I guess the best feedback I can give you on how to work up to getting your thoughts out of your mouth in therapy is to write them down...whether in a list formoat or brainstorm format or just write them out and bring that into your next session and let her know at the beginning that you have some things that you have been keeping inside that you have wanted to tell her but haven't been able to get it out. Let her know you wrote it down and either yoh try and read it to her or hand it to her and let her read it if you can't. I have done that with my T with things that are just too hard for me to initially say without writing it down first. She always gives me as much time as I need to read it and makes me breath beforehand because I struggle with anxiety qnd panic attacks as well. I don't know if this helps any...but this is what has helped me some.