Running out of things to say in therapy?

It sounds like this is a good problem to have, but what do you do when you can't think of things to say in therapy? Do you just sit there the whole 45 minutes in silence? Make small talk? I am wondering if I need therapy or not. I know I have social anxiety, but I don't ever think I will be able to fix that.

Anyone have a similar situation?

I have never had this as my T talks if I dry up. I admire her for the having the ability to do this, it is one of the reasons I stay with her. Do you prepare things to talk about before you go? I think social anxiety is fixable. I am finding that talking to my T is making me better at talking to people outside therapy, I think it is because I'm becoming more used to saying my thoughts out loud.

I am trying to write down topics we can talk about, but it isn't as easy as I thought it would be....
My T just sits quietly as I am quiet.

Maybe come up with questions about the social anxiety like ways to cope, how she usually treats people with it, etc? Maybe reading about it will spark questions you want to ask?
I have a list that I haven't even gotten to. My T. knows it bothers me but she keeps going deep on things I bring up and then, poof, the 50 minutes is over. And, I keep adding to the list. I am learning how much my mother's emotional neglect affected me, my relationships, friends, vulnerability, etc. And, then I have concerns about my kids.

You might need a more talkative T. I never really struggled with having enough to talk about thought I noticed that when I briefly had a very very quiet T who just sat there and nodded the whole time, I found it pretty awkward, like it had become my responsibility to carry a one-sided conversation or something. You might just not be meshing with your T, and that makes a world of difference.

Do you have another diagnosis besides social anxiety, one that would require such a non-engaged therapist? If you do, then what I'm going to say may not apply, but if social anxiety is a major problem for you, then, to be blunt ...

You need a different T and a different kind of therapy. Your current T may be excellent with certain patients, but to sit quietly when someone with social anxiety doesn't know what to say is not an effective approach.

If you knew what to talk about and how to talk about it and how to maintain a conversation, you would already be effectively dealing with your social anxiety. Letting you sit there is not going to help you. You might benefit more from a directive type of therapy, maybe some form of cognitive and behavioral therapy.

If your T is already a CBT therapist, she's not doing her job. Here are some therapies that have been demonstrated to work well with social anxiety. These also work with many other types of anxiety and I've done all of them myself. Every one of them. So, as you can imagine, to me it seems like a waste of time and money to sit in silence with a T when there are effective therapies out there that can bring about dramatically improvements quickly.

Cognitive-behavioral therapy: Cognitive-behavioral therapy, which helps you identify anxieties and the situations that provoke the anxiety. At first you may feel uncomfortable while addressing the feared situations, but it is an important part of your recovery. Several types of cognitive-behavioral therapy are used to treat social anxiety disorder, including:

Exposure therapy. You will be guided by a professional counselor to imagine you are facing the feared situation until you no longer fear it, such as eating in public. Next, you may go with your counselor to a public place and eat until, eventually, you can eat by yourself in public without fear.

Social skills training. This therapy helps you develop the skills you need in social situations through rehearsing and role-playing. Your anxiety is reduced as you become more comfortable with and prepared for the feared social situations.

Cognitive restructuring. This therapy helps you learn to identify and improve fearful thinking to help you better handle social situations.

I found that by learning to deal with various fears and feelings of awkwardness and wanting to run and hide -- you know the drill -- I was then able to move onto therapy that dealt with deeper and more philosophical issues of living well. But first I had to get rid of the overwhelming fear that came from terrible traumas in the past. I was also extremely shy and introverted. I'm still an introvert, but I'm no longer the least bit shy, which is something of a miracle considering the way I was when I was young.

I wish you the best.

Thank you SnakeCharmer. You really gave me some good insight in this. I have a stuttering problem, which fuels my social anxiety. My social anxiety fuels my stuttering. I have dealt with a speech therapist for many, many years. The psychologist I have now also thinks I may have borderline adhd. I was put on adderall which seems to be helping my confidence and my concentration.

I think I am going to interview other T's just to see what their thoughts are about all of this.

For me, it depends on why I'm running out of things to say. If it's because I'm stuck in my head and struggling to just get words out, I will tell T that I need some prompting because I have all these thoughts that I just can't put in to words. She'll ask me some questions which usually generate conversation.

If I just really don't have much to say, and that stays consistent for several weeks, then we'll talk about switching to appointments every other week for a while.

Recently, my T has asked me to fill out a pre-session assessment form, in which I detail my mood ranges for the preceding week, note down areas where I'm doing well and areas where I'm struggling, and note down some goals for the session. Sometimes, I find it very helpful to fill out, and sometimes I find it an annoyance. I do think it has helped to focus my sessions some, though.

I have session today, so I kind of what to address this.
What questions would be good to ask her?
So far I have....
What are your thoughts about me?
Do you see me getting better?
What do you think of me taking a break?
What are your long term goals for me?
Will I always have emptiness towards my family?
Will I always be socially awkward?

Just be prepared for her to either ignore the first question or turn it back on you as why do you want to know my thoughts about you.

I know you don't want to hear this but I love this kind of therapist. One that respects the boundary of the client by being silent and lets the client take the wheel and stir the ship wherever. I had a therapist like that but since then I've tried 7-8 therapists and they all turned out too talkative, interrupting me repeatedly or pushing solutions one me I don't need etc etc.

I wish I had a therapist like that. But with other therapists that are too yappy I run out of words too. I become silent and just tell her I am out of words and then not see her anymore.

Funny thing about my last session. I didn't really have anything to talk about, so I kind of free-styled it. I asked her....
Do you see me getting better?
What are your long term goals for me?
What is my diagnosis?
We talked about this, plus some issues I had. It was the best session I have had to date. I have a stuttering problem, but during that session, my stuttering was rare. My stuttering and my social anxiety kind of fuel each other, so during that session I felt amazing. I told her I trust her and there are not too many people in the world I can trust. I could see her eyes watering throughout the session.

It was weird, it seemed like more like a heart to heart than a T/Client appointment. I feel very lucky to have her after this session. To know she cares for me as a person and not just a client, really makes me feel very good. I wanted to hug her so bad, but I was scared she would get freaked out. I have told her in the past that I have had Transference with her, find her very attractive, dream of her, in love with her. She said that was all normal just as long as it doesn't interfere with my goals in therapy.

I'm just so happy to have her.

That's great you had such a good session! There are times I feel like it's just an appointment and there are times I feel like she is looking into my soul. I've told her that her eyes "get to me". Perhaps I've never had that connection before.
Instead of hugging her, you could pat her on her back or something small. I never wanted to hug my T. but I wanted HER to reach out to me. She would sometimes and I would feel like everything was ok. Once I told her what it meant to me, she stopped - she didn't want me basing my week on whether she remembered to. My husband told me to hug her and I about died. Then, I realized that perhaps she was open to me initiating but didn't want it to be all on her. I still don't have a desire to hug her but sometimes my appreciation is overflowing and that would be the most appropriate outlet.

I'd even feel weird patting her on the back. We never made physical contact once. I would love for her to initiate it though. I just don't want her to get the wrong idea if I did. Since I got her a book for her office and told her about my transference, I don't want her getting the wrong idea.

I'm really happy to hear your session went so well, MP182.

I wonder what kind of therapist that is that wouldn't adjust their style to the client at all. Surely it can't be that hard to endure the silence a bit longer, right?

My old one would often times have things to discuss based on what she had heard me say before. If I had something to bring up that would take precedence, but when I didn't have something, or if I asked her if she had a direction to go, then she would start asking me to talk more about something from before.

The new guy doesn't do that. We shoot the *****, too much in my opinion. That's why I'm thinking of making another change.

I'm glad it went so well for you, Mr. Pink, and the new sense of making connection keeps growing. I wish you the best!

I've felt the same way and I've also struggled with social anxiety, particularly with men. It's definitely more helpful to be in a structured, goal oriented therapy. When I was younger I tried straight up talk therapy a couple of times and it never went anywhere. A T who sits silently with a socially anxious client does not understand social anxiety. I'd look for a T who can help you address the your issues specifically, like a CBT oriented T.

I feel that I have another 3-4 sessions of "planned" discussion points with my therapist then I could see it being more open-ended. But I think it won't be a problem for a few reasons.
1) I've decreased frequency of visits to once every 6 weeks, so I'm sure I'll have regular life stuff that crops up to discuss. 2) I think she's skilled enough to have an idea where to go with me if I get "stuck" and 3) I have a general interest in psychology and we seem to be on a similar page in life (female medical practitioners, breadwinners of our respective homes, mothers to small children) that those items have been discussion points and will probably continue to be).