Starting therapy can be intimidating, especially if you’re someone who is used to having everything figured out on your own. You know that therapy is supposed to help, but when you walk into the room, you may feel stuck, unsure of where to begin, or anxious about what to say. For high achievers and overthinkers, the pressure to “get it right” or say something profound can be overwhelming. What if you show up and just… don’t have the words? What if you feel stuck or unsure where to start? The good news is that therapy isn’t about having a perfect script. In fact, there is no perfect script. Therapy is meant to create space for real, honest conversation, even if you’re not sure what to say in the moment.
What To Say When You Feel Stuck
It’s a natural instinct to want to show up in therapy with something meaningful to talk about. But therapy is a place where it’s okay to admit you’re not sure what to say. Many people walk in with a head full of thoughts, but when it comes time to talk, they feel paralyzed by the pressure to “perform.”
So, what do you do when you don’t know what to say in therapy? You start with where you are. It might sound simple, but admitting that you feel stuck or don’t know where to begin can be a huge breakthrough in itself. If you’re unsure of what to say in therapy, just begin with a feeling, a thought, or even an observation about your day. You might say, “I’m not sure what to talk about today, but I’ve been feeling really anxious lately.”
This can seem like a small thing to say, but it’s actually a really important step toward getting the most out of your session. It doesn’t matter if you have a complete picture in mind—you don’t have to.
What to Say When You’re Worried About “Doing Therapy Right”
If you’re someone who usually excels by being prepared, therapy can feel unnerving. There’s no script, no checklist, no guaranteed outcome. That uncertainty can make you second-guess what you’re sharing—or even whether you’re doing it “right.”
Therapy is messy. It’s about working through things as they come up, without the need for perfection. If you’re struggling to figure out what to say, try simply voicing that struggle. You could say, “I’m not sure what I should be talking about, but I’m here.” And that’s enough.
What to Say When You’re Ready to Approach the Hard Stuff
Sometimes, when you finally work up the courage to say something important, it can feel like it’s stuck inside you, waiting to get out. You know it’s necessary, but it feels hard to get the words right. Whether it’s talking about a past trauma, a difficult relationship, or even a lingering sense of dissatisfaction, therapy is meant to be a space where you don’t have to have it all figured out before you speak.
If you feel like something heavy is on your mind but don’t know how to start, it’s okay to just acknowledge it: “I’ve been holding onto something, but I’m not sure how to bring it up.” That’s still progress. Your therapist will work with you, helping to unravel the feelings and guiding the conversation. Don’t pressure yourself to be completely composed.
What to Say When You Feel Self-Critical
A lot of people struggle to open up in therapy because they feel like they should already have a solution to their problem. Maybe you feel like you’re not allowed to ask for help because others expect you to have it all together. If you find yourself criticizing yourself for not knowing exactly what to say in therapy, try sharing that with your therapist. Saying something like, “I’m worried I’m not doing this right” can open up a really important discussion about self-compassion and the pressure you may feel.
Remember, therapy is a process of self-discovery, not a checklist. It’s okay if you’re unsure. It’s okay if you feel like you’re still figuring it out. Sharing that uncertainty can be one of the most helpful things you can do to move forward in your sessions.
What to Say When Silence Feels Uncomfortable
You might find that there are moments of silence during your therapy sessions. It can be tempting to fill that silence with words just to avoid the discomfort. But this space—this moment of quiet reflection—is actually valuable. You don’t have to rush to fill the void. In fact, you might be surprised at what comes up in those moments of pause.
If you’re unsure of what to say next, just sit with the silence for a moment. If it feels uncomfortable, that’s okay. You can always say something like, “I’m not sure what to say next,” or “I feel stuck in this conversation.” That honesty keeps things moving forward, even if it feels like you’re not making immediate progress.
What to Say in Therapy When You Want to Move Forward
Ultimately, the most powerful thing you can say in therapy is the truth, even when it feels hard. If you feel confused or stuck, express that. If you’re unsure about the direction of the conversation, speak up. If you’re self-critical about not having the perfect words, let your therapist know. Every moment of honesty, no matter how small, is a step toward understanding yourself better.
The key is consistency. Therapy isn’t about having the “right” thing to say; it’s about showing up with what you’ve got and trusting the process. Over time, your ability to articulate what you’re feeling will grow, but that takes patience—and it starts with saying what you can, even when you don’t know exactly what to say.
Still need more support? Schedule a free 15-min phone consult to see if we’d be a good fit to help you take the next step from self-help to therapy (applicable for South Carolina residents).
by Samm Brenner Gautier, LPC, LPCS-C
