How Does Therapy Work When I Don’t Know What to Say?

The clock is ticking. The silence stretches. Your mind goes blank. “I should know what to talk about,” you think. “I’m the one who wanted therapy in the first place.”

At Televero Health, we hear this worry often. Many people imagine they need to come to each session with perfectly articulated problems and questions. They worry that not knowing what to say means they’re “bad at therapy” or “wasting time.”

But here’s what we want you to know: Not knowing what to say isn’t a problem in therapy. Sometimes, it’s actually where the real work begins.

The Myth of the Perfect Client

There’s a common misconception that good therapy clients arrive with organized thoughts, clear questions, and a structured agenda. They supposedly never ramble, get confused, or fall silent.

This myth creates unnecessary pressure. It makes people feel they need to perform in therapy rather than simply being present with whatever is actually happening for them.

The truth is, the “perfect client” doesn’t exist. Real humans are messy. We get confused. We lose our train of thought. We don’t always understand our own feelings. We sometimes struggle to put words to our experiences.

Therapists don’t expect perfection. They’re trained to work with you exactly as you are – including when you’re feeling wordless, confused, or uncertain.

Why It’s Hard to Find Words Sometimes

There are many reasons you might find yourself not knowing what to say in therapy:

You’re dealing with emotions or experiences that exist beyond language

You’re not used to having space to talk about yourself

You’ve learned to keep things to yourself as a way of staying safe

You’re experiencing something new that you don’t have words for yet

You’re disconnected from your feelings due to stress or past experiences

You’re afraid of saying the “wrong thing” or being judged

You’re not sure what’s important enough to bring up

These are all normal, understandable reasons for struggling with words. They don’t mean you’re doing therapy wrong. They just mean you’re human.

Silence as Information, Not Failure

When you don’t know what to say, that silence itself can be valuable information. It might reveal:

Areas where emotions feel too big for words

Patterns of holding back or self-censoring

Confusion that needs gentle exploration

Fear of judgment or rejection

Disconnection from your own experience

A good therapist doesn’t see these silences as empty space to be filled. They see them as meaningful data about your inner experience – sometimes more telling than words could be.

How Therapists Help When Words Don’t Come

Therapists have many ways to work with clients who don’t always know what to say:

They might ask gentle, open-ended questions to help you explore: “What are you noticing in your body right now?” or “What feels most present for you today?”

They might normalize your experience: “It’s completely okay not to have words for everything. Many people find that difficult.”

They might offer observations: “I notice you got quiet when we started talking about your job. I wonder what might be happening there?”

They might suggest alternatives to talking: writing, drawing, or using metaphors to express what’s hard to say directly.

They might help you build vocabulary for internal experiences that you haven’t had words for before.

They might simply sit with you in the silence, offering presence without pressure.

At Televero Health, our therapists understand that finding words for internal experiences is a skill that develops over time. They don’t expect you to have mastered it before you even begin therapy.

Starting Where You Are

If you’re worried about not knowing what to say in therapy, here are some places to start:

Share that very concern: “I’m not sure what to talk about today” or “I’m feeling stuck on where to begin”

Start with something small from your day or week that caught your attention

Notice physical sensations: “I’m feeling tightness in my chest today”

Mention recurring thoughts, even if they seem unimportant

Bring in dreams, song lyrics, or images that have been on your mind

Talk about your relationship with your therapist or how therapy feels

Remember, therapy isn’t a performance. There are no “right” topics. What matters is authenticity – showing up as you actually are, not as you think you should be.

When Not Knowing What to Say Is the Point

Sometimes, the experience of not knowing what to say is actually central to why you’re seeking therapy in the first place. This might be true if:

You’ve spent years not speaking about your true feelings

You’ve been disconnected from your emotions as a survival strategy

You’ve never had safe space to explore your inner life

You’ve been taught that certain thoughts or feelings are unacceptable

In these cases, learning to access and express your authentic experience is part of the healing process, not a prerequisite for it.

The discomfort of sitting with that initial wordlessness – with a therapist who doesn’t rush to fill the silence or rescue you from it – can be the beginning of reconnecting with parts of yourself that have long gone unexpressed.

So if you find yourself sitting in therapy without words, know that you’re not failing. You’re not wasting time. You’re not doing it wrong.

You’re simply beginning exactly where you need to – with the truth of your experience in this moment. And that’s always the right place to start.

Not sure what to say? That’s completely okay. Start therapy with us anyway.