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Things to discuss with a therapist


What to Talk About in Therapy: 12 Ideas to Consider

If you don’t know what to talk about in therapy, some things to consider talking about include recent life events, relationships, traumas, and more.

When I decided to go to therapy for the first time, I spent the whole car ride thinking about how ready I was to work on myself. But when I got there and actually sat down on my therapist’s couch, I clammed up. Suddenly, while sitting face-to-face with this stranger that I knew was there to help me, I had no idea what I actually wanted to say. My mind had simply gone blank.

Admittedly, I’ve always been shy, and talking to new people has always been a little overwhelming to me. But I thought it would be easy to open up to a therapist since it had been my choice to come there. It wasn’t easy. Instead, I felt so much pressure to make the most out of my session that I couldn’t think of a single thing to actually say.

Whether you’re like me and had difficulty opening up at your first sessions, or you’ve been going for a while and feel like you’ve “run out” of things to say, know that you aren’t alone.

“It is not uncommon for people to come to session and be unsure about what they want to discuss,” says Jessica Small, licensed marriage and family therapist.

Opening up is tough, and it may not come easily, especially when just getting to know your therapist. In order to help assist you with opening up, some therapists may give you an assessment to take to better understand you and your needs as their patient and help create a plan for future sessions.

Other therapists might let you lead the conversation. If you’re unsure how to begin a conversation with your therapist or don’t know what to talk about, here are 12 things to consider.

It’s easy to feel like you need to talk about “deep” or “serious” issues in therapy But remember, there’s no “correct” topic to discuss in therapy. You can talk about whatever you want.

True, some people come to therapy to address something specific, like anxiety or depression. But sometimes, people are just going through a life transition and want someone to talk with and help them cope with the change.

If you’re finding it tough to open up, Small advises remembering that nothing is off-limits.

“People talk about everything in therapy. They talk about their hopes, dreams, fears, disappointments, hurts, shame, conversations with their mom, interactions with their partner, perceived failures as a parent, sexuality, [or] their most recent date,” she says.

Not sure where to start the session? Begin by recapping what happened since you last saw your therapist — good and bad — and from there, see what you want to explore further together.

It may be a good idea to track your thoughts, patterns, and behaviors by keeping a journal between therapy sessions. This can be especially helpful if you’re shy or find it difficult to remember things on the spot.

Of course, you don’t have to bring your journal with you or read from it in session. But writing things down allows you to look for patterns in your feelings and behaviors that you might want to address with your therapist, Small says.

“For instance, a person may observe that they have been feeling inadequate or insecure and this would be a good thing to address with their therapist,” she says.

You might have felt sad, angry, or depressed during the week, but if you’re not feeling that way right now, you don’t have to start with that. Focus on how you’re feeling in the present, and just say how you feel — even if what you’re feeling is just, “I didn’t really want to take this hour for therapy today because I’m slammed at work.”

The truth is, what you need from therapy changes day to day. It’s OK if you went in thinking you’d talk about your relationship and instead spent the whole session venting about your boss.

“Therapy sessions really are meant to be as tailored as possible to what you’re needing at any given moment,” says Sol Rapoport, a marriage and family therapist working with UCLA’s Behavioral Wellness Center. “I actually tell my clients to think of their therapy time as the ‘Room of Requirement’ from Harry Potter — you get to get out of it whatever you are most needing that day. ”

“And sometimes,” she continues,” what you need at the moment is someone to allow you the space to just vent.”

Depression and anxiety can both involve rumination, or a tendency to go over the same thoughts repeatedly.

If you had a hard time falling asleep one night this week because your mind wouldn’t stop thinking about something you wish you’d done or you worried about something coming up, that’s often a great place to start your session.

This doesn’t just mean your love life. Tell your therapist about all your relationships, whether that’s your partner, your family, or your friends.

Do you feel like you have support at home? Do you feel like you have other people to share your feelings with, or do you have difficulty opening up with others too, not just your therapist?

Relationships are important to your mental health, and they play an important role in affecting your mood and feelings on a day-to-day basis.

So, if you’ve been avoiding your mom’s calls, even though you love her, let your therapist know, and maybe you two can explore why you’re avoiding her.

Even if you feel like you have good relationships, talking about them might help you realize the things that are working in your life — and the resources you can lean on out of session.

This one might sound obvious — or conjure up stereotypical images of lying back on a chaise lounge a la Freud — but the truth is, if you’ve been focusing on your present in your last sessions, you might not have gotten around to filling in your therapist on your past.

For example, maybe you’ve spent your last month telling your therapist about your current relationship troubles, but you’ve never discussed your past relationships or your parent’s marriage.

Taking a moment to step back from your present and choosing to talk about your past could help you address some feelings you’ve been bottling up or left unresolved.

People in therapy tend to have something they want to address, says Nicholas Hardy, a psychotherapist in Houston, Texas. “However, it is not always a problem. Sometimes, it is a feeling or an emotion that is unfamiliar to them.”

“When clients experience new aspects of life, like childbirth, marriage, relocation, this can ignite untapped areas in their life that they need help understanding,” he continues. “While not always able to articulate what that feeling is, they are able to recognize that something is different.”

If something has changed in your life and it’s making you feel different in some way, bring it up. You don’t have to talk just about the “bad” stuff. Change can be good and yet still bring up new feelings you might want to explore in a safe, nonjudgmental space.

This could be something you’re ashamed of thinking, or something you think is “silly” to worry about. Maybe it’s something you think is “insignificant” or “stupid.”

We all censor ourselves and judge our feelings. But therapy is exactly the place to explore all our thoughts and feelings, even the ones we feel like we shouldn’t be having.

For example, lots of people think they’re not entitled to be upset about the pandemic because they haven’t experienced as many hardships, like job loss or the death of a loved one, and yet they’re still having a hard time coping with its impacts.

It’s OK to feel whatever you’re feeling, and it’s definitely OK to bring it up in therapy.

“Sometimes I ask clients to think about what they’d least like to talk about that day,” says Rapoport. “It’s usually a good sign of where the trouble is.”

That makes sense. We often avoid talking about things that are uncomfortable, painful, or difficult, and yet when we let them fester, they get worse. Consider therapy your safe place to talk through those things you’d otherwise avoid.

If you’re having trouble opening up right now, and you’re not sure why, tell your therapist. There might be something to explore there.

“Even if a topic is not addressed immediately because of discomfort, it is valuable to understand what barriers are keeping [you] from opening up about a particular subject,” says Hardy.

For example, when you’re depressed, you often lose interest in things you once enjoyed and feel decreased energy levels. If coming to session today and last week felt exceptionally hard and you’re not sure why, your therapist might be able to help you unpack that and figure out if something else is going on.

Trust takes time to build, and sharing your thoughts and feelings with a stranger isn’t easy. If you’re having trouble trusting your therapist enough to open up, which is very normal, don’t be afraid to bring that up.

With that information, your therapist can work on building a foundation of trust that will allow you to open up more down the road.

“Therapy is about a relationship between the client and the therapist,” says Small. “If a client is having a hard time opening up, it may mean that there is still trust that needs to develop in the therapeutic relationship. I attempt to meet the client where they are at and build a rapport that will give them the safety and security they need to begin to be more vulnerable and open. ”

If you truly don’t feel comfortable with your therapist, there’s a chance they aren’t the therapist for you — and that’s OK.

Therapists have different professional backgrounds and specialties, and there are different types of psychotherapy.

“Think about how comfortable you feel asking for exactly what you need from them,” says Rapoport. “Some people prefer a more directive approach. Some people prefer concrete tools — for anxiety management, for instance. Others want to feel like they can talk about a specific subject with someone who is knowledgeable about that in particular.”

“Consider whether your needs are being met,” she continues,” and how open your therapist is to your specific requests and needs.”

If you aren’t getting what you need, if you don’t feel challenged in a good way or like your therapy is progressing, or if you prefer a therapist who shares your gender or racial identity, it might be worth exploring other therapist options.

Psychotherapy isn’t meant to last forever. So, if you used to find it easy to think of things to talk about, and now you’re not, it might be a sign you’ve reached an end point.

It’s perfectly normal to feel like you don’t need therapy after a while. “As a therapist, we want to work ourselves out of a job,” says Small.

But before you quit, make sure you’re ending therapy because you truly got what you needed out of your sessions, and not just because you’re dissatisfied with your therapist.

A 2019 study of 99 adolescents ages 11 to 17, for example, found that people who ended therapy out of dissatisfaction had poorer outcomes than those who left because they felt they “got what they needed.”

To tell the difference, Rapoport recommends thinking back to your first session. “Does it feel like you accomplished what you set out to accomplish? If so, have you identified new goals along the way that you could shift to instead?”

“If you’re continuing to feel like you’re learning more about yourself, or you’re gathering new information and resources, it’s usually a sign that you’re still getting something out of therapy,” she continues. “If it feels like you’ve stalled, or that you’re not getting anything from your sessions that you wouldn’t be able to get from a conversation with someone else, it might be time to take a break.”

Keep in mind that you don’t need to stop abruptly. You can always talk with your therapist about putting more time between sessions and seeing how you feel.

If you currently see them for weekly sessions, for example, you could try doing a monthly check-in. If something comes up and you want to resume weekly sessions, you already have a foundation with a therapist you know and trust.

“No one has therapy all figured out, even the therapist,” says Hardy. If you’re finding it difficult to open up at first, don’t worry. It might take some time for you to really get in the swing of it. But with time, you should start to feel yourself becoming more comfortable and opening up more. If not, consider whether you might want to work with another therapist.

Simone M. Scully is a writer who loves writing about all things health and science. Find Simone on her website, Facebook, and Twitter.

20 Things to Talk about in Therapy

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Published: March 18, 2022 Updated: November 28, 2022

Published: 03/18/2022 Updated: 11/28/2022

Therapy can be challenging, healing, and highly beneficial; however, it can also be awkward, and uncomfortable, especially in the beginning. In reality, there are no “wrong” things to talk about in therapy. Small things and big things are all OK to bring to your therapist. If it’s on your mind, it’s important.

Note that while it is great to prepare for therapy and have an idea of what you’re going to talk about, your therapist should be a professional question-asker, so to speak. If you find that you can’t talk to your therapist and/or your therapist doesn’t offer you any prompts, it may be that you need to seek a therapist with a more engaged approach.

Accessing therapy is now very easy. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp

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Although your therapist should be able to engage you in conversation, it doesn’t hurt to think about what you might discuss. Therapy has many benefits, especially when the client/therapist relationship is a good match, so think of it as a way to try and get the most out of the experience.

Here are 20 things to talk about with your therapist:

Think about when you made the decision to search for a therapist. What was happening in your life? What were you looking for? Talking about the reasons you think therapy could be beneficial for you is a great way to set goals with your therapist.

2. Feelings About Therapy

If you feel anxious or doubtful, tell your therapist! Saying that you are uncomfortable or not feeling safe enough to answer certain questions is honest, which is even more important than just answering questions.

3. Previous Experiences With Therapy

What’s your previous experience with therapy? Knowing what has been helpful/unhelpful in the past allows your therapist to understand how your mind works and avoid any unintentional triggers.

4. Current Relationships

Our relationships with significant others, family members, coworkers, friends, and even enemies shape and affect our lives. Discussing these relationships allows you to uncover and address patterns regarding communication, attachment, and boundaries.

5. Sexuality

Sex and sexuality are important parts of life. A licensed professional will not be embarrassed to discuss sexuality. For most clinicians, there is no “TMI” (Too Much Information). If sexuality is a specific interest or concern for you, you can even seek a therapist who specializes in sexuality issues and/or sex therapy.

6. Current Job/Career

Our career paths and interests serve as windows into our psyches. Talking about your place of business, workplace dynamics, or areas of professional interest can serve as ways to discuss bigger issues like communication and relationship patterns. Professional interests also help your therapist understand how your mind works and the ways you interpret the world around you.

7. Places Where You Feel Stuck

Where do you feel like you’ve hit a wall? Feeling stuck or trapped in an area can be a sign that something is not quite right. Therapy can help you process those stuck points and give you strategies for moving forward.

8. Creative Endeavors

If you engage in any creative activity, talking about your work can be a way to express yourself and convey difficult topics. As a therapist, I enjoy engaging with clients about their artwork because it is often a way of expressing ideas that are difficult to put into words.

9. Personal Strengths

Usually, we think that therapy has to be about what we struggle with, but discussing our strengths is also valable. Having a deeper understanding of your strengths allows you and your therapist to process ways to build on them.

10. Current Coping Strategies

Coping strategies can be healthy or unhealthy, though most fall somewhere in the middle. When you discuss the ways you typically deal with stressors, let your therapist know how well you think they work for you, too. Learning new, healthy ways to cope is typically a major part of therapy.

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11. Trigger Points

What causes you to react inappropriately with rage, panic, or disgust? Are there noises, smells, or feelings that cause you to immediately feel overwhelmed? All of these could be considered triggers. You may know where the triggers come from, but you also may have no idea why a certain thing bothers you. A therapist can help you identify triggers and learn ways to manage your reactions.

12. Major Life Transitions

A move, graduation, birth, death, job change, or any other life transition can cause inner turmoil. Even a positive change is inherently stressful on your body and mind. Therapy during life transitions gives you a way to process the feelings that come with change. Talking about past transitions can also highlight patterns and old wounds.

13. Grief

While grief is a common experience, it’s often pushed aside. While it certainly applies to the loss of a loved one, people also experience grief in a number of other circumstances including divorce, aging, and during medical diagnoses. A professional clinician will be able to walk you through the grieving process in a healthy way.

14. Childhood Experiences

The inflection points of childhood set the stage for continued patterns. Talking about your childhood in therapy may seem cliché, but it is a way to highlight and untangle the complicated patterns that keep us in unhealthy situations.

15. Abuse/Neglect/Violence In Your Past

Due in part to trauma and isolation, any history of abuse, neglect, or violence is important to discuss in therapy. Therapists, especially those skilled in trauma-informed care, are trained to help you manage the effects of those events.

16. Generational Patterns

When you look at your family tree, what kind of patterns do you see? Generational patterns of addiction, suicide, violence, and/or hospitalizations are important for a thearpist to be aware of. Patterns of relationship issues in prior generations can also help shed light on potential risk factors.

17. Medical History

While most therapists aren’t medical professionals, medical history does play a major factor in your mental health. If you have had a major medical crisis, you may be experiencing a trauma reaction. Certain medical diagnoses also have higher risk factors for depression or anxiety. Talking about your medical history and your experiences with the medical establishment may shed light on certain patterns or reactions.

18. Fears About the Future

Discussing your fears and anxieties about the future may seem obvious, but many people feel like they can only talk about things that are problematic in the present or past. Talking about your fears for the future can help you make a plan.

19. Hopes For the Future

Not all therapy sessions have to be about negative, difficult issues. By exploring your hopes and dreams for the future in therapy, you can set intentions while also learning and incorporating healthy strategies to allow you to achieve those dreams.

20. That Thing You’re Avoiding Talking About

You probably don’t want to talk about whatever it is that you’re avoiding, but you should probably find a way to bring it up. You may need to email your therapist if it’s easier to write than speak. Or let them know that there’s something on your mind, but you’re not sure how to mention it. The things we avoid are usually the keys to unlock future healing.

What to Talk About When Things Are Going Well

If things are going well and you’re not in crisis that doesn’t mean that there aren’t important things to discuss. It’s important to talk about what specifically is helping and how you are feeling about the positive things in your life. This can help you plan for what to do if life throws a curveball. It’s also important to process any concerns that things may go awry.

Things going well can also be a sign that therapy is at its end. If you are at a point where you feel that life is good, bring this up with your therapist! Ending a therapeutic relationship intentionally allows both you and the therapist to assess your progress, discuss any lingering concerns, and, most importantly, experience the ending of a relationship in a healthy way.

It’s also important to remember that pausing or ending therapy can be “for now” and does not have to be forever.

How to Find a Therapist

If you’re interested in starting therapy, finding a therapist can be tricky. Referrals from your insurance company or a medical provider can connect you with someone who will be in-network. Also, ask other people who have had good experiences in therapy to direct you toward the right clinicians. Alternatively, you can start your search in an online therapist directory.

Make sure to schedule an initial consultation or phone call with a prospective therapist. Ask them questions about their experience with the types of issues you are struggling with; assess not only their answers, but also how comfortable you feel talking with them.

Research shows that the strength of the therapeutic alliance is a stronger predictor of outcomes than the modality of treatment.1 Simply put, a strong relationship with your therapist matters more than the kind of therapy you engage in.

Final Thoughts On Topics to Talk About in Therapy

Therapy can be difficult, but it’s often healing. While you can (and should) rely on your therapist to work with you to make your experience worthwhile, knowing what is appropriate/common to discuss and how to bring it up can help reduce stress and increase efficiency. Good luck!

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

BetterHelp (Online Therapy) – BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Online-Therapy.com – Receive help for anxiety and depression. The Online-Therapy.com standard plan includes a weekly 45 minute video session, unlimited text messaging between sessions, and self-guided activities like journaling. Recently, they added Yoga videos. Get Started

Brightside Health (Online Psychiatry) – If you’re struggling with serious mental illness, finding the right medication can make a difference. Brightside Health treatment plans start at $95 per month. Following a free online evaluation and receiving a prescription, you can get FDA approved medications delivered to your door. Free Assessment

Talkspace (Online Psychiatry) – No monthly subscriptions! A Talkspace online psychiatrist costs $249.00 for the initial evaluation. Follow up appointments are $125.00. Talkspace works with major insurers, including Optum, UnitedHealthcare, and Cigna. Get Started

Choosing Therapy’s Directory – Find an experienced therapist who is committed to your wellbeing. You can search for a therapist by specialty, availability, insurance, and affordability. Therapist profiles and introductory videos provide insight into the therapist’s personality so you find the right fit. Find a therapist today.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp, Online-Therapy.com, Brightside, and Talkspace.

For Further Reading

Here are additional resources:

  • National Alliance on Mental Illness (NAMI)
  • Substance Abuse and Mental Health Services Administration (SAMHSA)
  • The National Suicide Prevention Lifeline at 1-800-273-8255. 
  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov

1 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Lambert, M. J., & Barley, D. E. (2002). Research summary on the therapeutic relationship and psychotherapy outcome. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp. 17–32). Oxford University Press.

If you are in need of immediate medical help:

Medical
Emergency
911

Suicide Hotline
800-273-8255

Questions you should ask your therapist: transurfer - LiveJournal

On the topic of finding a therapist. Article Questions you should ask your therapist.

1. How do you deal with your own (psychological) problems?
Do not ask what problems he has, this is a personal matter, ask what he does with them. If he says he has no problem, run away from him immediately.

2. How do you deal with religious issues in therapy?
Don't ask about his religion. You are interested in how he will deal with your faith.

3. Ask how his therapy work will help people?
If he says he'll "fix" you, run. Therapy is about finding your way, not about having a therapist heal you. In therapy, you should find out how smart and strong you are, not how smart and strong the therapist is.

4. Ask how the sessions will be and what will happen during them.
He must clearly state his approaches and techniques.

5. Ask how will your personal information be kept confidential?
Who will have access to it. What the therapist will do if your mother or your ex calls.

6. Ask what to do if you get very sick over the weekend or during holidays.
Can you call him or contact him in some other way, and if you cannot, where to call.

7.Cost of sessions.

8. Duration of sessions.

9. Ask what other options exist to solve your problem.
The therapist should be able to discuss with you the pros and cons of therapy, as well as the existence of other options (lifestyle changes, medications, diet, alternative medicine, etc.) and their effectiveness.

10. Ask about possible causes of your problem. Ask how common it is. Can it be hereditary. How it may be related to your gender and age, as well as recent changes in your life.
Therapists may have different views on the origin of a problem, and these views determine the methods they will use. Although they are not doctors, they can discuss your options with you, as well as tell you how your problem manifests itself in men and women, and people of different ages and different life circumstances.

If you suspect that your problem has a physiological cause, be sure to check with your doctor.

11. What are the chances that the problem will return in the future? What to do to prevent?
The therapist is not psychic and cannot predict the future, but can discuss with you possible scenarios or situations that could trigger a return of the problem. They can also talk about different ways to deal with the problem.

12. What other alternative methods (special diet, acupuncture, massage, vitamins, yoga, fitness, etc.) can be used in addition to therapy and contribute to the fastest improvement?

13. What else should I ask you?
Great question that they should be happy to answer.

15. If my friends or relatives want to help me solve my problem, what can they do?
Support plays a very important role in recovery and it is important to determine how to ask for it and what type of support would be best.

16. What materials can I read/watch on my problem?

17. What lifestyle changes should I make to get rid of the problem faster? Will these changes be for the duration of your job or are they for life?

How to communicate with a doctor to get cured

Life

Author:  Natalia Boldyreva

October 23, 2020

6281 views

- something looks. There are problems in the communication between the doctor and the patient: for a long time, doctors were not taught this, and people simply do not know how and what to ask.

Anna Simakova, managing partner of the Three Sisters rehabilitation clinic, communication and client service specialist, tells how to communicate with a doctor in order to get answers and the necessary treatment.

People feel uncomfortable at a doctor's appointment: they worry, get lost, forget what they wanted to talk about. They have to share intimate things about themselves, and time is limited, and the doctor does not look at the patient, but does something all the time.

In an ideal world, the doctor should make sure that the patient is comfortable, but if he does not, the patient can take care of himself. Here is what he can do with an example:

Do not immediately go for an examination, but sit next to the doctor and talk. A person comes to the dentist, and they immediately put him in a chair and ask him to open his mouth. He had not yet managed to say why he had come, but he was already sitting in an armchair and muttering, because he was being asked questions, but he could not answer with an open mouth. The doctor is responsible for him, and the patient in saliva is trying to insert something.

Or a woman comes to a gynecologist and is immediately put into a gynecological chair. Or in hospitals, during a round, the doctor comes to the bed, he has a few minutes, so he hangs over the patient, and she sits or lies, tries to throw her head back to look at the doctor, she is uncomfortable, it seems that the doctor needs to run, so there is no time talk about yourself. Meanwhile, the patient has some serious problems, but she is silent.

In all three cases, the doctors want to get down to business right away, but this does not help the patients: they hoped that they would first share their worries, they thought over the speech in advance, and in the end they cannot say anything, they are angry with themselves and the doctor, they ignore the appointments, and the problems get worse.

Therefore, it’s normal to go to the doctor’s office and not immediately go to the couch, to the gynecological or dental chair, but to sit next to you and tell what is bothering you. If the doctor asks to go immediately for an examination, answer that they would like to talk a little first:

- May I first tell you what brought me to you?

In the hospital during a round, you can say to the doctor:

- I have a few questions, if you sit down for a while, it will be much more pleasant for me to discuss them.

Introduce yourself and ask how you can contact. A person enters the doctor's office, he immediately starts asking what complaints. And it would be nice to first get to know each other and in response to questions say:

- I'll tell you everything now. My name is Anna, how can I contact you?

Sometimes the doctor sees the patient's name on the card, and when she comes in, he immediately starts: “Anna Sergeevna, hello. What are your complaints?" And this is confusing: not everyone likes it by patronymic, sometimes this emphasized politeness creates a distance and destroys the atmosphere of trust. If you don’t want to be called by my patronymic, you can ask:

- Doctor, it will be more comfortable for me if you call me without a patronymic, just Anna. I will now tell you about my health problems, and it seems to me that a patronymic is useless.

If a patient introduces himself and asks for the doctor's name, he sets up a relationship culture. So he tries to get away from the scheme in which the doctor is a guru and tortures with questions, towards a dialogue.

For example, women are in the hospital with children, and no one ever addresses them by name. They always just say "Mom". Of course, the doctor may forget the name, this is normal, but it is also normal if they tell him every time:

- I understand that you have many patients, my name is Anna.

Of course, these recommendations are followed if they are comfortable for the patient, no need to force yourself. Perhaps the advice may seem superfluous, but they help to attract the attention of the doctor and get what the person expects from the appointment.

A man came to see a doctor, sat next to him, introduced himself, drew the doctor's attention to himself, now it is important to say why he came. This is called the agenda - the main topic of the meeting.

There are agendas in all spheres of life: at work, they discuss the plan for the next quarter, in the kindergarten - the upcoming matinee, at school - classroom renovation.

Ideally, the doctor collects the summons. Imagine a woman comes to a therapist and says:

- Doctor, I have had a headache for the last week.

The therapist begins to clarify:

— How does it hurt? Why does she hurt? What did you do?

During the entire appointment they discuss the headache, the doctor prescribes pills, the patient gets up and leaves. And already at the door he says:

- And I also have terrible stomach pains, I can’t eat and I can’t sleep.

The therapist is horrified: the appointment is over, and at the exit it turned out something that changes the whole picture of the world.

Therefore, first the doctor clarifies everything that the patient came to him with; but not all doctors do it. As a result, the patient leaves unsatisfied, without resolving her issue. To prevent this from happening, she can formulate in advance everything that worries her: not just say “I have a headache”, but at the end of the appointment, remember that it’s not only she who hurts, but list the list of problems at the beginning of the appointment:

Three things brought me to you. My head constantly hurts, but my stomach hurts even more, I can’t eat and sleep. My sleep was disturbed, and after 4 p.m. I feel so tired that I can’t work. These are the things I want to solve with your help.

But in life it turns out the other way around. Here a patient came, they immediately put her on the couch, didn’t let her say anything, asked questions, and she thinks: there is not enough time, I won’t talk about fatigue, I’m even ashamed to somehow complain about fatigue, everyone gets tired. My stomach hurts, probably because it was my own fault, I should have leaned less on fried potatoes. Let's just talk about headaches.

And such a patient will leave with recommendations to rest more, but she could leave, for example, with an appointment for an examination.

Therefore, it is important to make a list of what you want to discuss at the appointment. It may turn out that there will be many items on this list, then it is better to prioritize and think about what is most important.

Imagine a 40-year-old woman comes to the gynecologist for a scheduled appointment, which she goes to once every six months, and the doctor asks what led her to him. Woman says:

- I just came for a scheduled checkup.

The doctor examines her and answers:

- I looked, everything is fine. You had an ultrasound six months ago, so there is no need to repeat it so often, we will now take only one smear, and that's it.

But in fact, this woman lives all her life with the fear that she will have ovarian cancer, because at the age of 40 her mother fell ill with such a disease. And every time she goes to a scheduled appointment and is afraid that they will find it. And to exclude this diagnosis, another examination is needed, but the doctor does not know about fear, and the woman is silent.

Patients can think of an agenda ahead of time, formulate questions around the agenda, and articulate their doubts and fears.

The summons does not have to be long: a person may come because he has side effects from the medicine or he is going to his daughter's wedding and is worried about whether he can drink wine and eat a piece of meat when he is being treated.

At a doctor's appointment, people are embarrassed when the doctor is typing or writing something all the time, instead of looking at them and listening. A person chooses words, tries to talk about things that are unpleasant or intimate for him, and at this moment the doctor says “yes, yes” and continues typing.

And it is not clear whether the doctor understands the patient, whether he hears at all and how the patient should be: to remain silent or continue to speak. And in general, was it worth it to start talking when the doctor is typing or doing something else.

In this case, the patient may signal to the doctor that it is difficult for him to talk about his health problems when he is doing something else. Suppose he just entered the office, and the doctor is typing or doing something else, you can say:

— Can I start?

During the appointment, the doctor was distracted, the patient may ask:

— Can I continue?

Perhaps the doctor is typing something important for the patient, so you should not be silent, but also not turn into aggression, but ask:

- Are you now writing down what I am telling? Do I need to repeat or can I continue, or how do you want me to tell?

The doctor may answer that, for example, he writes down complaints, but the patient is still uncomfortable and anxious, as if something terrible is happening. He can say this:

- I want to tell you a delicate moment, can you look at me? I get worried when you write something, I start to get scared: all of a sudden at this moment you give me some kind of fatal diagnosis and I don’t know about it.

Of course, in private and public medicine, the reactions of doctors can be different, but there are people who want to work the best, and vice versa. If the doctor does not respond, does not listen, continues to do his own business, it is better to get up and leave, and then make an appointment with another doctor.

There is no need to endure, because we are talking about health: if the doctor immediately behaves like this, the patient will continue to find it difficult to deal with him. The patient will not be able to trust, will doubt appointments, ignore treatment and may start the disease. You don’t have to endure it, even if you had to take time off from work or ask someone to babysit.

If the patient is going to have an examination, procedure or treatment, the doctor should tell you how it will be:

— Now we are treating the canal, it usually takes an hour, this time you will sit with your mouth open. For about ten minutes there will be an unpleasant procedure that everyone is afraid of, I will work with a drill. But we will anesthetize very well and wait for the anesthesia to take effect. If you feel uncomfortable, give a signal. After that, we seal and grind. This is how our process will look like, okay?

Maybe a person has never drilled his teeth or has not been given an enema, he does not know how it will be and what to expect. Well, if the nurse says:

- Look, the water will be warm, you will feel fullness, in about a minute you will want to go to the toilet.

But there are doctors who say nothing. They will simply say that you need to open your mouth, and let's do something there for an hour. And the patient is in a panic, does not know what will happen next. Or the patient has a negative experience, and he expects that this time everything will be exactly as before, for example, a tooth will be removed with a nasty “hrrrrr” sound. Patients are especially worried when gastroscopy or colonoscopy is due - they are frightened by the uncertainty and reputation of these medical manipulations.

Therefore, the patient can ask the doctor what awaits him:

— Of course, I trust you, because I came to you, but can you describe what will happen next?

This is an open question, and the doctor must answer it. But sometimes he answers:

- Oh, don't worry, everything will be fine.

With this answer, the doctor devalues ​​the question and the person’s feelings, but the question can be repeated, kindly, but persistently:

- Doctor, this is important to me, please describe how the process will take place.

The general recommendation is this: if there is any manipulation, ask the doctor to describe how it will happen, how long, what sensations will be, whether there will be unpleasant, how to react to them.

At the appointment, doctors prescribe an examination, and then treatment, possibly procedures or even surgery. The doctor can say:

— You will take such and such pills, but you will go here three times a week.

But this appointment can confuse the patient: for example, he does not want to have an operation, or he does not have money for the necessary procedures, or he does not want to take pills because he is already drinking handfuls of them.

In such a situation, it is better for the patient to clarify what other options he has and ask:

— Why is this particular treatment needed in my case? What other options do I have?

You can also ask what happens if you do nothing. For example, a person has a knee pain, he went to the doctor, and he says: “You need a joint replacement, we are preparing for the operation, we are changing, everything will be fine.” But the patient may have doubts. And it's better if he asks:

- And if you don't do the operation, what will it lead to?

You should not believe if the doctor answers that he has been working for twenty years, he treats everyone like that, and everything is fine. The doctor may make mistakes, and the decision on treatment is made not by the doctor, but by the doctor and the patient together. Therefore, it is important to clarify all the options, and then choose the right one.

The doctor can speak quickly and in complex terms. He thinks that he is understood, or he hurries to tell more in order to be in time for the reception. But in the end it turns out that the patient misunderstood everything, and in the doctor's conclusion there are only incomprehensible terms and abbreviations.

To avoid such situations, you can repeat the doctor's recommendations in your own words and make sure that everything is understood correctly:

— Can I repeat how I understood everything. So, now I’m leaving you, signing up for an ultrasound scan, then with this result I’m going to the surgeon to whom you sent, I take his opinion and return to you. Right?

Or a doctor prescribes a medicine, it seems that everything is clear in words and in the prescription, but it’s better to repeat here:

— You prescribed this antibiotic for me. I drink it for ten days twice a day, after ten days I stop it and start drinking this medicine. It's all right, right?

In ordinary life, we always summarize the results of the meeting, for example, after discussing the matinee, we agree on who buys sweets and who comes up with contests and games. This is what you need to do at a doctor’s appointment: say what needs to be done later.

So you can make sure that you understand the doctor correctly, and also form a clear plan of action in your head. A person is more likely to do everything that is needed when he understands what is required of him.

Maxim Kotov , surgeon-oncologist, lecturer in communications at the Higher School of Oncology

Medical science invents new methods of treatment, diagnosis, prevention, a huge amount of research is being carried out. And the global goal of these studies is to find the best method of diagnosis and treatment for people.

And doctor-patient communication is the bridge between research and people. If this bridge is not built, it turns out that all medical science works in vain. Because the end user of this science, the patient, does not get what he needs.

When normal communication develops between the doctor and the patient, trusting relationships appear. These relationships are the basis of treatment. If the patient trusts the doctor, he will follow his recommendations.

At the doctor's appointment, the patient can share everything. For example, there are opinions that doctors are annoyed when patients read about their symptoms on the Internet and then tell doctors how best to treat them. But people are worried about their health and can collect information from any sources and discuss it with a doctor. And it is better if the patient asks the doctor what he thinks about such and such information, than then he will experiment on himself.

It is better if it is in the form of questions rather than arguments, even if the patient seems to know everything, because he has been living with one disease for many years. I would recommend asking this question: "Doctor, I read an article on the Internet, they wrote this and that, what do you think about it?"

The doctor can also explain himself in terms, speak quickly and without pauses, and not give the patient time to think. It turns out such a monologue, and the treatment turns into one big lecture without feedback. In this case, we are not talking about communication, because communication is a mutual process.

In this situation, the patient may say: “Doctor, I'm sorry, unfortunately I don't understand what you are saying. Can you explain it to me in more detail?" Here the patient stops the doctor's monologue, asks to explain again and does it in the form of a question, not a counterargument.

There are three things you shouldn't do at your doctor's appointment. This is important, because otherwise you can get nothing at all from the doctor, only a formal attitude and dry answers, and no complaints will change this.

Do not include the boss. Sometimes people think that if they go to a private clinic, pay for an appointment, or have an important position at work, then in communication with doctors they can “turn on bosses”. For example, saying harshly "I told you so, you will do it" or "Write your phone number, I'll call you when it's convenient for me." This attitude is stressful for doctors, no one wants to deal with this patient.

Don't think you can get an accurate result. People may think that if they pay money, then the result is guaranteed. They come during or after serious illnesses and expect that if they paid at the cash desk according to the price list, then as if they would rewind time back. Paying for treatment is not like buying a car: you won’t be able to order the exact equipment, delivery time and body color. You can pay for medicines, procedures, and surgery and not get the result that a person hopes for.

Do not threaten. Sometimes patients come to doctors and say: “Oh, how wonderful you are, but in the last hospital I suffered, you understand, the operation was done on me by mistake, it was a medical error, I am now suing them, I will sue them, I will plant all of them." If a patient says that he has some kind of judicial practice with doctors, that he wants to punish everyone - that's it, no one will take such a patient. It seems to people that they are defending their rights in this way, but in the end, doctors will find a way to formally refuse. In general, you should not scare doctors with the words that we have imprisoned one doctor and we will imprison you.

Mom was taking her son from another city to Moscow for rehabilitation, but his condition worsened on the way, he was admitted to the hospital. It turned out that my son needed a very complex operation, which requires several surgeons of different specialties to work. Surgeons from different hospitals gathered to discuss how to perform this operation, and my mother told them how she hated the previous doctors and sued them.

The surgeons knew what a difficult operation was ahead, that complications could begin, and given the mother's attitude, they were able to find a reason for refusal. Nobody wants to go to jail because they agreed to the most difficult operation. As a result, the guy died without waiting for the operation.

All recommendations from the article are more suitable for private clinics, but this does not mean that they do not work in public hospitals. Doctors in state clinics cannot always devote enough time and attention to patients, but you should not pretend that everything is in order. If the doctor is minding his own business, you should not be silent, and if he completely ignores it, go to another doctor.

If you try the tips from the article, the likelihood that a person will be helped with his question is higher than if nothing is done.

Let's summarize all the recommendations in one list. Here is what you can do to make the appointment with the doctor efficient and the patient get everything he needs:

1. Make sure that the appointment is comfortable. You can ask to be called by name, without any "darling" or "mommy", and also sit next to the doctor in a comfortable position, and not try to talk during the examination.

2. Prepare an agenda for the meeting: write down the main topic, questions, concerns, and expectations. In general, everything that you consider important on the agenda.

3. During an examination or procedure, ask the doctor or nurse to tell you what to do and what to expect.

4. When choosing a treatment, ask about other options and what happens if nothing is done.

5.

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