"Help, I'm in Therapy and Don't Know What to Say!" - A Guide to Normalize that Awkwardly Introspective Space

What to talk about in therapy.

Ever sat down in a therapy session and suddenly forgotten every problem you've ever had? You're not alone. Here's your guide to navigating the "So, what should we talk about today?" moment without pretending your life is suddenly perfect.

At least twice a week, people sit in my office with this feeling. At the end of the session, they often say, "Well, I feel lighter. I wasn't sure what I was going to talk about, but I'm glad I came." This leads to what next week's blog will be about: the four ways therapy helps. For now, let's get back to how to fill that space when your mind goes blank.

The "Everything's Fine" Paradox

Isn't it funny how your life can feel like a three-ring circus all week, but the moment you sit in that therapy chair, you're suddenly "fine"? It's like your problems went on vacation right when you needed them to show up for work.

People have mixed interpretations of this experience. Sometimes, they feel like this means they're steady and ready to space out therapy sessions. Other times, they feel like this means their brain associates the therapy office with a safe space to take a break from trying to manage the chaos of life. Either way, I assure you that therapists experience this process more often than you may think. Here's how we navigate this.

Start With the Small Stuff

- That weird interaction with your barista? Talk about it.

- The fact that you organized your sock drawer at 3 AM? Mention it.

- The slight annoyance at your friend's Instagram post? Yep, that too.

Sometimes the smallest things are just wearing clever disguises as bigger issues.

Here's an example: I was sitting with some family this holiday season and really wanted to talk. At that moment, I started to feel anxious in silence. I could sense my core bracing and shoulders caving in, while my breathing became shallow. I chose to ask a tough question: "What's one lesson you think people should learn in life?" The conversation flowed in ways I didn't anticipate, and I noticed that throughout the talk, my core trembled, and my breathing shifted into various modes. My body was regulating itself, and although the conversation didn't go great, it went better than expected.

As a therapist reading this, I might explore what was it about the silence that felt intimidating. Was it the people or context? What value did you pursue and how could that help navigate future moments? 0-10 (10 being the most pride ever); how proud of your choice to ask the question and engage in conversation were you? Did you feel you had to talk or did you choose to talk? So many possibilities for further exploration, even though the "small talk" went well.

The "Right Now" Rule

Can't think of anything profound? Start with:

- How you're feeling right this minute

- What made you sigh heavily today

- That thing you're trying not to think about (yeah, that one)

Many clients feel this to be intimidating at times. Two possible directions here: 1) they don't want to do therapy "wrong," or 2) they don't want to create conflict with the therapist. There is no right or wrong for therapy, which I'll explore in next week's blog. Secondly, conflict is not always aggression, anger, or division. Conflict, when a curious mind and seeking understanding are at the forefront, helps improve relationships.

For example, maybe you decide to share that you feel anxious about not having more to share. You are concerned you're not getting the value from therapy. As a therapist, I would steer our conversation to reflection on what you've made progress on in the past and what our next focus could be on. Sometimes, the silence reminds us that we've gotten into a pattern of checking in instead of focused teamwork to improve our wellness. That would be a worthwhile "conflict."

The Greatest Hits List

Keep a notes app list of things that pop up between sessions. It's like creating a playlist, but instead of bangers, it's:

- Random thoughts while driving

- Late-night worries

- Things that made you say "Ugh" out loud

I've lost track of the number of people asking if they can bring in journals or make notes throughout the week to bring up in session. YES! 10000000% yes! Please do so. That's an amazing tool, and I highly encourage anyone who likes lists or writing to bring it in. I've even had the privilege of being sent journal entries before the session so I can read them and we can jump right into processing what they wrote.

Permission to Be Boring

Here's a secret: therapy doesn't have to be dramatic. You don't need to have an emotional breakthrough every session. Sometimes talking about your new plant-watering schedule is actually code for discussing responsibility, care, and growth.

My wife used to ask, "Are there any breakthroughs today?" While they do happen, the bulk of therapy is piecing together patterns and retraining our behavior and brain to operate in new coping mechanisms. Sometimes, our brains are using iOS 1.0, which was great for the first iteration and helped us survive an environment that we're no longer in. New tools will help, though, and that comes from sometimes boring conversations about the neighbors' decorations you saw on your walk.

The "There's No Wrong Answer" Truth

Things you can totally talk about in therapy:

- Why you hate Mondays (beyond the obvious)

- Your relationship with your coffee maker

- That dream where you showed up to work as a penguin

- Why you're worried you're "doing therapy wrong"

How else can I reassure you that any talking is okay? I'll speak solely for myself here. I'm glad you showed up, glad you prioritized your wellness, and grateful that you're putting effort into the session by being alert. Coffee maker to trauma. Any conversation is welcome, as they all build rapport.

When in Doubt, Meta It Out:

- Why you're finding it hard to talk

- What you think you "should" be talking about

- The silence that's happening right now

- Why you picked this exact shade of blue for your therapy day outfit

Metacognition means thinking about thinking. Let's talk about your thoughts. Where they come from. New hobbies you've been exploring and how you made the decision to pursue those.

The Bottom Line

Remember: Your therapist isn't sitting there expecting you to deliver an Oscar-worthy monologue about your childhood. They're trained to help you navigate both the big crises and the "I don't know why I'm even mentioning this" moments.

Sometimes the most important sessions start with "So, this is probably stupid, but..." (Spoiler alert: it's probably not stupid.)

Just show up and be honest, even if that honesty is "I spent 20 minutes in the parking lot trying to decide if I should reschedule." That's therapy gold right there.