You’ve thought about starting therapy. Maybe you’ve even found someone you’d like to contact. Then another worry shows up: “What am I supposed to talk about?”

You might have plenty on your mind but struggle to explain it. Or you may worry that once you sit down, you’ll forget everything that made you schedule the appointment.

You don’t need to prepare a speech. A sentence about what has been difficult lately is enough to begin.

Start with one ordinary moment

Trying to summarize your whole life can make the first conversation feel bigger than it needs to be. Choose something recent instead.

“I was exhausted last night, but I kept replaying a conversation.”

“I wanted to cancel plans because I couldn’t stop thinking about what might go wrong.”

“I keep checking my work, even when I’ve already checked it.”

An everyday example gives you something specific to talk about. You don’t have to know why it happens or have a name for it.

You can say that you don’t know where to start

That sentence belongs in therapy, too.

You might say, “I’ve been feeling overwhelmed, but I’m having trouble putting it into words. Could you ask me a few questions?”

Or: “I almost didn’t come because talking about myself makes me nervous.”

There’s no need to hide your uncertainty to make the appointment go well. It gives the therapist useful information about what starting feels like for you.

Bring a few notes if that would help

A short note on your phone can be useful if your mind tends to go blank under pressure. You could write down:

  • What made you consider therapy.
  • One situation that has been difficult lately.
  • Something you’d like to feel more able to do.

Keep it brief. “I want to fall asleep without reviewing the entire day” says more than a carefully written paragraph that doesn’t sound like you.

You can read from your notes or use them as a reminder. And if preparing becomes another thing to worry about, you can come without them.

Ask your own questions

You’re also getting to know the therapist.

You can ask how they work with anxiety, what appointments are usually like, and how you’ll choose goals together. If something is unclear, ask for an example.

It’s also reasonable to say that you need time before discussing a particular topic. The therapist can explain what information is important to understand early on and talk with you about a manageable pace.

Let the first conversation be a beginning

You may leave the appointment thinking of something you forgot to mention. Write it down for next time.

You don’t have to explain every worry, remember every detail, or leave with everything figured out. The first conversation gives you a place to start and a chance to consider whether this therapist feels like a good fit.

Jennifer Pankow-Martinez, EdS, LMHC offers anxiety therapy for teens and adults in Coral Gables and Miami, with telehealth throughout Florida.

Learn more about anxiety therapy or contact her with questions about starting.