You booked the appointment. You showed up. And then you sat there, said things were “fine, mostly,” talked about work for forty minutes and left without mentioning the thing you actually came in for.
If that sounds familiar, you’re in very good company. Opening up to someone you’ve just met is hard, even when that person is a therapist and even when you’re paying them to listen. Here’s why it’s so hard, why it matters, and sixteen practical ways to make it easier.
Seeking therapy is a big step
Opening up is especially hard if you’re a private person who doesn’t like talking about yourself. Most of us have things we’d rather not share with close friends or family, let alone someone we met an hour ago. That’s normal.
But therapy works best when the things that are really affecting your life make it into the room. To get the most from your sessions, it helps to learn how to open up in therapy: to notice the vulnerable feelings that come up, and to find a way to say them out loud.
Holding back is also extremely common. Researchers who study psychotherapy have found that many clients, likely most, have held something back or shaded the truth with a therapist at some point. Common examples are things people feel ashamed of: sex, substance use, self-harm or thoughts of suicide, and feelings about the therapist themselves. If you’ve done this, it doesn’t mean you’re bad at therapy. It means you’re human.
If you haven’t started yet, my post on how to email a therapist for the first time covers the step before this one.
Why is it essential to open up during therapy?
If you’ve decided to go to therapy, part of you already knows it could help. The tricky part tends to come when it’s time to put your thoughts into words.
Because your therapist starts out as a stranger, you might leave out details you assume aren’t relevant. Or you might soften the truth so you don’t have to sit in the discomfort of saying it. Both are natural ways of protecting yourself. Both also leave your therapist working with an incomplete picture.
Your conversations are private and free from judgment
A good therapist isn’t sitting there grading you. Thoughts, actions and behaviors that you’re embarrassed about aren’t evidence against you. To a therapist, they’re clues: they help us understand what’s going on and what might help. My job is to help you make sense of what’s happening, not to judge it.
If you’re worried about your story leaving the room, know that confidentiality is a core legal and ethical duty for therapists. I don’t discuss what happens in sessions with anyone in your life. There are a few narrow exceptions set by law, such as a serious risk of harm to yourself or someone else, or suspected abuse of a child, elder or dependent adult. Any therapist should explain these limits at the start, and you can ask about them any time.
Therapists are human too. It isn’t unusual for me to think about a client between sessions, usually wondering how I can be more helpful next time. That’s part of caring about the work.
The devil is in the details
When you leave out a detail or bend the truth, it can feel like no big deal. Why spend time on something you’d rather avoid? The trouble is that the thing you skip is often the thing that matters most.
When you see a doctor for a bacterial infection, the treatment is usually straightforward. Therapy doesn’t work like that. There’s no single plan that fits everyone, and what helps depends on the specifics of your life, your history and your relationships. The small detail you think is irrelevant (“I always feel sick on Sunday nights,” “I haven’t told my partner about the credit card”) might be exactly what makes the rest make sense.
It isn’t always easy to open up, and nobody expects you to do it all at once. But as you let a little more in, therapy usually starts to feel more useful. You notice new things about yourself, and the work starts to move.
16 tips to help you open up during therapy
These are things I suggest to clients, and things therapists commonly recommend. Try one or two. You don’t need all sixteen.
1. Write down your thoughts before sessions
Before a session, take ten minutes to jot down what’s been on your mind: feelings, events, conversations, things you keep replaying. Many people find it much easier to talk once the thoughts are already on paper.
A notebook or notes app just for therapy can help you track patterns over time too. Some people write their therapist a short letter before the first visit, so there’s context before they even sit down.
You can bring your notes into the session. If something feels too hard to say out loud, you can read it, or simply hand it over. That counts.
2. Prepare yourself physically and mentally
Walking in tense makes it harder to talk. Before the session, try a few minutes of slow breathing, a short walk, or music that settles you. If you’re coming in person, arriving a few minutes early gives you time to get used to the space. If you’re meeting online, find a private spot, close other tabs and give yourself a buffer before you log on.
3. Choose a convenient appointment time
Squeezing therapy between two meetings, or on a lunch break with your phone buzzing, makes it hard to let your guard down. If you can, choose a time when you aren’t rushing in or out. Some people like a bit of space afterward too, because sessions can stir things up.
4. Ask about confidentiality
Most people know therapy is private, but hearing your therapist explain it in plain language, including the limits, can make a real difference. It’s a completely normal question. Ask it in the first session, or any time it’s on your mind.
5. Don’t feel pressured to dive in immediately
You don’t have to bring everything to the first session. That would overwhelm anyone. You can start with who you are, what your life and relationships look like, what you care about and what you’re hoping for. As trust builds, the harder things tend to come more easily. There’s no deadline.
6. Practice what you’re going to say
If there’s something specific you want to bring up, try saying it out loud before the session: in the car, in the shower, to the mirror. It may feel silly. It also makes the words familiar, so they come out more easily when it counts.
7. Follow your therapist’s lead
Therapists know that many people find it hard to open up, so we often guide the conversation more in the first few sessions. You don’t need to arrive with an agenda. If your mind starts drifting to what you’ll say next, or to your to-do list, gently bring your attention back to the conversation you’re in.
8. Use references
If it’s hard to describe how you feel, borrow from something else: a song, a movie scene, a character, a meme. “I feel like the guy in that movie who keeps waking up on the same day” says a lot. A reference gives your therapist a way in, and you can work out what it means for you together.
9. Ask about other ways to communicate
Talking isn’t the only way in. You can write things down, draw, bring in a photo, or text yourself notes during the week and read them in session. Some therapists also use approaches like art or sand tray work. Tell your therapist what feels easier for you, and see what fits.
10. Remind yourself why you came
Sometimes it helps to step back and remember what made you book in the first place. What do you want to be different in six months? Keeping that goal in mind can give you the push to say the harder thing.
11. Know that you’re not alone
Whatever you’re carrying, other people are carrying something similar. Feeling like you’re the only one can make it lonely and harder to say. Your therapist has almost certainly heard versions of it before, and won’t be shocked.
12. Understand that therapy is guidance, not instructions
A common myth is that therapists tell you what to do. That isn’t really how it works. A good therapist helps you notice your patterns, understand what drives them, and find the choices that fit your life. You stay in charge of your decisions.
13. Be honest
Leaving out important information keeps you stuck, because your therapist is trying to help with a version of the problem that isn’t quite real. You don’t have to say everything at once, but whatever you say, try to make it true. It’s also fine to say, “There’s something I’m not ready to talk about yet.” That’s honest too.
14. Be yourself
You don’t need to be a “good client.” You don’t need to be articulate, calm or funny. Your therapist needs to know the real you, including the parts you usually hide, to be able to help in the way you need.
15. Tell your therapist you have trouble opening up
This one is underrated. Saying “I find this really hard” is one of the most useful things you can say in therapy. It tells your therapist how to pace things, and it often becomes part of the work itself.
If opening up is hard here, it’s probably hard in other relationships too. Working on it in therapy often helps with your partner, family and friends. In couples therapy, one partner going quiet while the other pushes to talk is one of the most common patterns I see.
16. Give it time
The early sessions can feel awkward. That’s normal. Trust builds through repetition: showing up, saying something a little vulnerable, and noticing that it was received with care. Over time, the relationship with your therapist becomes one of the things that helps.
Reasons you might struggle to open up to a therapist
One reason is the shape of the relationship itself. Your therapist may come to know a lot about you, while you know very little about them. That’s by design, but it runs against how trust usually works. In most relationships, we share as much as the other person shares back.
Other common fears include:
- Being misunderstood, judged, labeled or rejected
- Being seen as dramatic or attention-seeking
- Your information ending up in the wrong hands
- Your problem not feeling “serious enough” for therapy
- Saying the wrong thing
All of these make sense, and all of them are worth saying out loud in session. If you worry your problem is too small, tell your therapist. A good one will help you see that if it’s affecting your life, it’s worth talking about.
You can bring up nearly anything in therapy, including how therapy itself is going. If you’ve given it a fair chance and still don’t feel comfortable with your therapist after several sessions, it’s fine to say so, and it’s fine to look for someone who’s a better fit. Fit matters.
Therapy is more effective when you open up
It’s hard to be vulnerable with anyone, especially someone new. But the more of your real life you bring into the room, the more useful therapy tends to be. Pick one or two of these tips, try them in your next session, and see what happens.
If you’re looking for a therapist in Los Angeles or anywhere in California, you can read more about how I work in individual therapy. When you’re ready, book a free 20-minute consultation. No pressure, just a conversation.
