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  • Writer's pictureAmanda Marie

Speaking Points in Therapy: Do I Need an Agenda? - Dr. Amanda Aster-McKenna, Licensed Psychologist in Montclair, NJ

Dr. Amanda Aster-McKenna - Licensed Psychologist in Montclair, NJ

If you are new to the therapeutic process, or even if you are a seasoned veteran, choosing what to share with your therapist can be an unnerving process. Please note that you are not going at it alone for the total 50-minute therapy hour. You can expect some help from your therapist along the way. The most ambiguous yet simple answer to the question of “What should I talk to my therapist about today?” is “whatever you want.” However, for a more concrete response to this common question, you could think about the rationale and reason on why you decided to embark on therapy in the first place, and start there. Frequently, folks that have made the intentional commitment to begin therapy are aware that there is some aspect within their life that is not working for them, or that is causing psychological distress and suffering.

What Brought You to Therapy? 

Some typical reasons for saying “yes” to therapy are: grief/loss issues, past trauma, substance use/misuse/abuse, difficulties at work and/or in relationships with family, friends, and/or intimate partners, major depression, extreme anxiety, perfectionistic tendencies, family of origin “stuff,” and sexual identity issues, to name a few.

It is almost unnecessary to bring in pre-contemplated material in an effort to fill a full 50-minute therapy session because in most cases, your therapist will also have questions to ask of you; will be able to note on non-verbal behavior patterns; comment on your thought processes and feeling states; and help to guide the conversation. This is especially true if your therapist employs an evidence-based framework utilizing more modern approaches to treatment such as Acceptance and Commitment therapy (like myself!), Cognitive Behavioral Therapy, and other acceptance and mindfulness-based therapies.

However, if you are ridden with anxiety and feeling stuck, or have no idea why you are experiencing this bout of depression, or are overall well-functioning, for example, some questions to consider are:

  • Why did I choose to seek therapy at this point in my life? 

  • Is there any place in my life that I feel stuck or stagnant in?

  • What is the quality of my interpersonal relationships? Am I satisfied with them or is there room for change?

The Role of Vulnerability in Therapy

All this to say, do you need an agenda to think about before your therapy session begins? The short answer is no. While it is completely within the realm of reason to not know where to start, the true magic happens in therapy when you choose vulnerability over avoidance, and allow yourself to share the un-sharable. You would be surprised how often I hear from the amazing folks I work with say towards the end of the session “Wow, I didn’t think we’d go here today!” or “Wow, I had no idea I would bring that up with you during this session.” More often than not, the therapeutic dance of back-and-forth banter combined with clinical expertise and courageous vulnerability can lead to rich, informative, and transformational conversation and learning experience.

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Peace, Love, & Fierce Acceptance

Dr. Amanda Aster-McKenna, Psy.D.


NJ Licensed Psychologist #5888, Private Practice, Montclair, NJ

Adjunct Professor, Kean University, Department of Advanced Studies in Psychology

Board Member, Mental Health Association of Essex and Morris

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