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Most clients know that some of their best sessions happen when they don’t know what their therapy topic is going to be. In the absence of an external event to report, the unconscious manages to insert itself into what feels like random meanderings of thoughts in the first few minutes of the session.

There is certainly nothing wrong with talking about the events of the week in a session. But therapy’s realm is the internal. I don’t mean to say that we should start ever session talking about our mothers. The past is only relevant when it has been activated in the present. But similarly, the random events of the week are only relevant when they aren’t random, but rather linked to key issues that we have going on in our inner worlds.

Therapists are often aware of several overall themes their client is working on.  A handful of examples would be:

  • Learning how to be close without feeling swallowed
  • Learning how to be separate without feeling panicked
  • Risking expressions of anger without fear of abandonment
  • Risking expressions of love without fear of being compromised
  • Authentic experience of being seen/heard/known
  • Being able to see/hear/know others as separate entities
  • Developing an integrated view of themselves and others that includes good/bad and love/hate

When clients are able to track their own themes, they are able to bring in relevant dreams, key realizations in the week, experiences that brought repetitive or new feelings or thoughts to the surface. They are more likely to refer to work in past sessions to incorporate the new thoughts they have had.

Here are some tips for deciding what to talk about in sessions to get yourself delving deeper.

  • What do you wonder about, percolate on, during the week? What plagues you regularly? Even if it is things like anxiety about money, that may bear interesting conversations.
  • Ask your therapist what they think are the key issues you two are working on.
  • Note your dreams, particularly ones you have the night before a session, as they are your unconscious self’s attempt to alert you to its concerns.
  • Note your day dreams and the themes they contain. It may feel too revealing to report the details of a day dream to your therapist, but the elements contain your wishes and aspirations, even if in symbolic form.
  • Ask your partner, or your close friend what they think the major issues in your life are that may be preventing you from living life more fully.
  • If you find yourself sobbing at a movie or a song, ignore the details, and explain to yourself out loud what is sad about it and you will find the theme that relates it to you. People don’t all cry at the same part of movies or songs; if you are getting choked up, it is relevant.

Life can be so incredibly rich and full. It is worth untangling some basic issues at their root to free us to engage life with openness.

Smith is an analytically oriented psychotherapist with 25 years in practice. She is additionally the Founder/Director of Full Living: A Psychotherapy Practice, which specializes in matching clients with seasoned clinicians in the Greater Philadelphia Area.

If you are interested in therapy and live in Philadelphia or the Greater Philadelphia Area, please let Full Living: A Psychotherapy Practice match you with a skilled, experienced psychotherapist based on your needs and issues as well as your and own therapists’ personalities and styles. All of our therapists are available for telehealth conferencing by phone or video in response to our current need for social distancing.


For posts on similar topics, follow the links below:

Psychotherapy is a Great Tool

Should I Go to Psychotherapy?

In Defense of Long Term Psychotherapy ( a video blog)



Author Karen L. Smith MSS LCSW Karen is the founder and director of Full Living: A Psychotherapy Practice, which provides thoughtful matches for clients seeking therapists in the Philadelphia Area. She provides analytically oriented psychotherapy, and offers education for other therapists seeking to deepen and enriching their work with object relation concepts.

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