my t usually starts with "so how things have been since we last met" (she uses "things" instead of "you" because it's ok to talk about things and not ok to talk abou me, lol) and I always respond with "normal". Then we talk about what "normal" means to me on that day. IMO it's a perfect start Sometimes she starts with something i wrote emailed her between sessions or some event that she knows took place between appts, like some major work stuff or concert.