What to Talk About in Therapy: How to Get the Best Results – Part Two

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What to talk about in Therapy, the 2nd part in a six-week series about what you should say to your Therapist. Therapy is sometimes a scary first step!
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What to Talk About in Therapy: How to Get the Best Results - Part Two

What to Talk About in Therapy: How to Get the Best Results – Part Two

What to Talk About in Therapy. This second part is a six-week series about what you should say to your Therapist. The first article is How To Get The Best Results: What To Talk About In Therapy – Part One.

I remember the second time James drove me to my appointment. I sat in the car and cried so hard. It isn’t very comforting sometimes when you don’t know what to say or have too much to say and don’t know where to start! 

TRIGGER WARNING - Rape, Recreational Drinking, and Drugs

As I always say, I am not a Therapist or a Psychiatric. I am a person with mental illness who has been to several Therapists. I am confident in telling you the things that helped me in my sessions and why. You should always seek medical attention. 

Your Therapist is there to help you. They need to know these things first, though. If you can plan ahead, it will help you immensely! 

Last week we looked at 

  • Your Sexual Orientation and Gender Identity.
  • Family History
  • Medical Conditions
  • Religious Beliefs 
  • Political views 
  • Things you want to work on

This week we are going to talk about 

  • Attitudes about Medication 
  • Substance Use History
  • Negative Habits and Addictions 

Attitudes About Medication

You will want to talk about failures with medicine in the past. Did you have a reaction that makes you not want to try something else? Or did you abuse the medication because it really helped, and you wanted more? Both are important things to tell your Therapist to understand your position better.


How do you perceive medicine? Do you think it confirms you are “crazy”? Some people have a stigma about taking psychiatric medication because they believe it is admitting there is something “wrong” with them. I can relate! When my Doctor wanted me to try Prozac, I instantly resisted! I was thinking, “NO, crazy people take that!” I voiced my fears, and my Therapist explained the reasons why she felt the medicine would help me and that there was not anything “crazy” about it


Does your Therapist work with a Psychiatrist on staff? Some Therapists do not prescribe the medication themselves and refer you to a doctor in practice or one they are affiliated with. Do they consult together regarding your meds? You will want to know if your Therapist will discuss your treatment with your Doctor. If so, they will better understand adjuting doses in the future.


Many people fear pharmaceutical companies and the side effects you hear in commercials. This is a common fear! I watch too many commercials where the whole dialogue is side effects and ends with may result in death. I think I would rather have a mental illness than be dead! Your support team will explain all the things you need to look for and will reassure you that the “may result in death” is in rare cases.


What if the medication doesn’t work? Do you try something else? Is it a guessing game? I do not want to be a guinea pig! I have often had to try different forms of the same type of medicine until my Doctor found the one that worked for me. This is not uncommon. Drugs affect other people differently. Your Doctor will know what a drug can do, but he is unaware of how your physical body will react. Sometimes they require a change.


Will it change my personality? People are concerned about how the medicine will affect them. I was always afraid that they would make me mean or “like a zombie” Today’s medication has come a long way compared to older drugs. If you choose to take them, you just need to monitor your emotions. If you see changes you do not like, report them to your Therapist or Physiatrist immediately.


Will I be on this forever? To be truthful, you might be on some medication for a lifetime. It depends on your condition and how the drug helps you. I am on medication forever. It is not a comforting thought, but it is better to know. I recommend asking your staff about it.


You ultimately say yes or no, knowing beyond a doubt that you are in control of your body unless you cannot make decisions for yourself (that is some other topic). You can refuse or accept taking medications. It is a choice that is made in agreement with your Therapist, your Doctor, and you. If you refuse, no one can force you to take it. They might try to explain why they feel like you need it, and I advise that you make an informed decision, NOT purely on your fears. In many cases, medicine has dramatically reduced symptoms of mental illness.

Substance Use History

Your Therapist is bound by confidentiality. That means they can not repeat or “tell on you” unless certain things happen. For example, you threaten death to yourself or someone else or endanger yourself or others (child abuse or elder abuse). With that being said, I do not think a therapist would turn you in for occasionally smoking marijuana. BUT They need to know because symptoms of alcohol and drug use can mirror symptoms of some mental illnesses. If they were to diagnose you with paranoia and you had just taken too much marijuana, you could be misinterpreted and given medication you didn’t need. It is wise to tell that you use alcohol or recreational drugs.


Alcohol and recreational drugs can make your medicine stronger or weaker. It alters the chemicals in them. Doctors know that this is the case. If you are drinking alcohol, your Doctor might prescribe a different medication that will work as intended. He will most likely say stop your alcohol use or reduce it but can make an informed choice on what to prescribe or tell you how to take it correctly.

Negative Habits and Addictions

Negative Habits and Addictions that are related to Mental Illness. Your Therapist needs to know these things. There is NO shame. They might be a symptom of a mental illness. Your Therapist is a trained professional. There is NOTHING that you can say they have not heard before. 

  • Excessive Social networking.
  • Procrastination
  • excessive worrying
  • Criticizing yourself constantly

  • Poor eating habits (over-eating or not at all and skipping meals)
  • Poor sleeping habits (a lot of sleep or no sleep)
  • Showering or bathing infrequently (neglecting self-care)

  • Poor spending habits.
  • Emotional shopping sprees or Stress-shopping 
  • Recklessly spending money on things you don’t need

  • Saying yes to too many things (people pleasing)
  • Agreeing with everyone just to avoid an argument or conflict 
  • Habitually Lying 

  • Drinking too much coffee/caffeine/Soda 
  • Taking dangerous stimulants (pills or energy drinks) 

I can say without embarrassment that I have many of these habits. I am also mentally ill and can say that I need help with these issues. It is NOT bad or wrong to need help. This is the main reason I have for writing this blog. I want people to know that they are not alone and it is OK to get help. It is OK to admit that you use recreational drugs. Mentally ill people usually had serious things happen in their lives, abuse or other trauma before they used drugs or experienced chronic pain. 


People have reasons for not taking a shower as they should, I am taking better care of myself, but for those that do not know, I was raped by a family member many times in the shower. I HATE taking a shower. It is a trigger for horrible memories for me. It does NOT mean that I shouldn’t shower; I need to work with my Therapist to redirect my thoughts when I am in there or shower when my husband is at home, which can help me feel safe. To know more about me, please read Uncover My Account In The Journey Of My Life.


We all have pain, shame, and embarrassment over some of these things or all of them. Maybe every single thing I brought up is you on the dot. I am not pointing at you. Honestly, I am telling myself and saying I can help someone! My pain and my illness can have a purpose, to help you. Your pain and embarrassment and shame can help someone too. We have to unite to change the world’s view on Mental illness. It is NOT your fault.  


Please reach out to me! Let me know that you are with me in this battle! I support you, and I care. I will listen! YOU matter! 


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4 Responses

  1. These are great tips. I totally agree that therapists are there to help you and they can only help if they know your whole story. Great read, thanks!

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