Should Therapy Really Be This Hard?
Though it may seem counterintuitive, feeling worse at the beginning of therapy can be a sign of progress.
So you’ve taken the hardest step, you made the decision to seek therapy. You’ve done your due diligence, asked for recommendations from your physician and perhaps friends and family members you know have a therapist they are pleased with. You’ve researched each of the options and possibly spoke with a few. At long last, you have finally settled on a therapist who you believe can help you.
You’re ready, even eager, to get started and more than ready to feel better. You go to the first few sessions and it seems that you are already starting to feel better. But then something odd seems to happen. You begin to feel worse.
“What’s going on,” you begin to wonder? “What happened? Shouldn’t I keep feeling better and better? Especially, given how much this is costing me, shouldn’t therapy make me feel good? I know I came in because I’ve been feeling terrible — depressed and anxious, but shouldn’t the therapist say things that make me feel better not worse? And what’s this business about things getting worse before they get better anyway? Is that just an excuse so I keep coming in for a while even though it’s not working?”
When you think about it more carefully, though, it makes You’ve made the decision to seek therapy because there are things going on in your life that are making you unhappy but which you haven’t been able to work through yourself. This likely means a few things. The issue is probably complex and while you think you understand what is happening you may not have a clear view of the problem. The problem has likely also been going on for a while and has built up into something that you find overwhelming.
When things are painful to us, we do whatever we can to get rid of the pain. This can mean that although we couldn’t determine positive ways to resolve the issue, we found negative strategies which we were willing to use despite them being maladaptive because they got rid of the pain. These strategies now may be interfering in ways that we need to address.
It’s also possible that as you begin to explore the problem, what you have repressed in order to avoid the pain resurfaces. Therapy often involves cutting through these types of defense mechanisms that you have used to protect yourself from difficult thoughts, emotions, and experiences. This can be painful. However, while it may be uncomfortable right now, processing what is causing the pain and working through it will help you move past it so you can live a happy life.
It’s important to understand that just because you are paying the therapist, this doesn’t mean that it is up to them to do the work. They will help you learn how to do it and support you along the way. But therapy involves rewiring the connections in your brain through new experiences that allow you to tolerate uncertainty, negative emotions and troubling thoughts. This means you will likely become uncomfortable at some point during the course of therapy.
One thing that can make this work easier is to think about what you have lost from whatever problems you are going to therapy for and how much pain they have caused you. While there may be discomfort learning how to change the problem, once you have fully dealt with what you need to, the pain you once felt will no longer derail you.
A side benefit of this is you also will be able to handle other problems which may come along with the new coping strategies you have learned. You will have gained self confidence in your own effectiveness at handling what life throws at you, making doing so in the future easier.
At the time though, this can seem frightening, especially when you were starting to feel better and gain hope that you were on your way to recovery only to feel like you experienced a major setback. However, a skillful therapist will have the knowledge to help you determine how far to go each session without it becoming overwhelming. Over time, although there will still likely be lows, they’ll become less painful and the highs will become greater.
When you are working on difficult problems, it is important to have the right therapist. This is someone you trust who takes the time to really listen to you. While you may be the one needing to do the work they will be the one to keep things under control. They should be able to gauge when something is becoming overwhelming to you so they can dial it back.
The aim of therapy is not to make you suffer and your therapist should make it a safe space for you to do the work you need to do. If they open you up to something that’s really hard during the session, they need to help you close it back down at the end so you aren’t faced with coping with something you aren’t ready for without support. When you have the right therapist despite the discomfort that often occurs when exploring tough issues, you will feel protected and hopeful about the future.
The right therapist provides a consistent sense of support, acceptance and validation. They will work with you to create a plan of action with specific steps for effectively dealing with the problem or distress that brought you in. Knowing what to expect of future sessions and the process overall can go a long way to relieving the discomfort of processing psychological problems and real life consequences.
Dr. Natalie Frank has a Ph.D. in Clinical Psychology and has worked with patients who have a variety of problems and disorders. She specializes in health psychology and pediatrics.
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