitions in North Carolina, Texas, Maryland, Georgia, South Carolina, and Florida.
If you’re ready to have a space where you don’t have to figure everything out by yourself, schedule a consultation. We can start with whatever you know right now.