I journal. I started journaling as part of my therapy. I give about 95% of what I write to my T. She reads them between sessions. Often I will read portions of what I wrote in session - initially, I would have her read those portions silently to herself because I couldn't voice them. At times I write letters to her in the journal. I write the journal to her even when it is not a letter. When I first started writing the journal it was more for me; however, the more I started sharing with her the more it just seemed to make sense to refer to her as "you" rather than "she/her". It makes it interesting when I do slip back and refer to her (or myself) in 3rd person.
I also use the journal to bring up things I'm not ready to talk about so that she has time to figure out how she'll handle it before I bring it up - especially around me wanting to ask something of her.
Sometimes, nothing is ever said about what was written. She rarely brings up anything I wrote but when I do bring it up or bring up something similar she'll refer back to it.
I have found it incredibly helpful.
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