How Do I Know If My Therapy Is Working?

You have been seeing this therapist for some time. Your therapist is likable, compassionate, empathetic and supportive, and seems to understand your struggles. He (or she) gives you some good insight about your situation and your state of mind. You’ve become accustomed to seeing this person every week and even look forward to each session, but, despite all of the above, you are still suffering… Naturally, you are confused. You don’t know if the therapy is working. Talking to your therapist feels good, but outside of the therapy room your life doesn’t seem to change much, it could even be getting worse. Is your therapy really working?

Even if the objective answer is no, you might still feel reluctant to admit it. Why? One of the potential reasons is that you might have gotten a little addicted to seeing your therapist because it feels good. After all, he or she seems to be a good person, who understands you better than anyone else. You receive about 45-60 min of their full and undivided attention every week. Also, during this time, you get to talk about things that are very important to you, things you may not be able to discuss with other people because they are deeply personal. Your therapist empathizes with you, gives you their professional insight on your situation, doesn’t judge you for having feelings and thoughts other people might judge you for. All of the above feels good and is helpful to some extend, but no matter how good the experience of being understood and accepted feels, this alone won’t give you the knowledge and the strengths to make positive changes in your life.

Many therapists like to promote the idea that says: “Sometimes you get worse before you get better”. It is true. Sometimes, feeling worse is a necessary prerequisite to feeling better. In therapy, people often uncover things about themselves and their personal lives they didn’t know before. For the first time they might see some major problems in their marriages and other relationships, they might realize they are not happy with their career and see many other things they have chosen not to see for a long time. All those realizations could be painful but necessary if we want to learn how to constructively deal with reality.

At the same time, even though going through a certain amount of pain may be necessary to improve our life, feelings of hopelessness and helplessness are neither necessary nor helpful. Pain, in its pure sense, could be productive, because it could close some old chapters of our life we no longer need to live. This kind of pain can be excruciating, but it is also transient. It comes and goes and after each cycle, we feel better, more alive and more capable of tackling life’s challenges. Suffering that comes from hopelessness and helplessness, on the other hand, becomes chronic and destructive. Unfortunately, many therapy clients get stuck in that dark place of hopelessness and helplessness and, at the same time, they may not always recognize it as a place of impasse, where therapy is no longer working.

Sadly, some of the therapists would not take the clients’ state of mind seriously and continue to insist that feeling miserable, helpless and hopeless for a prolonged period of time is just a “normal” part of the healing process when it’s clearly not the case. Clients often blindly trust what their therapists tell them. After all, we are all led to believe that a therapist is a professional who should know better! All of the above may create a very depressing situation when clients continue to pay big money for something that isn’t working for them and when they continue to see their therapists only because they formed a strong emotional attachment to them. If you found yourself in the situation like the one I described, I highly recommend you to take a break and try to evaluate what’s going on as objectively as possible. Look at your situation from the following perspectives:

  • Is the therapy helping me better deal with my life challenges?
  • Am I feeling more confident and empowered since I started therapy?
  • Am I feeling more accepting of myself since I started therapy?
  • Do I generally enjoy life more since I started therapy?

If you answer negatively to those questions, it may indicate that your therapy is not working. Even if you are not ready to call it quits with your therapist, you may benefit from obtaining a second opinion from another mental health professional. Allowing someone else, not directly involved in your situation, may help you realize what you want to do next with your therapy process. Remember, patients have the right to receive a second opinion at any time about their therapy or therapist’s methods Note: If your therapist tells you he or she will no longer be able to work with you in case you seek a second opinion, refer them to Patient Bill of Rights that clearly states that getting a second opinion is your civil right as a patient.

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