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sister said:
How do you all decide?

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I don't! There are times in which I want to tell him something specific, but that doesn't mean we are going to talk about it. For example, I feel like it is important for him to know that I did some SI, but that doesn't necessarily mean we are going to talk about it. Being all analytically obsessed, I now go to therapy with the pretense that whatever is ready to come out, will. I often bring my journal with me, but not often with the idea that I'm going to read something specific. I believe in the effect of the therapeutic situation on what I talk about. I don't think I could decide beforehand because I rely on the environment of actually being with T to steer me where I want to go. I told him 3 sessions ago, that I SI'ed. We acknowledged it, and also acknowledged that although I have told him about my SI many times, we have never talked about it in depth. T said that it's okay-- it's just not ready to come out yet.

When there are times in which I feel at a loss, I say to T, "So. What do you want to talk about today?"

Sometimes I give him "homework" at the end of a session. This is because things always get particularly intense at the end. His homework is to remember what we were talking about and bring it up again at the beginning of the next session, so we can continue with that. He always remembers.