What Should I Talk About In Therapy?

So…what should you talk about in therapy? Deciding what to bring up and when can feel daunting – especially if you have a lot to talk about. Welcome to the So, How’s Therapy Podcast where we push beyond the traditional therapy format to demystify, debunk, and destigmatize therapy. Hosted by Karen Conlon, LCSW, CCATP.


There are so many myths about what you should talk about in therapy.

Deciding what to bring up and when can feel daunting – especially if you have a lot to talk about. In this episode, I’ll walk you through how to decide what topics to bring up, and when. Often the overlooked, uncomfortable, and hard to talk about topics can lead to the biggest realizations.

What You’ll Learn

  • How talking about things you don’t think are important can be the missing piece to a larger puzzle
  • Why progress in therapy can cause bigger, underlying things to come up
  • That therapy is an ’emotional sandbox’
  • Why there’s always a reason to talk about things, even if you think you can’t do anything about them
  • That talking about your problems does not make you a bad person, friend, family member, or spouse
  • What limits there are – confidentiality

Transcript

Hello, and welcome to the So, How’s Therapy? Podcast, where we push beyond the traditional therapy format to demystify, debunk, and de-stigmatize therapy. I’m your host, Karen Conlon, and in today’s episode I’m going to be talking about a question that so many people have, but rarely ask out loud. And that question is, what should I talk about in therapy?

And in answering that question, I am also going to debunk six of the biggest myths on the topic.

What Should I Talk About In Therapy?

So what should I talk about in therapy is always a big question. And at some point, it comes up even after a while of being in therapy. Let me explain further. People oftentimes start therapy for a very specific reason or come in with a very specific problem that they want to talk about. Oftentimes they’re in crisis and are really looking to find relief or resolution or better ways of coping with whatever it is that they’re coming in with.

And at some point they might start feeling better or feeling more capable of handling whatever this issue is or was. And they might start thinking about some other things that they want to bring up in therapy, but they find themselves feeling unsure about whether they should bring it up, not certain that the therapist would be receptive to it. And so it is a question that comes up more often than one would realize. I figured, let’s talk about what I should talk about in therapy and some of those myths about what you can or cannot talk about.

In Therapy, Everything is Related

So the first myth that I’d like to debunk is the thought of this topic that I am thinking about bringing up isn’t important, or I don’t think it relates to anything. Here’s the thing about therapy. When you are in therapy, think about the issues and the things that you’re bringing into the therapy space like a big thousand-piece puzzle. And imagine that your life right now is like that thousand-piece puzzle and you are trying to figure out what goes where. You’re trying to make sense of things. Sometimes things come up in therapy that feels out of place for whatever it is that you’re talking about or the content or the context.

And you might feel a little bit shy or insecure about bringing it up in the first place, but I’m going to encourage you to not be afraid and quite the contrary, bring it up because if you think about therapy and the things that you talk about, your life being that big old 1000 piece puzzle, if you’re working on a puzzle, you don’t throw pieces away just because you don’t know how they fit in.

No, you might put them aside. You might take a quick look at them and say, okay, let me remember that I have this piece here, but I’m going to put it aside because I don’t know where it fits just yet.

As you go through therapy and you start working things out and working through things, you might find that that piece that you thought didn’t fit in anywhere all of a sudden is actually the missing piece to get the bigger picture or to see the bigger picture. So if you’re ever in therapy and you’re thinking, I don’t know if I want to bring this up, this isn’t important, I’m not sure how it relates to anything, think of that metaphor of it being like a puzzle.

You may not know exactly why it’s coming up for you or where it’s going to fit in in the bigger picture of what it is that you’re trying to resolve, but don’t discard it, because if it’s coming up, then it’s important.

Your Original Reason Doesn’t Have To Be Your Only Reason

So the second thing that comes up in the therapy space is the thought that I can only talk about the thing that I brought in when I originally started therapy. So for example, you might have started therapy because you are really perplexed about what to do because you want a career change, or maybe you are the adult child of an aging parent and your role is changing.

And you started therapy because you wanted to learn how to manage that a little bit better and now that’s been resolved and you might be finding that you’re now dealing with other aspects of care or maybe other aspects of your life, but you’re feeling like, well, but that’s not what I came in for, so is it worth talking about?

Maybe you’re having chronic illness issues or health issues and you are coming into therapy because you want some help with learning how to cope with some of these issues. And as you start coping better with those issues, you might say, okay, well, I’m better now, even though now you’ve started to think about other parts of your life that you might want to address or see some improvement in, but you’re thinking well, this isn’t what I started with.

You don’t have to continue talking about the same thing that you brought in originally to therapy. As a matter of fact, what you want to see is that the original topic evolves into other things, because chances are that that thing that you brought in initially is also impacting other parts of your life.

And the thing about this is that as therapy moves along, or as things are moving along in therapy, it really is not uncommon for other bigger underlying things to actually come up. You might start finding yourself wanting to talk about other things that might not be necessarily connected to you personally, but maybe about the world around you. Frustration with the world around you. Family origin issues like relationships with your parents or siblings. Perhaps you are dealing with alcoholism or the substance abuse of a loved one.

The Difficult Conversations

Other things that you might not even think about are things that are really quite appropriate for talking about in a therapy space. If you are, I don’t know, for example, the only white person or white couple living in a gentrifying neighborhood, and you are struggling with some of the thoughts that you are having about that, or perhaps you’re the only person of color in a predominantly white neighborhood. You may think, well, why would I bring that up in therapy?

Well, you might bring that up in therapy because it’s something that might be impacting your way of life, the way that you see yourself, the way that you’re interacting with other people. So there are a lot of reasons of that nature of why you might want to bring a conversation like that into therapy, even if that’s not necessarily what brought you into therapy in the first place.

I’ll share with you that as a woman of color myself, having conversations like this with clients who are of a different race than I am, can be a very healing conversation, both for my clients and for myself. These are sometimes difficult conversations that they may not typically have the opportunity to have within their own circles and in their own lives.

And quite honestly, having the support, the validation and the understanding, is something that they may not always get when they’re trying to have these conversations with a friend or a family member who have different opinions, or who may not readily be able or wanting to openly share their thoughts or feelings about something that is a difficult topic to talk about. So having the opportunity to reflect on things in an emotionally safe space is something that can be incredibly helpful. And again, this may not be what you came into therapy for, but it is a part of you, and it’s a part of you that is impacting your everyday life.

Therapy is An Emotional Sandbox

I kind of refer to therapy like an emotional sandbox. If you think about it in those terms, think about a sandbox, as a kid if you’ve ever had the opportunity to play in one, it’s small, it’s safe. The sand feels nice in your hands and you feel relatively safe in that space. And that’s what it’s like to be in an emotionally safe space.

Therapy can be that space where you can learn how to identify thoughts and feelings that are getting in the way and doing that by interacting with someone who is there to listen to you in a non-judgemental and unbiased way.

If I Can’t Do Anything About It, I Shouldn’t Even Bring It Up

The third myth that I want to debunk about what should or should not bring to therapy is, “If I can’t do anything about it, there’s no point in talking about it.” So this is a big one. This is one that actually comes into the therapy space more often than one might think where someone might say, “Well, I was thinking of bringing something up, but honestly, there’s nothing I can really do about it so I don’t know that I really want to waste my time.”

And the truth of it is that even if you feel like you can’t do anything about it, talking about it can be helpful in many, many ways. Sometimes when you don’t talk about something, what you’re actually doing is suppressing your feelings or you’re denying yourself the opportunity to acknowledge that you feel something about whatever that thing is, or you’re repressing what you are feeling.

And the thing about these feelings is that they’re there. They don’t really go away and they will manifest themselves in other ways. Manifestations of feelings that you keep inside sometimes come out in the form of physical illness or symptoms. Other times you project onto other people what you’re feeling about yourself, right? Other times there is the opportunity to misplace your anger or taking it out on other people.

So rather than taking it out on the person that you should be angry with, you take it out on those loved ones or other people who either have no defense against what you’re saying or what you’re bringing to the table, or you know that even if you take your anger out on them, they’re not going to leave you. They’re not going anywhere. That’s still doesn’t make for a healthy relationship. Just because you can take it out on people that are not going to leave you, it doesn’t really leave you feeling better, does it? If you think about it.

Feelings Are There For A Reason

Not talking about things also doesn’t give you the opportunity to get validation for your feelings about whatever it is that you’re experiencing. Feelings are there for a reason. They matter because they help us to express something about whatever it is that’s going on. And when you don’t allow yourself to talk about something that’s bothering you, you’re also not allowing yourself to receive validation, that your feelings are important and that they mean something and that they count.

Not talking about something can also really enable or contribute to low self-esteem and self doubt. It can limit your ability to be creative in your thinking about things, or even about how to look at things in a different way. Because if you’re not talking about it, you are not addressing anything. And if you’re not addressing anything, you can’t think about things in a different way. You can’t really be flexible in how to look at things.

When you think about the thought of, “I can’t do anything about it, there’s no point in talking about it,” it’s a very finite and rigid way of looking at things and it can keep you stuck. And I’ll tell you what, sometimes that works. Sometimes that works for you for a long time and in certain situations, but at some point it doesn’t work for you anymore.

And this is when you have to start considering maybe I should talk about it. When you keep doing the same thing that you’re doing and not getting different results, somebody out there said, “What is the definition of insanity? The definition of insanity is doing the same thing over and over and expecting a different result.”

Discussing Something With A Therapist Won’t Cause You To Lose Control

The fourth statement, or thought, that I’d like to debunk here about what I should talk about in therapy, or what can I talk about in therapy, is if I let my emotions out about this problem, I’m going to lose it. And the fear usually around quote-unquote losing it, is that once I open those flood gates, I’m not going to be able to gain control of my emotions again. I’m not going to be able to compose myself again. Therapy’s a really great place to let your emotions out.

Therapy can help you gain an understanding of where that thought process even came from in the first place. Is that something that you figured out on your own? Yeah, I’m just not going to let my emotions out because otherwise I’ll lose it. Or is it that anytime that you’ve quote-unquote lost it, historically the people in your life were unable to tolerate these emotions and then you were forced to adapt by holding things in.

I’m going to reframe that and say that again, because usually this is where this comes from. When we grow up in an environment where negative emotions, and by the way, I say negative in quotations because there are no such things as negative emotions, but there are people who define things like anger or pain or even crying as negative or related to negative emotions and they don’t tolerate it.

And if you grew up in a household or in an environment where people were unable to tolerate that, well, you probably were either turned away or told, “Hey, get ahold of yourself. I can’t talk to you when you’re like this. You’re too sensitive,” et cetera, et cetera. And so it’s really important to understand where this all started so that you can also make the changes that you need to make in your thought process and start dealing with emotions.

It May Not Feel Comfortable, But It Will Be Worth It

Getting through emotions so that you can get yourself to the other site and actually see that you made it through just fine. Letting out emotions, I’m not saying it’s going to be comfortable. I want to be really clear about that. I’m not saying you’re going to like it. I’m not even going to say that you’re going to come through it feeling, “Oh, I feel so much better,” on the other end.

Growth is uncomfortable. And if you’re not used to letting emotions out and now you are letting emotions out, it is going to feel uncomfortable. It is supposed to feel uncomfortable. But the important thing is that the more you do it, the more you practice, the more you understand that you can get through it.

And remember I talked about that emotional sandbox, that therapy is like an emotional sandbox where you get to practice trusting that your therapist can hold that space for you while you figure out what you can actually get through. This is how you use therapy. You use it in a way that you have never been able to use anybody or any other situation before.

You use it in a way where you can allow yourself to be vulnerable and trusting that that person can hold the space for you and trusting that when you get through things, that person is going to be there on the other side as well.

Discussing Concerns About and With Those You Love Doesn’t Make You A Bad Person

The next and fifth thought that comes through, which I’d like to debunk is, “If talk about problems in my family, I am saying that they are bad people or being disloyal.” Here’s the deal and I talked about this a little bit in the childhood emotional neglect episode. It’s really important that we learn to integrate feelings that don’t always seem to go together.

I can love someone and not like their behavior. I can talk about the problems that I have in my family, with my siblings, with my cousins, with my parents, and not be disloyal. I am allowed to love people and not always love their behavior or their interactions. You have your own thoughts and you have your own feelings and your own attitudes. And guess what? Those thoughts and feelings and attitudes may not always align with your family.

And while some people come from families where even the thought of that is not okay. I mean, you’re not even allowed to, I don’t know, even consider that your thoughts, feelings and attitudes might be different than theirs. The truth of the matter is that you do have, you do have that autonomy, but sometimes you might need a little bit of help to find that, to find your voice.

Going To Therapy Doesn’t Mean Something Is Wrong With You

The last statement that I’d like to bring up and debunk is, “If I have to go to therapy to talk to somebody about this problem, something must be wrong with me.” So here’s the deal. When you are in it, when you are dealing with something, the waters can be really muddy for you. It can become very, very difficult to see clearly, to see through things. And so sometimes that also means that you’re too emotionally involved to see solutions or other important factors that you need to really be aware of.

And by the way, who said that you’re supposed to have all of the answers? Who said that? Where did you learn that? I mean, you may feel like you should be able to figure everything out, but is that really true? I mean, can that thought or belief that you have be the thing that’s getting in the way of you being able to find a resolution in the first place?

There’s so many more things that come into the space that I’d love to be able to debunk and that’s why I started this podcast. I’m going to be doing some episodes in the future where they’re going to be specifically to focus on demystifying something about therapy. Other ones are going to be geared towards de-stigmatizing. And this one is specifically to debunk these six things. I’m going to repeat them really quickly for you.

So the first one is, this isn’t important and I’m not sure how it relates to anything. So, I don’t know. Should I talk about it in therapy? The second one is, I can only talk about the thing that I brought in when I originally started therapy. The third one is if I can’t do anything about it, there’s no point in talking about it.

Fourth one, if I let my emotions out about this problem, I’m going to lose it. Fifth one is, if I talk about problems in my family, I’m saying that they are bad people or being disloyal. And the last one is, if I go to therapy, if I have to go to therapy to talk about this, something must be wrong with me.

What Therapy Is And What It Isn’t

I’m glad we’re talking about this today because so many people are just walking around with the wrong impressions about what’s okay to talk about in therapy and what’s not. I think it’s important to mention here that there are limits of confidentiality, no matter who you’re seeing. Whether you’re seeing a therapist or a doctor or professor, those limits of confidentiality are around hurting yourself and expression or wanting to hurt others. Or if you’re in some type of eminent danger.

And those limits of confidentiality are not just for therapists, they’re for medical providers, they’re for teachers. So that’s important for you to know. And so these are not things that we’re talking about. We’re talking about other things that come into the space that you weren’t really expecting to talk about.

I’m really curious to know, is there anything that you’ve hesitated about sharing in therapy because you don’t think it’s important? I hope this episode makes you think, or actually rethink that, and I’d love to hear from you. Please feel free to reach out by visiting www.cohesivetherapynyc.com/podcast, where you can contact me, subscribe to the podcast and check out the show notes for this episode. Thank you so much for being here with me today and I’ll see you next time when I ask, so, how’s therapy?

About So, How’s Therapy?

In each podcast episode, Karen and her guests work to push through the traditional therapy format to demystify, debunk, and destigmatize therapy.

Whether you’ve been in therapy for years, or are thinking about reaching out, Karen is here to guide you through it all.

She tackles everything from Anxiety, Trauma and PTSD, to Childhood Emotional Neglect, to dealing with chronic illness, and everything in between, through the lens of her private practice in New York City, Cohesive Therapy NYC.

Karen Conlon LCSW | Licensed Clinical Social Worker | Cohesive Therapy NYC

Your Host: Karen Conlon, LCSW CCATP

Owner, Founder, and Clinical Director of Cohesive Therapy NYC

Want to know more, be a guest on the podcast, or are located in New York or New Jersey and interested in therapy? Reach out at info@cohesivetherapynyc.com. We’d love to speak with you.

About the author(s)

Karen is the founder and Clinical Director of Cohesive Therapy NYC. She earned a Masters in Social Work from New York University and has extensive training in Hypnosis, Anxiety, Cognitive Behavioral Therapy, Brainspotting, and DGBI. She is a member of the Institute of Certified Anxiety Treatment Professionals, The Rome Foundation, the National Association of Social Workers, The Crohn's and Colitis Foundation, and the American Social of Clinical Hypnosis.

About Cohesive Therapy NYC

At Cohesive Therapy NYC, we believe that you have an immense amount of inner strength and resilience, even if it is yet to be discovered. Cohesive Therapy NYC is a private group psychotherapy practice in New York City that focuses on treating adults who struggle with Anxiety, Trauma, Chronic Illness, and the adult impact of Childhood Emotional Neglect (CEN). Cohesive Therapy NYC therapists see clients all throughout New York State (Manhattan, Queens, Brooklyn, Bronx, Staten Island, Westchester, and statewide) using online therapy and are also available for in-person visits in their NYC offices, located at 59 East 54th Street, New York, NY 10022. We specialize in helping people who are dealing with anxiety, relationship issues, chronic illness, and digestive and adult trauma related to childhood family dynamics. We all deserve a chance to be well and have support.