Do you stress out about what to bring up in your next therapy session? Then this one is for you!

Here is a common misconception about therapy: You need to be in crisis to benefit from therapy, or come to a therapist with a ‘problem’

This is NOT true! Here is why.

When we are in crisis, a therapy session will most likely involve managing the crisis or learning how to cope with the intensity of emotions. This is completely fine! In fact, many people’s first experience with therapy is triggered by a crisis or significant life change.

However, sometimes when our thoughts and feelings are NOT wrapped up in an urgent situation, the therapy session can go in a deeper direction.

We can work on building self and bodily awareness, understanding our thought patterns, accepting and coping with emotions- the list goes on.

The truth is that a therapy session is rarely wasted

Most of the time, therapy occurs on a regular basis and not ‘as needed’.

This is because while therapy helps us put out fires, it can also allow us to develop deeper insights about our lives and experiences. This ultimately helps us cope with urgent situations more effectively!

Let’s discuss a common situation that we encounter often as therapists.

A client is propelled towards therapy by a personal crisis. Or perhaps they recognize a pattern in their life that needs to shift. Initially, sessions were focused on the crisis or specific pattern. There is a lot to talk about and unpack- the history of events, important context, and anything else that helps the therapist understand who the client is and how they understand themselves.

After several sessions, circumstances shift for the client. The situation is less urgent. They begin to feel anxious about upcoming therapy sessions, worrying that nothing is pressing enough to talk about and the time will be wasted. They consider ending the sessions.

Take It From Me, A Therapist

Many people feel very stressed out about not having a particular issue to discuss in therapy.

In case you needed to hear this: you don’t have to plan your therapy sessions in advance! Not every session needs to have a problem-focus or a a breakthrough to be valuable.

Your therapist does not necessarily expect you to come to the session with your own agenda or a prepared list of talking points! In fact, sometimes being ‘too prepared’ for a session can emotionally remove you from the very thing you want to discuss.

Also, more often than not, the conversation ends up going in a different direction than the planned talking points!

Note: This doesn’t apply if preparation is an important part of your therapy plan. For example, some therapists will request that clients track their thoughts or changes in mood to discuss in the next session. In that case, you actually DO want to be prepared!

How Does A Therapist Approach A Session Without A Presenting Problem?

There are so many ways of approaching this! If you arrive at a session with nothing in particular on your mind, a therapist might begin with an awareness practice.

This can look like:

Practicing moment-to-moment awareness

Focusing on your body and breathing

Following the trail of your thoughts

Usually, a thought, memory, dream, or bodily sensation emerges that the client brings to the therapist’s attention. These are often excellent points of entry into the session!

The Benefits Of Not Planning Ahead

Here are a few reasons why you might want to consider trying not to think too much about what you will talk about in therapy.

1. What Emerges Naturally Can Be Really Interesting

After an awareness exercise, some clients find that the seemingly random thoughts that emerge lead to richer and more deeper therapy sessions than arriving with a particular issue.

For example, a client may find that the awareness exercise is difficult for them because they feel mentally elsewhere. This can be a good opportunity to talk about ongoing discomfort with bodily awareness.

Or perhaps the client is feeling awkward and needing to compensate for not bringing an issue with them. A therapist can help the client explore why they feel the need to make the therapist’s time worthwhile (i.e. people-pleasing) and how this connects to other relationships in their life.

2. The Quieter Parts Of Our Mind Deserve Attention Too

Therapy sessions that are not centred on a crisis or presenting problem are a great opportunity to zoom out and examine the larger context our issues are nestled in.

The loudest and post painful issues in our lives often take centre stage and take up all of our energy and resources, including therapy minutes! Once again, this is expected and completely okay!

When life feels a bit calmer (even boring), it allows us to focus on the quieter aspects of our mind that we rarely examine. When the loudest voices are softer, we can go deeper into the underlying reasons beneath our issues.

For example, once a client is coping better with the grief of ending an unhealthy relationship, a therapist can explore the underlying issues of low self-worth that led the client into the relationship in the first place.

The deeper aspects of our existence are often quieter. However, they are just as meaningful (sometimes perhaps even more so) than the problems themselves.

3. Building Comfort With Silences

In our society, we are never silent long enough to even feel truly uncomfortable. Many clients feel the need to fill silences with chatter and avoid awkwardness.

Conversely, most therapists will actually hold space for silence in the session. Silence helps us gather our thoughts, appreciate the weight of certain moments, and build awareness of how our body responds to discomfort.

So, long pauses are okay. Not knowing exactly what to say it okay. Having meandering thoughts and lulls in the conversation is okay! An unplanned session can give us an opportunity to be silent, and this is highly valuable.

4. A Chance To Talk About Therapy Itself

If you have been sitting on some thoughts about the process of therapy itself, an unplanned session can be a great opportunity to bring those up.

Try discussing what you like and don’t like about therapy, what you find surprising, what you find difficult, and even how you feel the therapeutic relationship is coming along.

This can feel strange at first, but most therapists will be interested and encouraging.

Wrapping Up

If you are considering cancelling your next therapy session solely because there’s nothing to talk about, try resisting the urge for one more session. Sometimes walking in with nothing in particular to discuss can lead to the most interesting and meaningful sessions!

If not having a presenting problem makes you nervous, try journaling between sessions. This can be an excellent way to develop and explore thoughts and feelings that you can bring to your therapist the next time you see them. This includes the initial nerves about not having a problem to discuss!

I want to hear from you: Do you like to go into therapy with a particular problem, or do you prefer to see where the session takes you?

Until next time!

Zainib Abdullah

Co-founder

WellNest Psychotherapy Services

Zainib Abdullah is the co-founder and a psychotherapist at WellNest Psychotherapy Services. Her approach to healing incorporates various therapeutic modalities. She works from a client-centred, anti-racist/oppressive/colonial & trauma-informed framework. As a yoga teacher and student in the lineage of Classical Yoga, she further incorporates mindfulness based therapies to support clients in accessing greater connectedness to their inner wisdom and peace.