This worry keeps a lot of people from ever scheduling their first appointment. They sit there thinking about therapy, wanting to try it, but then hit the same wall. What would I even say?

It feels like you need to show up with a script. A list of problems. A presentation on everything wrong in your life. And if you can’t organize your thoughts into neat talking points, maybe you’re not ready for therapy yet.

That’s not how it works.

If you knew exactly what was wrong and could explain it perfectly, you probably wouldn’t need therapy in the first place. Part of the reason people go to therapy is because they can’t quite name what’s happening. Something feels off. Life feels harder than it should. Emotions are all over the place.

That confusion is actually a great starting point.

A therapist’s job is to help you sort through the mess. They’re trained to ask questions that help you find the words. You don’t need to arrive with answers. You just need to show up.

Most first sessions aren’t about solving anything. They’re about getting to know each other and figuring out what brought you in.

Your therapist will probably ask some version of “what’s going on” or “what made you decide to try therapy.” You can answer that however feels honest. Something like “I’ve been feeling really overwhelmed lately” or “I don’t know exactly, I just feel stuck” is a perfectly fine response.

From there, they’ll ask follow up questions. They might ask about your sleep, your relationships, your work, your mood. These questions help them understand your situation and also give you something to respond to. You’re not sitting in silence trying to come up with topics.

The therapist does a lot of the heavy lifting in early sessions. Your job is just to be honest about what’s going on, even if “what’s going on” is “I’m not really sure.”

If you’re worried about having nothing to say, here are some things people often bring up when they’re new to therapy.

Something specific that’s bothering you. Maybe it’s a fight with a family member, burnout from work, or a messy breakup. You don’t need to know why it’s bothering you so much. Just knowing that it is gives you something to explore.

A pattern you’ve noticed in yourself. Maybe you always get anxious before social events. Maybe you shut down during conflict. Maybe you can’t stop scrolling your phone late at night even though you know you should sleep. Patterns are great material for therapy.

Something you’ve never told anyone. Therapy is one of the few places where you can say the things you’ve been holding in. You don’t have to share everything in the first session. But knowing you have the space to eventually talk about hard things can be a relief.

How you’re feeling right now. Nervous about being there? Say that. Skeptical that therapy will help? That’s worth talking about too. Whatever is happening in the moment counts.

This isn’t a job interview where you need to prove yourself. It’s also not a performance where you need to be interesting or impressive.

Therapists are used to working with people who don’t know where to start. They have training in how to draw out what’s going on beneath the surface. They’ll notice things in what you say and follow up on them. They’ll ask questions you hadn’t thought to ask yourself.

You’re not alone in the room trying to fill silence. You’re in a conversation with someone whose whole job is helping people figure out what they need to talk about.

Sometimes there are pauses. Sometimes you’ll say something and then not know what comes next. That’s normal and it’s not a problem.

Silence in therapy isn’t like silence on a first date where everyone feels awkward. It’s space to think. Space to notice what’s coming up. Sometimes the most important realizations happen in those quiet moments.

A good therapist won’t rush to fill every pause. They’ll give you room to find your own words.

Here’s the thing. If you wait until you feel ready, you might wait forever. The uncertainty you’re feeling right now is actually part of why therapy could help.

People across Philadelphia and South Jersey put off therapy for years because they feel like they need to reach some level of crisis first. Or because they think their problems aren’t serious enough to take up a therapist’s time. Or because they can’t articulate what’s wrong.

None of those are real barriers. They’re just the stories we tell ourselves to avoid doing something that feels vulnerable.

Once you start talking, most people find they have more to say than they expected. The act of sitting down with someone who’s there just to listen, without judgment, without interruption, without trying to fix you, opens something up.

You might end up talking about your childhood. You might vent about something that happened at work near Rittenhouse that week. You might finally admit something you’ve been avoiding.

Or you might spend the whole first session just getting comfortable. That’s fine too. Therapy isn’t about getting everything out at once. It’s a process that unfolds over time.

If you’re in Philadelphia or Haddonfield and you’ve been thinking about trying therapy, you don’t need to figure out what to talk about first. You can schedule an appointment and let the rest unfold.

The hardest part is making that first call. Everything after that gets easier.

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