In Therapy: What Will We Talk About?

Jay R. Feld - In Therapy: What Will We Talk About?Recently a client came into my office and announced, “I have five things I want to talk about!” He knew just what he wanted to talk about. Other clients know they want to be in therapy and that now’s the time, but they’re not exactly sure what to talk about. What issues do people usually talk about in therapy? Here are four common ones:


At birth, our “self-care quotient” is 0%. By our mid-twenties we’re shooting for 100%. In early adulthood we’re learning to manage both our inside and outside worlds, but we still have gaps in our ability to care for ourselves. We sometimes self-abandon instead of self-care.

Some of my clients hear “self-care” as “selfish” or “self-centered.” I encourage my clients to put “first things first” — after all, if they’re struggling with their own self-care, it will be much more difficult to care for those around them.  We focus on self-care skills such as:

        • Self-soothing, self-regulation
        • Self-awareness
        • Self-sympathy
        • Healthy self-esteem.

Work and Creativity.

Sometimes clients are stuck in unsatisfying jobs and need encouragement to explore new avenues. Some are contemplating launching out on their own, but are afraid of failure – or afraid of success! Others have good, well-paying jobs, but long for a more meaningful vocation, so we talk about how they can reposition themselves to make a greater contribution, bringing renewal, peace and justice into the world. In Judaism this is called tikkun olam – the healing, restoration or repair of the world.


By far, the most frequent topic in my office is relationships – past and present, family, friends and romantic. We talk about lost love, fragile love, broken or painful love, and how to rekindle love and make it grow again.

The #1 issue in my counseling practice is loneliness, and the difficulties people encounter in connecting well. A close second is boundaries, the give and take between closeness and distance. Many conversations are about living and growing in community with other like-minded people.

Spiritual connection.

Many clients want to talk about their spiritual lives, their desire to discern God’s will for their lives. They talk honestly about their fears, sometimes their guilt and shame, and their longing to feel God’s love. Some don’t talk of God at all, but are clearly searching for a greater sense of meaning and purpose in their lives.

It’s a great privilege for me to witness and support the sincere wrestlings of my clients over issues of spirituality, meaning and purpose. Viktor Frankl was a Jewish psychiatrist who survived a World War II concentration camp. In his book Man’s Search for Meaning, he wrote, “Those who have a ‘why’ to live, can bear with almost any ‘how’.” Therapy is often about clarifying the ‘why’ of our lives.

Self-care, work and creativity, relationships, spiritual connection – which of these is whispering to you, or perhaps shouting at you, right now? It would be my privilege to witness your wrestlings and support your journey.

Jay R. Feld - In Therapy: What Will We Talk About?Dr. Jay R. Feld
Licensed Marriage and
Family Therapist
(917) 572-4068

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