What to Talk About in Therapy: 50 Ideas for When Your Mind Goes Blank

If you are not sure what to talk about in therapy, start with whatever is taking up the most room in your head right now. That might be something that happened this week, a feeling you cannot explain, a pattern you keep noticing, or something you have been avoiding. You do not need an important topic. Therapy works with ordinary material, and the 50 ideas below are here for the moments your mind goes blank.

There is no wrong thing to bring

Many people think a session needs an agenda, a crisis or a neat story. It does not. Your therapist is not grading the topic. They are listening for how you think, feel and react, and small, messy, half-formed material often shows that better than a polished summary.

A good rule is to bring what has energy. If something makes you tense, embarrassed, irritated, sad or oddly relieved, it is worth a mention. If you are not sure it matters, that is a reason to say it, not to skip it.

For exact phrases to open a session with, see our guide on what to say to your therapist. This post is different: it is a list of topics to choose from.

50 things to talk about in therapy

Skim until one makes you pause. That pause is usually the one to bring.

This week

1. The moment you felt most like yourself, and the moment you felt least like yourself.
2. A small interaction that stayed with you longer than it should have.
3. Something you said yes to when you wanted to say no.
4. A decision you keep going back and forth on.
5. A day that went worse than it looked from the outside.

Patterns you have noticed

6. A situation that keeps repeating with different people.
7. A thought that shows up whenever you are stressed.
8. What you do when you are overwhelmed, and whether it helps or just feels familiar.
9. The times you feel strongest emotions, and what is usually happening just before.
10. A rule you follow without knowing where it came from.

Relationships

11. Someone you feel drained by and why you still make time for them.
12. A friendship that has changed, or one you miss.
13. How you handle conflict: do you go quiet, fix it fast, or leave?
14. Who you feel safe with, and what they do that helps.
15. A conversation you keep rehearsing but have not had.

Body and sleep

16. Where you feel stress physically, such as your jaw, stomach or shoulders.
17. How your sleep has been and what your mind does at 2am.
18. Changes in appetite, energy or motivation you have brushed off.
19. How you treat your body when you are low: rest, ignore it, push harder?

Things you avoid

20. A topic you change the subject on, even with yourself.
21. Something you feel ashamed of that you think others would judge.
22. An email, call or task you have put off for far too long.
23. A feeling you try not to have, such as anger, envy or neediness.
24. Something you are afraid your therapist will think if you say it.

The past

25. A memory that arrives unprompted.
26. How feelings were handled in the home you grew up in.
27. A time you were praised or criticised that still echoes.
28. A version of yourself you have outgrown, or wish you could protect.
29. Something that happened that you have never fully told anyone.

Work or school

30. The part of your day you dread and what exactly it is about.
31. A comparison with someone else that is hurting your confidence.
32. Whether your standards for yourself feel motivating or punishing.
33. What rest looks like for you, and whether you allow it.

Goals and change

34. One thing you want to be different in three months.
35. Something you want but do not feel allowed to want.
36. A change you have been circling but not started.
37. What would count as a good enough week, not a perfect one.

Therapy itself

38. Something your therapist said that you are still thinking about.
39. A moment in a session when you felt misunderstood.
40. Whether the pace feels right or whether you want to go deeper or slower.
41. How you feel about the homework or between-session work.
42. Whether you feel you can be honest in the room, and what would help.

If you want questions to put to your therapist about how they work, see questions to ask your therapist.

In your first sessions

43. What made you decide to start now rather than last year.
44. What you hope will be different if therapy goes well.
45. What you have tried before, in therapy or on your own.
46. What you would like your therapist to know about how you like to be supported.

Our guide to the first therapy session covers what the first appointment usually looks like.

When you feel nothing

47. The numbness itself: when it started and what it feels like.
48. What you are doing to keep life running while feeling flat.
49. Moments, even tiny ones, when something did register.
50. The fact that you do not know what to say, and what that is like.

What to do when you have nothing to say

Silence in a session is not a failure. Sometimes the blank is the topic. Here are a few ways through it.

• Say the blank out loud. "My mind is empty and I am not sure why" gives your therapist something to work with.
• Pick one number from the list above and read the sentence aloud. You do not need to answer well.
• Start with the body: what do you notice right now, in your chest, hands or breathing?
• Describe your day in order, from waking up to arriving. Details often surface on the way.
• Tell them you feel fine. A good week can be worth looking at too: what helped?

How to bring up something you have been avoiding

The hardest topics tend to wait until the last five minutes. You can change that.

1. Name the avoidance first. "There is something I have not wanted to say" is enough to start. You do not have to explain it yet.
2. Say it early. Mention it in the first few minutes, even in a single sentence, so you are not squeezing it in as the hour ends.
3. Set the pace. You can say how much you want to share today. Many people find it helps to tell their therapist, "I want to tell you a little and go slowly."
4. Write it down beforehand. If speaking feels impossible, bring a note and read it, or hand it over if your therapist is comfortable with that.
5. Check in afterwards. Notice how you feel once it has been said, and bring that to the next session as well.

Use a five-minute pre-session note

You do not need long preparation. Five minutes before you go can be enough, and it is the habit that makes the biggest difference to what you remember. Our guides to how to prepare for a therapy session and therapy session prep go deeper, but here is a simple version.

1. One minute: the headline. Write one sentence about how your week felt overall.
2. Two minutes: pick up to three topics. Choose from the list above or from what happened. Short phrases are fine.
3. One minute: the hard one. Add one thing you are tempted to leave out.
4. One minute: what you want from the session. Comfort, a plan, space to vent, a different perspective?

Notes taken during the week, even one line when something stirs, make this much easier. Bring the note with you. Looking at it during the session is completely normal.

When to get support

Therapy is a good place to talk about difficult feelings, but if you are in distress between sessions or feel unsafe, do not wait for your appointment. Contact your therapist if they have said you can, a licensed professional, local emergency services, or a crisis line in your country.

Where Symplia fits

Symplia is a private mental health app that helps you collect what matters during the week so you are not trying to remember it all in the chair. You can journal, check in on your mood, and use Session Prep to gather topics and questions before an appointment. You choose what to share with your therapist. Symplia is not therapy and does not replace a licensed professional.

Try Symplia free at app.symplia.app. Monthly and Annual plans include a 7-day free trial.

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