What if I run out of things to talk about in therapy?

March 16, 2023 4:22 PM

I've had about ten sessions with a therapist. He mostly just listens and occasionally offers comforting words and some suggestions. We also work together to come up with homework assignments that I'm supposed to do before the next session. So therapy has been going OK, but I now feel like I'm running out of things to talk about.

I have a bit of social anxiety, and I hate awkward silences. Also, I'm not naturally a very talkative person, and I tend to get right to the point without a lot of lead-up or tangents. I feel like during my ten sessions, I've adequately covered the issues that plague me, and some of them I've described multiple times in detail. I know it's silly, but I'm now worried that I won't have anything else to say in future sessions.

I don't want to stop therapy, as I feel like it's comforting to have someone supportive and non-judgemental who listens to me (unfortunately, I have no one else in my life I can turn to). And the homework assignments are useful. But... I'm starting to have some anxiety about this.

I have another session coming up in two days, and I'm looking for advice.

posted by akk2014 to Health & Fitness (12 answers total)

I think the classic thing to do would be to talk about this in your therapy session. Including the anxiety and worry, the comfort you get etc. You could explore with him whether you want more input from him, whether there are other ways to make progress, whether you should take a break or have less frequent session. You might find that you uncover new layers of things from this conversation, or you might find that you're kinda done with therapy for the time being. Either would be fine.
posted by plonkee at 4:28 PM on March 16, 2023 [11 favorites]

So tell your therapist about this anxiety.

That's what they're there for.
posted by Artifice_Eternity at 4:28 PM on March 16, 2023 [5 favorites]

Sorry answer: I think this is a perfect thing to talk about in talk therapy!

Long answer: it might be useful to think about how to talk about what's going on in your mind irrespective of the actual events of your week.

Some therapists suggest thinking about topics before hand that relate to your goals. For example if you are trying to speak up more, examples of what you tried, how that felt, what impact did it have on you and such is a way to do it.

Some therapists think that interesting therapy happens when you run or of things to talk about and start bringing up whatever comes to mind.

There is no right way to spend your time in session. If you want to keep going that's absolutely fine. You will find things to talk about even if you don't feel like you will at the moment.
posted by AlexiaSky at 4:29 PM on March 16, 2023 [2 favorites]

I had a therapist who just would not fucking Talk To Me, I guess her method was just to get me to talk and maybe that works for some people but for me it was incredibly frustrating and unhelpful. So I found a new person who made therapy much more of a back and forth, which suits me better. Maybe this person’s methods just aren’t for you.
posted by showbiz_liz at 4:58 PM on March 16, 2023 [15 favorites]

I agree that this is great thing to talk about and also that different therapists have different styles so if you find that you really run out of things to the point that it doesn't actually addressing your problems then you might do better with someone who has a different style.

But on a more practical level, have you tried the homework? What happens? Especially if you feel blocked or resistant or it turns out badly then that is actually fantastic material to discuss in session since that lets you see the problem in action. Also, in the beginning the discussion might be more descriptive, just stuff that you already knew about what was going on. But over time, it should get deeper and you should be learning new things about yourself and about what is really happening when your issues show up and eventually figuring out some new ways of responding so things start to change. So you might be talking about the same things but the conversation should be changing.
posted by metahawk at 5:16 PM on March 16, 2023 [2 favorites]

I’m a therapist, and some of my most productive sessions start with a client saying “I don’t know what to talk about.” It’s not your responsibility to come prepared with a topic, or to keep the sessions going. Some therapists take a very passive approach, but most nowadays are more collaborative—hopefully not rushing to fill the silence, but offering observations, suggesting topics, and otherwise helping the client figure out where to go.

Also, it’s ok to talk through the same stuff a bunch to really dig into what you’re feeling, what assumptions and beliefs inform your behavior, how your past experiences may be relevant, etc. I’m not suggesting over-analyzing or spinning in circles, but if you’ve covered all the topics that feel important and you’re still experiencing the symptoms that brought you to therapy, you don’t have to consider those topics done. Your therapist will be used to revisiting topics, memories, symptoms, fears, and relationships he’s already heard about. It’s often really useful to come back to something either to focus on the emotions involved (rather than the facts or problem-solving logic) or to explore ways to reframe it.
posted by theotherdurassister at 8:27 PM on March 16, 2023 [5 favorites]

I see my therapist once a fortnight, there’s always that option. I have had a lot of therapy over the years and at the moment this pattern works great for me.

You can always go back to weekly again later if you want to, if both of you agree.
posted by Erinaceus europaeus at 11:36 PM on March 16, 2023

The other thing is, it's your time and money. If you want to talk about something that's not obviously related to the problems you identified as benefitting from therapy then you can do. You might find that they're not as unrelated as you thought, or that the session offers some benefit to you, or you learn something about what you want, expect or need from therapy.

I think more than anything else, if you actually do repeatedly find your sessions a waste of your time then you probably want to think about moving on from this therapist - either to a different person or modality if you've still got the same problems or just on completely. But if they're useful to you overall and you can afford them, then it's fine to continue with them.
posted by plonkee at 5:15 AM on March 17, 2023

I think sometimes there's an expectation that therapy means a client narrates the issues in their life, the therapist waves a metaphorical magic wand (in movies, it's generally via an insightful monologue), and then the client sees immediately where they've been wrong and immediately changes their life for the better, the end. So it may be worth thinking about whether you're expecting to kind of offer up your story and then the therapist is supposed to do the work for you. I've seen therapy get stalled out that way.

If you're feeling much better after 10 sessions, you may just be at a stopping place. If you're not feeling better, though, or not as much as you'd like, I agree that talking to the therapist about what you've posted here is a great next step. Your social anxiety is coming up in this context, so it's a great opportunity to talk about your social anxiety and to look at why it's happening now.
posted by lapis at 6:58 AM on March 17, 2023 [2 favorites]

Have you talked about your goals for therapy? Not all therapists of clients set goals, but I think it can be really useful. It can be easy to generally talk, but if you have defined goals, your therapist should be able to help you talk more effectively.
posted by theora55 at 8:01 AM on March 17, 2023

One thing you can always talk about in therapy is your feelings in that moment, e.g., "I'm worried about running out of things to say... I'm afraid of your silence... because [fill in what you fear]..." IME this can be a really important exploration. Why are you afraid? What do you think will happen? What do you want to know in that moment about what your therapist is thinking and feeling?
posted by tuesdayschild at 9:46 AM on March 17, 2023

I feel like during my ten sessions, I've adequately covered the issues that plague me, and some of them I've described multiple times in detail.

Depending on the way your therapist works, and more importantly what you're looking for out of treatment, 10 sessions may be enough time for that, or it may be enough for covering only the tiniest fragment of the iceberg poking out above the waterline.

I'll speak as a therapist (and therapy patient) who focuses more on working to change deep, characterological features rather than overt, specific behaviors: 10 sessions is very much in the tip-of-the-iceberg territory. But this doesn't mean you have to keep on saying new things about yourself every session. You can say things you've said before, as they feel/become relevant in the week-to-week course of your life. This kind of repetition is, in many cases, necessary for the work to work. Just this morning I came across a lovely Virginia Woolf quote from A Room of One's Own that applies here:

"There one might have sat the clock round lost in thought. Thought – to call it by a prouder name than it deserved – had let its line down into the stream. It swayed, minute after minute, hither and thither among the reflections and the weeds, letting the water lift it and sink it, until – you know the little tug – the sudden conglomeration of an idea at the end of one’s line: and then the cautious hauling of it in, and the careful laying of it out? Alas, laid on the grass how small, how insignificant this thought of mine looked; the sort of fish that a good fisherman puts back into the water so that it may grow fatter and be one day worth cooking and eating. I will not trouble you with that thought now, though if you look carefully you may find it for yourselves in the course of what I am going to say."

There's nothing wrong with just speaking in session, even if you repeat yourself. The important thing is to have a therapist who can help you listen to yourself, because if you do, you'll at some point find yourself surprised by what you hear yourself say.
posted by obliterati at 11:38 AM on March 17, 2023 [1 favorite]