What Are You Supposed to Talk About in Therapy?

One of the questions I'm most frequently asked is, "What are you supposed to talk about in therapy?" It's not surprising that this question comes up with such frequency. After all, most doctors take the lead with their patients. They ask where it hurts, how it happened, when they noticed. They make a diagnosis and write a prescription.

With therapy, in contrast, the doctor follows the patient. The patient tells the doctor what he is feeling, and the doctor listens closely and tries to grasp his experience. He may make a diagnosis, but he won't write a prescription (unless he is a psychiatrist and wants to add medication). He tries to help the patient come to terms with his feelings. To name them. To think about them. And to act on his reflections.

So, what are you really supposed to talk about it therapy? Talk about anything you feel strongly about. Your boss, your boyfriend, your wife, your mother. The election, the war, health insurance, your taxes. A book, a poem, a movie, a painting. Especially about something that's gotten under your skin.

The key is to talk in a personal way. Discussing the nuances of military strategy can take you away from your troubling feelings. Discussing your sadness at the death of a friend, your anger at the poor treatment of the wounded vets, or your frustration with the politicization of the military conflict can bring deeply held feelings out into the open. The payoff in therapy comes from talking about your feelings. Talking about your ideas can be a defense.

At the end of the day, it doesn't matter what you talk about as long as you talk about how it makes you feel. Like the leaves of a tree, the things we talk about are connected. Follow them deep enough and you'll get to the root.

Your anger at the poor treatment of the wounded vets, for example, may remind you of your fury toward those who hurt animals. This may call to mind a painful memory from childhood in which you saw a pack of angry boys kill a cat. That may remind you of bitter fights between your parents in which you saw your mother being struck by your father. Suddenly, your feelings about the wounded vets have more meaning. You see why you feel as upset as you do.

Which is not to say that every feeling should be traced to its origin. Or that each feeling is rooted in some agonizing trauma. But it is to say that if something is really bothering you, there may be more at stake than you might think from the surface. Tracing the feeling inside can reveal these connections, make the feeling less confusing, and help you think about its significance. It won't take it away, but it will help you to deal with it. A good way to create the emotional space within which to feel a great deal more free.