When Therapy Feels Awkward: How Do I Know What to Talk About?
Let’s face it—starting (or restarting) therapy can be a daunting experience, and it’s completely natural not to know exactly what to expect. Whether you’re brand new to therapy or have had several therapists in the past, each session can bring up many different emotions, including uncertainty, nervousness, or even dread. The idea of sitting across from someone and trying to open up about your inner world can feel incredibly vulnerable. If you've had therapy before, chances are you have a story (or a few) about a session that felt especially awkward or uncomfortable—maybe you couldn't find the right words, didn't know where to start, or left feeling unsure about what just happened. These experiences are not only common—they're expected. Therapists understand that part of the process involves moments of silence, confusion, or emotional blocks. Most therapists anticipate this and are trained to guide you through it gently.
Here’s something else worth knowing: many therapists have sat on the other side of the room themselves. They've experienced the same unease, hesitation, or self-doubt that you might be feeling now. That shared understanding is part of what makes the therapeutic relationship so human and healing. In this article, we’re going to talk about what it actually feels like to be “stuck” in therapy—those moments when the words just don’t come, or you feel emotionally frozen. We’ll explore some common reasons why this happens, and more importantly, we’ll offer practical tools and gentle encouragement to help you feel more at ease. Because therapy is not about being perfect—it’s about showing up, even when you don’t quite know how.
There are many reasons why it can feel so challenging to know what to say during a therapy session. When your mind is racing, or your emotions feel heavy, it's easy to become overwhelmed or unsure of where to begin. For neurodivergent individuals—such as those with ADHD, Autism, Dyslexia, or other related conditions—this can be especially challenging. One reason is that organizing thoughts, prioritizing what to discuss, or even identifying how you're feeling in the moment may require more effort. In particular, people who experience something known as Pathological Demand Avoidance (sometimes referred to as Persistent Drive for Autonomy) can feel strong internal resistance when they sense expectations or pressure—even gentle ones. This isn't about laziness or defiance; it's a nervous system response where motivation decreases when you feel that a task is being externally imposed, even if it's something you genuinely want to do. So, when therapy starts to feel like something you "should" be doing or when there's pressure to "open up," it can trigger that avoidance response. If this sounds familiar, know that you're not alone—and it's something worth exploring with your therapist. Naming this experience can be the first step toward finding strategies that honor your autonomy while still allowing you to engage meaningfully in the therapeutic process.
Another common barrier in therapy is the difficulty some people have with identifying and naming their emotions. This isn't unusual, and it certainly isn't a personal failing. Many adults reach therapy without ever having been taught how to recognize, label, or express their feelings. Often, this gap stems from early life experiences. Some caregivers may not have had the tools or emotional awareness themselves, while others might have been overwhelmed, emotionally unavailable, or focused on survival rather than emotional education. During childhood, learning how to understand and express emotions is a vital part of healthy development—but when this learning is disrupted or absent, it can leave us feeling confused or disconnected from our inner world later in life.
There are also neurological and developmental reasons why someone might struggle with emotional identification. For example, neurodivergent individuals—such as those with Autism, ADHD, or other differences in brain function—may experience what’s known as alexithymia, a difficulty in recognizing and articulating emotions. This doesn't mean something is wrong; rather, it reflects a different way of processing internal experiences. For some, the link between emotions, thoughts, and bodily sensations is simply less intuitive or more fragmented, making it harder to “tune in” to what’s really going on inside.
The good news is that emotional awareness is a skill—and like any skill, it can be developed with time, practice, and the proper support. No matter how disconnected you might feel now, it is possible to strengthen your ability to recognize emotions, understand their origins, and communicate them more clearly. Therapy can be a safe space to begin building this foundation, one step at a time.
Another common challenge in therapy is figuring out what feels "important enough" to bring up. You might question whether your thoughts, feelings, or experiences are significant or valid, especially if you've spent years minimizing them or comparing them to what others have gone through. It's easy to find yourself thinking, “This probably isn’t a big deal,” or “Other people have it worse.” These kinds of thoughts can lead to silence in session, even when a lot is stirring inside. On top of that, many people carry shame, guilt, or self-judgment about discussing personal struggles, past mistakes, or traumatic experiences. These emotions can make it even harder to speak openly—even when you genuinely want to.
But here’s the truth: if it matters to you, then it matters. Every thought or feeling you bring into the room is valid. Therapy isn’t about ranking problems by severity—it’s about making space for your inner experience, whatever that looks like. You are not expected to share everything right away (or ever), but as trust builds between you and your therapist, and as the environment begins to feel more emotionally safe and non-judgmental, it often becomes easier to know what you want to explore and to feel more confident doing so. Therapy is a space where you set the pace—and everything you choose to share is worthy of being heard.
Getting to the point where you can openly share in therapy and begin to feel "unstuck" is often a gradual and deeply personal process. It doesn't usually happen all at once, and that's completely normal. In fact, many people experience periods of feeling blocked, uncertain, or emotionally guarded during therapy—especially when touching on painful or vulnerable areas. It's easy to feel frustrated or discouraged when progress doesn't seem linear or immediate. You might wonder if you're doing it "right" or if therapy is really helping at all. These thoughts are common and completely valid. The critical thing to remember is that feeling stuck doesn't mean you're failing—it can actually be a sign that you're approaching something meaningful that needs care and patience to unpack. Trust and self-awareness take time to build. If you’re in that place now, you’re not alone. Below are some gentle, practical tips that might help you begin to move forward, feel more connected in your sessions, and share more openly with your therapist:
Take your time finding the right therapist. It's completely okay if you don't click with the first therapist (or even the second or third). A strong therapeutic connection is essential, and sometimes, it takes a few tries to find someone you feel comfortable with. If you notice the fit isn't quite right, don't hesitate to bring it up with your current clinician—they can often help guide you toward someone who might be a better match for your needs and style.
Talk about how you're feeling. Naming your emotions during a session—especially when you're feeling "stuck," uncertain, or overwhelmed—can be incredibly powerful. While it might feel intimidating at first, sharing what you're experiencing in real time gives your therapist valuable insight and allows you to work together to address the block. You don't need to have the perfect words—just starting with "I'm not sure how I feel right now" is a meaningful step.
Use journaling between sessions as a tool. Journaling can help you process your thoughts and track what's coming up for you throughout the week. This doesn't have to be traditional pen and paper (though research shows that can be especially effective); it could also mean jotting down notes on your phone, typing thoughts on your computer, or even expressing yourself through art or voice memos. Try prompts like: “What’s been on my mind lately?” or “What have I been avoiding talking or thinking about?” Let it be flexible and judgment-free.
Practice self-compassion throughout the process. Therapy doesn't have to feel "productive" every time for it to be meaningful. Some of the most significant growth comes from sessions that feel quiet, frustrating, or emotionally heavy. These moments are part of the process and often lay the groundwork for deeper insights. Give yourself compassion—you’re doing the work, even when it doesn’t feel obvious. Over time, you may come to see how even the small, uncomfortable moments contribute to your healing.
Above all else, talk to your therapist. Open communication is key, especially when something feels off, or you're unsure how to move forward in a session. Like many therapists, I aim to create a space that feels relaxed, welcoming, and free of unnecessary formality. Therapy doesn't need to be stiff or overly clinical to be effective. I believe in active listening and truly hearing what you have to say—but that doesn't mean we need to sit in silence, staring at each other, waiting for the "right" thing to be said. That dynamic can be especially difficult for neurodivergent clients, as mentioned earlier. Therapy should never feel like a space where you have to mask who you are—that’s exhausting, and it goes against the goal of healing. I often reassure clients that it’s completely okay not to know what to say, and I’ll step in with more structure or guidance when needed. When you feel safe to show up as your authentic self, conversations tend to flow more easily and naturally.
If you're thinking about starting therapy—or returning to it—consider this your green light. This is a great time to take that next step and reach out to someone you feel might be a good fit. Keep in mind that not every therapist will feel right for you, and that's okay. Finding the right therapeutic match can take time, but it's worth the effort. Every person deserves to feel truly seen and understood, and your story deserves to be met with empathy and care. I strongly encourage you to reach out to clinicians who are licensed in your state so you can begin to build that safe, supportive space where you can start to feel comfortable exploring your thoughts and experiences. You deserve it.
