Figuring out what to talk about in therapy can feel daunting, but the most important part of this work is simply showing up. Take the phone or video call and settle into your space. Your therapist will be there to guide you and see how things have been going.
If your mind goes blank, don’t worry. Saying “I actually don’t know what to bring today” is a real opening that your therapist will work with.
Even if in that moment nothing feels organized enough, urgent enough, or coherent enough to say out loud, you’ll find that with the right therapist, saying it brings relief and clarity.
Just so you know, this experience is common and happens often in therapy. Yet it’s hardly talked about. There’s nothing wrong if this happens. And it doesn’t mean the session is going to be a waste.
Knowing what to talk about in therapy takes trust, vulnerability, and time. Some people come in every week with a carefully kept list. Others sit down and stare at the ceiling while their therapist waits. Both approaches get you somewhere.
Here’s what you can bring to therapy when you have a clear problem. And when you don’t.
That blank feeling before a session
“Fine” is a complicated word in therapy.
When you sit down and are unsure what to talk about in therapy, a few different things could be happening. Your therapist will likely want to explore which one.
Sometimes it’s state-dependent memory. The week felt heavy on Wednesday, but by the time your session rolls around, you can’t quite access the feeling. You know you were stressed. You just can’t feel it right now.
Sometimes it’s avoidance. “Nothing to talk about” can be a way of circling around something that’s still too uncomfortable to name directly. The thing you keep thinking about, almost bringing up, and then don’t. That actually matters.
And sometimes, genuinely, things are okay. You’re doing better. The space that used to be filled with crisis is now open and available for self-exploration. Take note of this progress. It’s worth talking about, because what you do with stability is part of the work too.
What people actually bring to therapy
There’s no checklist of approved topics. At Inner Room, therapy is about self-discovery, and likely one of the only spaces in your life where you bring your whole self.
Often, people start by talking about anxiety, depression, relationships that aren’t working, grief, trauma, and burnout. Eventually, they start to bring the quieter things: the thing they’re worried if spoken out loud would mean they’re a bad person, the guilt they have from responding to a loved one, a conversation from two weeks ago that still sits wrong, a pattern they keep noticing in themselves, the creeping feeling that they’ve become someone they don’t quite recognize.
Research consistently shows that the most common areas covered in therapy include current emotions and feelings, relationship dynamics (romantic, family, friendships, work), stress at work, recurring behavioral patterns, past experiences and how they’re showing up now, and questions about identity [1].
One study found that culture-related conversations (including discussions of identity, background, and lived experience) came up in approximately 43% of cross-cultural therapy sessions overall, and in nearly 48% of sessions when the therapist was a woman. More often than most people expect, and more often when clients had space to bring them [2].
If you’ve been dealing with exhaustion, difficulty concentrating, or a growing detachment from things that used to matter to you, those are all worth bringing. Also bring in any questions you may have around these feelings and experiences.
Examples of what to talk about in therapy.
The short answer: anything you’re thinking about is worth saying.
The longer answer is that certain areas tend to lead somewhere. These are the ones clients and therapists return to most:
- How you’re actually feeling right now, not the curated version
- Patterns you keep noticing in your relationships, reactions, or behaviours
- Something that happened recently that you’re still thinking about
- Stress at work, and what work is doing to the rest of your life
- Family dynamics, past or present
- Grief, loss, or a change you haven’t fully processed
- Your sense of identity, especially if something has shifted
- Anxiety, low mood, or anything that feels heavier than it used to; and/or
- What you want your life to look like and what seems to be getting in the way
Any of these is a real starting place. And the thing that’s been at the back of your mind since you read that first sentence? That one too.
What to talk about in your first therapy session
First sessions feel different from all the ones that follow. You don’t know your therapist and they don’t know you yet. You’re both figuring out whether this is a good fit.
You don’t need to arrive with a prepared speech or a complete history of everything that’s brought you here.
A few things that tend to be useful to mention:
The reasons that made you reach out when you did. The timing tells your therapist what’s shifted, accumulated, or could no longer be tolerated. Even if you can’t name it precisely, pointing towards the general idea is enough.
Your goals and what you’re hoping to get out of therapy. Even a rough idea like “I want to feel less anxious,” “I can’t keep running on empty,” or “I don’t know, I just knew I needed to talk to someone” will work.
Any topics that have felt hard to talk about in the past, if anything. Some people have been to therapy before and have a sense of where they’re getting stuck. That’s worth sharing early on in the therapy process.
The first session is exploratory. Your therapist is listening to learn about and get an understanding of you, so there’s no way you can get it wrong.
What to do when you don’t know what to talk about in therapy
Say that. Literally.
“I don’t really have anything to bring today” is a full sentence your therapist can work with. It often opens up more than a prepared topic would.
Beyond that, here are a few ways to find something when your mind feels blank:
Start with your body, not your thoughts. Where are you holding tension? What feels different from how it usually does? The body often registers things before the conscious mind can. A tightness in your chest, a low-level restlessness, the sense of bracing for something. These are worth naming even when you can’t explain them.
Bring the small things. The minor irritation you almost mentioned to a friend but didn’t. The interaction that left you slightly off. The task you keep avoiding without knowing why. These things seem too small to bring to therapy but are usually the ones that lead somewhere insightful.
Look for themes instead of events. Instead of searching for a story to tell, try finishing this sentence: “I’ve been feeling a lot of _______ this week.” Impatience. Tiredness. Flatness. Restlessness. A feeling state, even a vague one, gives your therapist something real to work with.
Notice what you’re not bringing. If there’s something you’ve been actively steering away from sharing, or have had it sit as a persistent thought for a long time, that’s definitely worth talking about. You don’t need to explain it. You can just say “there’s something I keep not bringing up.”
The session doesn’t need to begin with the most important thing. Start by sharing something. Anything.
What topics are off-limits in therapy?
Nothing is technically off-limits. Therapists are trained to hold difficult conversations. There is no topic too dark, too strange, or too small. Therapists do have varying levels of understanding in different topic areas and will let you know if something is outside of their scope.
What differs is what your therapist can keep confidential. Registered Social Workers in Ontario, like the therapists at Inner Room, work within the professional and legal guidelines set by the Ontario College of Social Workers and Social Service Workers. Confidentiality protects everything you share, with a few specific exceptions.
If you share information that suggests serious risk of harm to yourself or others (especially children), your therapist has a legal obligation to respond. This isn’t a restriction on what you can say. It’s a protection for you, and for the people around you. Your therapist will walk you through the limits of confidentiality in your first session.
On a more practical level, if something feels too difficult to say directly, you can say that: “I’ve been wanting to talk about this but I keep stopping myself.” You don’t need to have the words fully formed to bring something forward.
How your Inner Room therapist prepares for your session
You’re not the only one who shows up prepared.
Before your session, your therapist reviews what you’ve been working on, where you left off, and what was still open from your last conversation. Research shows that therapists who take time to center and review before a session are rated by clients as more present and effective [3]. That preparation is part of how sessions at Inner Room are structured, and the reason we also ask for at least 24 hours notice for any appointment time changes and cancellations.
This also means that when you arrive with “nothing to say,” your therapist usually has something they noticed before: a thread they wanted to return to. This can be something you said almost in passing that’s worth examining closely. The continuity is there.
A few things that actually help before your session
The research here is clear: formal pre-session homework has mixed results [4]. It can sometimes put pressure on the session before it even starts. You don’t need to prepare like you’re presenting.
What tends to help is simpler. A few minutes of quiet before you open the call, putting your phone down or on Do Not Disturb, and noticing how you’ve actually been feeling over the past few days — to name a few.
If you’re doing virtual therapy in Ontario, you already have the comfort of being in your own space. Use it! Find somewhere you won’t be interrupted, have water nearby, and give yourself a buffer before and after the call rather than taking it back-to-back with work.
Jotting one thing down before you start can help when your mind goes blank in the first minute. Not a script. Just a note: “I’ve been really tired lately,” “something my mother said has been on my mind,” “I don’t actually know what to bring.” Any of these will do.
When “nothing to say” might be worth paying attention to
There’s one version of “I have nothing to bring” that deserves a closer look.
It’s the version that’s been happening for several sessions in a row. The one that comes with a kind of flatness. Things are fine, but not quite right. You’re functioning. You’re keeping up with everything. You’re just not feeling much.
That pattern, especially in people who are high-achieving or used to managing their own emotional life, can be easy to dismiss. Nothing is wrong. Nothing dramatic is happening. But the absence of anything is a signal.
If any of that lands, it might be worth looking at what’s underneath the “nothing” that is “fine.” That’s some of the most useful work therapy can support with. Not the surface problem, but the quiet ones that have been running in the background for a while.
Frequently asked questions
What are good topics to discuss in therapy?
Good topics include your current emotional state, relationship patterns, recurring thoughts or behavioural loops, stress at work, past experiences that are still affecting you, and anything that’s been on your mind lately, even if it feels small. There’s no wrong topic. The right one is usually whatever you’ve been thinking about on the way to your session.
What should I talk about in my first therapy session?
Start with what brought you in when it did, what you’re hoping therapy will help with (even in rough terms), and anything that’s felt particularly heavy lately. You don’t need to have it organized. The first session is about getting a sense of each other and what the work might look like.
Is it normal to have nothing to say in therapy?
Yes, and it happens often. It can mean you’re doing better, that you’re in a quieter stretch, or that there’s something you haven’t fully named yet. Sometimes it’s a form of avoidance, and noticing that is itself useful. You can always say “I don’t know what to bring today” and let your therapist guide you.
What topics are off-limits in therapy?
Nothing is off-limits. Therapists are trained to hold difficult, complex, and uncomfortable conversations. The one area that operates differently is confidentiality: if you disclose information suggesting serious risk of harm to yourself or others (especially children), your therapist has a legal obligation to act. Your therapist will explain these limits at the start of therapy.
What is the 3-3-3 rule in therapy?
The 3-3-3 rule is a grounding technique for anxiety. It involves noticing three things you can see, three things you can hear, and three things you can physically feel or touch. It’s designed to bring you back to the present moment when you’re feeling overwhelmed or disconnected.
What are the 5 Ps in therapy?
The 5 Ps is a clinical assessment framework covering: the Presenting problem, Predisposing factors, Precipitating factors, Perpetuating factors, and Protective factors. Your therapist may use this when building a picture of what you’re working with, though most clients won’t hear it named directly in session.
How do I prepare for a therapy session?
You don’t need to prepare extensively. A few minutes of quiet before the session, a brief mental note of how you’ve been feeling lately, and one thing you might want to bring up is enough. The most useful preparation is simply showing up willing to say what’s actually on your mind.
Can virtual therapy sessions work if I don’t know what to talk about?
Yes. Being in your own space often makes it easier to access what’s real. There’s less transition pressure and more room to settle in before the call starts.
You don’t need to have it figured out to start
If you’ve been thinking about therapy but weren’t sure you had “enough” to bring, that hesitation is normal. You don’t need a presenting problem to benefit from the work.
At Inner Room, our therapists work with clients across Ontario through virtual sessions built around your pace and your needs. A free consultation is a chance to get a sense of the fit, ask questions, and figure out your readiness to start therapy.
References
- Norcross, J. C., & Wampold, B. E. (2011). What works for whom: Tailoring psychotherapy to the person. Journal of Clinical Psychology, 67(2), 127–132. https://doi.org/10.1002/jclp.20764
- Maxie, A. C., Arnold, D. H., & Stephenson, M. (2006). Do therapists address ethnic and racial differences in cross-cultural psychotherapy? Psychotherapy: Theory, Research, Practice, Training, 43(4), 466–475. https://doi.org/10.1037/0033-3204.43.4.466
- Grepmair, L., Mitterlehner, F., Loew, T., Bachler, E., Rother, W., & Nickel,M. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: A randomized, double-blind, controlled study. Psychotherapy and Psychosomatics, 76(6), 332–338. https://doi.org/10.1159/000107560
- Kazantzis, N., Whittington, C., & Dattilio, F. (2010). Meta-analysis of homework effects in cognitive and behavioral therapy: A replication and extension. Clinical Psychology: Science and Practice, 17(2), 144–156. https://doi.org/10.1111/j.1468-2850.2010.01204.x
Wondering what your first session would look like? It's simpler than most people expect →
Start the conversation →
