I started seeing my t for "adjustment disorder". I had a life altering event that put me into a serious depression. For the first 5-6 visits, I talked about the life altering event and cried. She provided support, listened, and validated my experience. Then I decided to go in for the long haul. I knew I had many issues that put me just within arms reach of so many dx's that I didn't know how to tackle things. All my previous experience with therapy had been short term CBT style. And none of that really touched the core issues when the emotional storms were happening. I like I said, I decided that I liked this t enough and trusted her at a level that I thought I could work with her over the long haul. I then wrote out a very long letter that spelled out all my issues as I perceived them including possible dx's, character traits, personality disorders, sexuality and gender, weight and eating, attachment, and some beliefs. I then listed out my goals - which were and still are pretty generic - to live whatever is the remaining days of my life in less pain (emotional and physical), work on my gender dysphoria, work on resolving/addressing my eating issues so that I am able to get to and maintain appropriate weight/fitness levels.

From here I went several months of not knowing what to say, what was important and what wasn't, second guessing everything even though I would walk through the door with a list of topics.

Like CrispApple, I wrote stuff out and when I could/can (as just Wednesday she read a letter) I would read it, when I couldn't I would hand it to her to read. She has always been accepting of my level of communication. That was one of the first things I needed her to do, was to be able to receive information as I communicated it.

What I have come to ... is it doesn't matter when we talk about what we talk about - the process isn't linear and talking about something once doesn't mean it won't come back. It is important that I communicate ... simply communicate and over time things come up. Now I don't stress it - I still have a list, I don't always stick to the list and more often than not, the list consists of... keep talking about x from previous session.