For me, I never told anyone what had happened and pretty much denied it to myself for a couple of years. When (of course) issues surrounding it started affecting me again, I called my T and left her a message saying that something was really upsetting me and I didn't know how to talk about it. She called back to help calm me down, but we didn't address the topic till we were face-to-face in session. At the next session, she was then able to ask a few questions and kind of let me lead. It pretty much ended up being me staring at the floor or my hands and going through what had happened. She had a few things here and there to say and was overall so wonderful about it. It seemed so freakin' hard to bring up, but I was (and am) so glad that I did. Just telling her was such a relief. We actually didn't deal with it much after that, because it wasn't the most pressing issue for me, but it was nice that the secret wasn't weighing me down anymore. I agree that just mentioning there's something on your mind and that it's hard to talk about is a good starting place. You can always go at your own pace.