How to Talk About Tough Stuff: Expert Advice from a Psychotherapist

Talking things out makes us feel better and strengthens our relationships. But starting those conversations—and keeping them positive and productive—can be a challenge. Luckily, experts can help. Joicy Salgado, LMHC, is founder and psychotherapist at Salgado Psychotherapy. We spoke to her about what qualifies as a “tough” topic, why an intersectional approach is so important, and how to affirm and respect both yourself and your conversation partner throughout the process.

Joicy Salgado on a hike

Remember: Tough looks different for everyone.

“What is ‘tough’ for one may be different for another person,” Salgado says. If you’re having a hard time, don’t compare or minimize your circumstances. And if someone comes to you saying they’re struggling, don’t diminish their experience or try to convince them it’s not so bad. “This can create space for empathy for ourselves as well as for others.”

Talking about tough stuff keeps your mind from “tricking you.”

When all the tough stuff is kicking around in your mind, it can take on a life of its own. And your mind can “trick you,” Salgado says. “Keeping things inside of you can even bring physical and medical issues: changes in mood, changes in appetite, panic-like attacks, rashes, muscle spasms, physical aches.” That’s why it’s so important to move on to the talking stage, which involves “processing the information by verbalizing it.”

Tough conversations need to consider the whole picture of what someone is going through—not just a specific issue.

“Mental health and substance use intersect with background, sexuality, gender, race, people with different physical and cognitive abilities,” Salgado says. “This intersectionality greatly affects resources and accessibility for education and treatment. If we are not aware that systemic issues exist, then conversations about mental health (including substance use) become erroneously skewed.” During tough conversations, seeing and respecting each other’s complete humanness is key.

There’s no “right” time for these kinds of conversations.

Still, according to Salgado, “you might want to set a low-stress environment by checking in with the receiver and asking if they have the time and energy to talk. If you suspect that the receiver is busy, see if another time can be better.” This will reduce unnecessary stress and potential evasiveness or defensiveness. Salgado also recommends creating a distraction-free space. That means switching off the TV and putting electronic devices like smartphones and tablets in a different room. (For neurodivergent folks, keeping a small item in hand or using some other supportive tool during the conversation is of course fine.)

If you’re initiating a tough conversation, here are Salgado’s tips.

  • Remember that you deserve to be heard and listened to.
  • Remember that creating community and support is important and beautiful. You cannot do it all on your own.
  • Remember that you are taking ownership of what is going on with you. You might not feel it, but that is powerful.
  • Remember that certain conversations are ongoing, and you might not resolve it the same day. This is okay.
  • Take a break if the conversation becomes too overwhelming and come back to it at a later time (a few hours or days). Don't forget to go back to the conversation.
  • If you don't know the answer to what the listener is asking, you can say that you do not know. This is okay. Sometimes we don't know how we feel or reasons to feel what we feel. This is found with patience and understanding; don't rush or add more pressure to yourself.
  • Have some space within yourself to understand the receiver/listener's questions and concerns. Again, you do not have to have all the answers; mutual understanding and patience is imperative.
  • Practice grace, self-compassion, self-empathy. These often take the form of reminders/affirmations and kind internal dialogues.
  • If you are intending to speak to a specific person, it can help to process your thoughts first with someone else you feel comfortable with.

If you’re on the listening or receiving end during a tough conversation, here are Salgado’s tips.

  • Remember that someone is speaking with you because they want your support. You mean something to that person if they come to you.
  • Listen first, ask questions later.
  • Same as for the initiator, take a break if it becomes overwhelming and don't forget to come back to the conversation once you're ready. We often see that it takes a few hours or a few days.
  • Accept if the person tells you they do not know something, or they don't have more information to share. This can be hard for the listener/receiver as this can usually be a person who might want to protect. When our protective mode comes on, we want to know everything so that we can help. However, realize that in our efforts to want to protect we might be hurting, and adding so much pressure to the person who came to us is important.
  • Practice grace, self-compassion, self-empathy. When our internal dialogues are kind, we often can extend that to others. 
  • You do not have all the solutions and that is okay.

Don’t forget to express love.

This applies to everybody involved in the conversation. It’s especially important to express love at the end of an unfinished talk so that both parties walk away feeling supported and can sustain interest in finishing the conversation later.

Therapy helps!

“Psychotherapy or mental health services can aid people in processing how to talk to their loved ones,” Salgado says. It’s just one tool in your toolbelt, but it can be a very powerful one.

September 2021

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