As a Therapist, Here Are the 5 Most Common Things People Bring Up in Therapy

Table of ContentsView AllTable of ContentsFeeling ‘So F***ed Up’Thinking They’re ‘Behind’ in LifeThinking They ‘Should Be Over This By Now’Feelings of LonelinessThey ‘Just Can’t Get Motivated’

Table of ContentsView All

View All

Table of Contents

Feeling ‘So F***ed Up’

Thinking They’re ‘Behind’ in Life

Thinking They ‘Should Be Over This By Now’

Feelings of Loneliness

They ‘Just Can’t Get Motivated’

As a therapist, I consider it such a privilege and a gift that people let me into their inner worlds. I get to hear people’s triumphs and am entrusted with shining a light into the darkness that not many other people get to see.

I hear it all—huge, exciting news my clients share with me, as well as some pretty messed up stuff that makes me so sad to think that another human could do this to someone.

But in between these two extremes, there’s a handful of themes that I hear all the time. If one of these resonates with you, please remember that just because a concern is common doesn’t mean it’s not real. If anything, it means you’re not alone in having a hard time with it.

You’re not fed up: fed up st happened. I absolutely do not believe that any of my clients are inherently f*ed up. Idobelieve that a lot of really messed up stuff has happened to them, though. Maybe the resulting feelings or behaviors are undesirable to themselves or others, but these are in reaction to what has happened to them.

I really findself-compassionto be at the core of so much of the work we do on ourselves. It’s really hard to get to any deeper work if we don’t even believe that we are deserving of basic levels of care and kindness to ourselves.

Often, we lash out at either ourselves or others because our feelings have been invalidated, and we’ve been told that whatever isn’t a big deal. Self-touch can regulate our cortisol levels,which will then also regulate how we perceive stress.

How to Develop and Practice Self-Regulation

But in the modern-day, behind our keyboards, comparing ourselves to others will mostly hurt us. Research shows that spending more time onsocial media is linked to higher rates of depressionand anxiety.

It’s really hard to get to any deeper work if we don’t even believe that we are deserving of basic levels of care and kindness to ourselves.

Typically, if a client starts comparing themselves to someone else—particularly comparisons based on what they see on social media—I’ll remind them that what they see on someone else’s feed is a highlight reel. Sure, you may see a picture of a “perfect” family, but what you don’t know is that one of the partners is battling asubstance use disorder, and they had a huge fight just before this picture.

If it’s a client in their 20s, I’ll also point out that probably up until relatively recently, everyone was on a similar life path: graduating high school, maybe going to college. When one is in their early-to-mid 20s, it’s typically their first time playing without a rulebook in life. While that can be scary, it can also be really exciting.

Part of our work will also be deconstructing where these views of where they “should be” came from. Their parents? Their peer group? Society? Some combination therein? I’ll help people focus on whether they even want to play that game. Do you want 2.5 kids and a picket fence, or would you maybe be more happy as a nomad or some life path that doesn’t even exist yet?

Arrival Fallacy: Will Reaching a Goal Make You Happy?

But just as you and I could both scrape our toes today, and our wounds would recover at different rates, the same applies to our hearts. I often will remind clients that they had x time with their person—yet they think their grief will just heal in a few months?

Or, I ask them to pretend that it is their best friend that they are telling me about. Would they say these same mean or unrealistic things to their best friend? For nearly everyone, this one question gives them at least a little bit of pause—sometimes before they then tell me why, “No, but I’m different,” but all I’m going for is interrupting those well-worn neural pathways with a bump in the road.

As someone who made her career as a writer before becoming a therapist, a whole lot of my life is out there on the internet. This means I certainly self-disclose probably a little more than the average therapistsince I know that it’s also totally possible that a client has read what I’ve written about any given topic.

As I began to self-disclose a bit to this client, it struck me:the experience of feeling lonelyis what was actuallyconnectingus at that moment. Loneliness, I told her, is one of the most universal human emotions. It feels so paradoxical that feeling alone can unite so many of us, but we have a loneliness epidemic on our hands.

…all I’m going for is interrupting those well-worn neural pathways with a bump in the road.

I walk a fine line between helping people see the forces that might have contributed to some of their problems—andhelping them see places where they can change that. I never want a client to feel blamed for their problem—rather, I want them to see that they have the agency and power to change many of the things in their life they’re currently unhappy with.

I’ll also do some reality testing with them of if these beliefs are accurate. I know that, for me, I can often feel lonely, but Idohave many people who care about me. I tend to downplay how much I might matter to someone else, so my own therapist helps me challenge that to see where Idohave support, which often makes me feel less lonely than I originally thought I was.

But, of course, there are plenty of people whoaregenuinely isolated. I will help them see if therearepeople in their lives they can start reaching back out to, or how they might be able to find more people in their lives around a shared interest or location.

How to Cope With Loneliness

While we all struggle with motivation from time to time, if you find it more difficult than usual to focus or get things done, you’re probably really frustrated! I’m pretty sure every single client I’ve ever seen has told me at some point or another that they’re struggling with motivation.

I want to know what that means to them. Does “not feeling motivated” mean that they can’t get out of bed and are struggling to fulfill their basic daily obligations, or does it mean that they have expectations that may be unrealistic to them?

Depending on their answer, I may tell them to do less because they’re actuallyburnt out. On the other hand, if “not feeling motivated” means struggling with basic tasks, I will help them come up with strategies to make things easier for themselves, which could range from assigning themhomework for accountabilityto recommending a consultation with a psychiatrist to consider medication.

If you or a loved one are struggling with motivation or getting things done, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

For more mental health resources, see ourNational Helpline Database.

What This Means For YouWhether you’re dealing with one of these common issues or something else entirely, don’t be afraid to tell your therapist—we’ve truly heard it all. There is no issue too shameful to bring to therapy.

What This Means For You

Whether you’re dealing with one of these common issues or something else entirely, don’t be afraid to tell your therapist—we’ve truly heard it all. There is no issue too shameful to bring to therapy.

3 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Self-soothing touch and being hugged reduce cortisol responses to stress: A randomized controlled trial on stress, physical touch, and social identity. Comprehensive Psychoneuroendocrinology. 2021;8:100091. doi:10.1016/j.cpnec.2021.1000918.Shensa A, Sidani JE, Dew MA, Escobar-Viera CG, Primack BA.Social media use and depression and anxiety symptoms: a cluster analysis. Am J Health Behav. 2018;42(2):116-128. doi:10.5993/AJHB.42.2.11Henretty JR, Currier JM, Berman JS, Levitt HM.The impact of counselor self-disclosure on clients: a meta-analytic review of experimental and quasi-experimental research.J Couns Psychol. 2014 Apr;61(2):191-207. doi:10.1037/a0036189

3 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Self-soothing touch and being hugged reduce cortisol responses to stress: A randomized controlled trial on stress, physical touch, and social identity. Comprehensive Psychoneuroendocrinology. 2021;8:100091. doi:10.1016/j.cpnec.2021.1000918.Shensa A, Sidani JE, Dew MA, Escobar-Viera CG, Primack BA.Social media use and depression and anxiety symptoms: a cluster analysis. Am J Health Behav. 2018;42(2):116-128. doi:10.5993/AJHB.42.2.11Henretty JR, Currier JM, Berman JS, Levitt HM.The impact of counselor self-disclosure on clients: a meta-analytic review of experimental and quasi-experimental research.J Couns Psychol. 2014 Apr;61(2):191-207. doi:10.1037/a0036189

Self-soothing touch and being hugged reduce cortisol responses to stress: A randomized controlled trial on stress, physical touch, and social identity. Comprehensive Psychoneuroendocrinology. 2021;8:100091. doi:10.1016/j.cpnec.2021.1000918.Shensa A, Sidani JE, Dew MA, Escobar-Viera CG, Primack BA.Social media use and depression and anxiety symptoms: a cluster analysis. Am J Health Behav. 2018;42(2):116-128. doi:10.5993/AJHB.42.2.11Henretty JR, Currier JM, Berman JS, Levitt HM.The impact of counselor self-disclosure on clients: a meta-analytic review of experimental and quasi-experimental research.J Couns Psychol. 2014 Apr;61(2):191-207. doi:10.1037/a0036189

8.Shensa A, Sidani JE, Dew MA, Escobar-Viera CG, Primack BA.Social media use and depression and anxiety symptoms: a cluster analysis. Am J Health Behav. 2018;42(2):116-128. doi:10.5993/AJHB.42.2.11

Henretty JR, Currier JM, Berman JS, Levitt HM.The impact of counselor self-disclosure on clients: a meta-analytic review of experimental and quasi-experimental research.J Couns Psychol. 2014 Apr;61(2):191-207. doi:10.1037/a0036189

Meet Our Review Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?HelpfulReport an ErrorOtherSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?HelpfulReport an ErrorOtherSubmit

What is your feedback?

What This Means For You#

What This Means For You