These Are The Most Common Issues Women Bring Up In Therapy

Mental health professionals reveal the topics that are often talked about in their sessions and what you can do if you're feeling them, too.
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Certain topics — like motherhood, wanting or not wanting kids and societal pressures — are common among women in therapy.

While women are not a monolith, there are societal pressures and cultural expectations that many experience (like being told what not to wear by controlling partners, or stressors that come with reproduction). And these issues are often brought up in safe spaces like a therapist’s office.

These problems vary, of course, depending on age, race, religion and socioeconomic status. “But there are a lot of things that I feel like I see a lot of, and many similar themes that come up a lot in relationships too,” said Emma Mahony, a therapist at A Better Life Therapy in Philadelphia and a mental health content creator on TikTok.

Many of these issues can feel all-consuming at times, but it’s helpful to know you aren’t the only one experiencing them. Below, experts share the issues that women commonly bring up in therapy, along with some advice for how to cope.

Life transitions

According to Meredith Van Ness, psychotherapist and owner of Meredith Van Ness Therapy in Colorado, life transitions are a reason many folks seek therapy.

“Becoming a parent, divorce, empty nest syndrome or menopause. These transitions can bring about a range of emotions and challenges, and therapy can offer support and guidance during these times,” Van Ness said.

She added that any kind of major life adjustment can bring up past unresolved issues, whether it’s a sense of loneliness when you move to a new state that stems from losing a loved one when you were a kid, or a feeling of depression when your children move out that is reminiscent of depression you experienced in college.

Becoming more self-aware is one way Van Ness said she helps her clients through life transitions. This can help people understand why they are having such a hard time and what they can do to feel a little better.

An inability to define themselves outside of motherhood, marriage or a career

“A lot of women struggle with who they are — ‘who am I outside of being a mom, outside of being a wife or girlfriend?’” said Alicia Brown, a psychotherapist with Grow Therapy in South Florida. And the same goes too for who they are outside of a career, she noted.

“This could look like, ‘I recently just became a mom and I feel like I don’t have any friends,’ or ‘I feel like I’m not as connected as I used to be.’ ... It could also happen for those who are transitioning into a new career or not really knowing what they want to do, but knowing whatever it is that they’re doing right now is not working for them,” Brown said.

People go to therapy to figure this out while still maintaining the relationships they want with their kids, their partner or doing their day-to-day responsibilities at work, she said.

To help people in this situation, Brown said she has people identify who they are in the moment along with their ideal version of themselves. “And together we come up with a way to merge those two,” she explained. “What things do we need to put in place so that you could cross that bridge and get to that ideal self? What are some of your needs that are going unaddressed? What are some of your goals and desires that you want to work on but haven’t worked on them?”

Once you have your goals and desires set, Brown said you can prioritise the goals that will make you feel accomplished and take steps to achieve that goal.

Stress about motherhood, like not wanting kids or wanting kids but struggling to get pregnant

“I think the whole umbrella of reproduction and fertility weaves throughout a great deal of therapy issues with women as well,” Mahony said.

Whether it’s conversations about not wanting kids, nerves around pregnancy, infertility, stress about the uncertainty of reproductive rights in the U.S. or how to balance children with a career, many baby-related issues are the centre of therapy, Mahony added.

There are beliefs and societal expectations that need to be worked through, she added. Many ideas about pregnancy and motherhood are really ingrained in our culture. You can decide to adopt kids when you’re 45, get pregnant years and years after your friends or fully decide not to have kids, and that’s all OK.

While these are tough topics to deal with, Mahony said it’s important to normalise these conversations with the women around you — and not to make people feel judged.

“It’s so important that you talk to other women and normalise that being a woman isn’t one-dimensional. And there are a million ways it can look to be a woman in the United States these days,” she said. “We are hard enough on ourselves as it is, and the last thing we need to do is question women on the choices that they’re making, but just be more curious and open to their experiences.”

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It's important to create a community with other women you can talk to in an open, judgment-free space.

Self-esteem and self-worth

“Some of those common things that come up for people are self-esteem and self-worth ... how people feel about themselves,” Van Ness said.

Confidence is something that Van Ness works on with many of her clients “so that they can show up in their own lives being who they want to be without a lot of the societal pressures and body image concerns or even past traumas or past relationships that have maybe done something to diminish their self-worth and how they feel about themselves.”

In Mahony’s experience, this lack of self-esteem also shows up as self-comparison and negative self-talk. “I would say a majority of the women I see ... just, overall, are extremely hard on themselves,” Mahony said.

Mahony added that it’s never too late to start working on your relationship with yourself. Getting to know yourself better and understanding your limiting beliefs can eventually help you break this harmful cycle. Journaling, support groups and therapy are all ways to understand yourself on a deeper level, she noted.

The pressure of having to do it all

There’s a deep-seated notion that women need to do it all — work, clean, cook, raise kids — without any help. Many women struggle with “this idea that they’re supposed to be Super Woman. They’re supposed to have it all figured out,” Brown said. And not just that, but “they’re supposed to do it with a smile.”

She said her clients feel that society asks a lot from them and it’s hard to know where to start, especially if some of the pressures aren’t what they signed up for.

Brown said she works with her clients to unpack these expectations, including where they come from and when. Generally when people are “doing it all,” they’re typically doing so to please others, and that is a problem.

“If you’re always striving and working and doing all these things to please other people, how do you please yourself, right? How do you develop this relationship with yourself, right? That you don’t feel like you have to prove yourself to anybody,” Brown said.

Anxiety

“Women may experience high levels of stress and anxiety due to various factors such as work pressures, family responsibilities, societal expectations and personal goals,” Van Ness said.

Anxiety is also tied to overthinking, which can show up as self-doubt — like overanalysing how you acted during past situations. For example, think back to a time when you overanalysed something you said at a party. You may think “Why’d I say that?” or “Why am I such an idiot?” when, in reality, no one else is likely thinking about the so-called error you’re obsessing about.

To combat this, Van Ness said to focus on looking at rational thinking patterns in your life versus irrational thinking patterns. Is it likely that someone is as caught up with a “dumb” thing you said at a party? Probably not. Additionally, she said you can consider which thoughts are keeping you stuck in a past behaviour and what you can change in that thought process to move forward.

Seeking help to deal with all of this is important

If any of this sounds like you, know that you’re not alone and you don’t have to deal with it alone either. An always-on-the-go culture requires a lot from people, so it’s no surprise that you’re feeling overwhelmed.

Brown said there are fewer safe spaces for women, which makes lots of folks feel like they just have to get it “right” the first time around. Think about it: If a woman is older and not settled down, she is blamed for that. But if she’s a single mom, she’s blamed for that too, Brown said. It’s deeply unfair.

“There’s a lot of double standards that also play a role in how women have this superhero, superwoman kind of complex,” Brown said.

Mahony stressed that it’s important for women to find a community to lean on when times are tough. “We’re not meant to deal with things on our own. We are social creatures,” Mahony said. “I think with women it’s extremely important to lean on other women.”

You can seek support from friends or family, as well as find help through therapy, which can help you work through any of the issues mentioned above (and more).