Therapy can be an important part of your mental health. It can help you process trauma, cope with anxiety, or help you recover from burnout (to name a few). However, therapy isn’t a one-size-fits-all approach, there are so many factors that can influence what you get out of the therapeutic relationship. Here are 8 reasons why therapy may not be working for you, and what you can do about it.
8 Reasons Therapy May Not Be Working For You
Have you been seeing your therapist for awhile and feel like you’re stuck, not making progress or like therapy just isn’t working for you? Here are some reasons you may be feeling like something is missing in your therapy work.
1. Lack of fit with your therapist.
One of the biggest reasons for feeling stuck or like therapy isn’t working for you is therapist fit. It may seem like if your therapist has the credentials and works with clients experiencing the issue you want to bring to therapy, they should be a fit for you – but it’s not that simple. Not every therapist is for everyone. While it can be a lot of time, energy and money to try out a few therapists, finding someone you really click with makes all the difference. In fact, many therapists offer free initial consultations so help with this process. Initial consultations give you a chance to meet your therapist, hear about their approach, and ask any questions that you may have before getting started – this can help the process of finding the right therapist.
2. Type of therapy/modality.
The type of therapy, or modality that your therapist uses can be just as important as their personality/approach. Modalities are the frameworks that your therapist may use to approach the presenting concern you have and inform the interventions, questions, and process of therapy with them. Modalities include:
- Cognitive Behavioural Therapy (CBT)
- Acceptance and Commitment Therapy (ACT)
- Internal Family Systems (IFS)
- Emotion-Focused Therapy (EFT)
- Dialectical Behavioural Threapy (DBT)
- Psychodynamic Therapy
and many more. While it can be more difficult to know whether the modality your therapist uses is the right fit for you, asking questions about your therapist’s chosen modalities in a consult can help get an overview and see if that’s something you’re interesting in trying. It’s also normal to find one modality effective for a particular issue, or period of time and then find yourself feeling stuck later on. Sometimes we just need a change in approach – and that’s okay.
3. Therapeutic relationship issues.
The therapeutic relationship (the relationship between you and your therapist) is essential to progress. When you’re just starting with your therapist, you may not feel like therapy is working for you because you haven’t built enough rapport with your therapist yet – you’re still getting to know each other. Later in the therapeutic relationship, you may experience ruptures. These can be quite significant and may push you to want to end therapy due to loss of trust with your therapist (such as them invalidating your identity, not feeling seen/heard, etc.) or they may be minor and repairable (such as miscommunication, being pushed too far outside of your comfort zone when you weren’t ready). Most therapists should have the skills and awareness to notice and name these ruptures and work with you on repairing them. Your therapist should also be open to addressing any concerns in the relationship you bring up in a professional manner.
4. Myths and misconceptions about therapy.
If it’s your first time in therapy, you may be holding on to myths and misconceptions about therapy and the therapeutic process. These can get in the way of your progress. Some common myths that can impact the effectiveness of therapy for you include:
- Assuming the process is linear – therapy has it’s ups and downs. Depending on what you are seeking therapy for, you may actually notice that you feel a bit worse for a short period of time after starting therapy because you are talking about and working through memories and feelings that you may have been avoiding. In general though, progress ebbs and flows but you should start to notice that even when you are experiencing “downs” you’re coping better, or making more subtle improvements over time.
- Expecting your therapist to give you “the answer” or direct advice – your therapist isn’t there to solve your problems for you, they’re there to help you explore, process and make sense of your feelings, thoughts and experiences so that you can come to your own realizations. They can help you build skills, challenge you and help you to see things from different perspectives but rarely will they offer you clear cut advice.
- Therapy only happens in the therapy room – one of the more common misconceptions I see is when people believe that therapy begins and ends in that 50 minute session once every week or two. What we do in the therapy room is just the beginning of the process – much more of the work happens outside of the therapy room and between sessions. Both actively (“homework,” coping skills, communication) or passively (ways of relating to others, changes in thinking, etc).
5. Readiness.
Being ready to start looking for a therapist, doesn’t always translate to being ready to do the work in therapy. Sometimes you may find the motivation to start the therapy process, but need more time to work on the bigger issues in your life. Often this shows up as wanting to work on surface level concerns (that annoying co-worker, for example) or quickly feeling like you have nothing to talk about in session. This can mean that you may not be ready for therapy, it can also mean you need more time to build rapport and feel safe with your therapist.
6. Lack of or unclear therapeutic goals.
It’s common for clients to come to therapy with goals like “I don’t want to have a panic attack again,” or “I want to be happy.” In ACT we call these “dead person goals,” if a dead person can do it better than you, it’s unlikely to be a realistic goal. Your therapist should be able to support you in creating realistic, clear goals for your time in therapy. While these may change over time, goals give you a map for the therapeutic process, and something to go back to when you feel stuck, or stagnant in therapy.
7. External factors.
Sometimes this feeling of lack of progress has nothing to do with you OR your therapist. If there’s a lot going on in your life or you’ve experienced a lot of big changes recently these external factors could be getting in the way of you doing deeper work. That doesn’t mean you can’t still gain something from therapy – you may just need to adjust your goals and shift focus for the time being.
8. Feeling unsafe, invalidated or lack of understanding of culture/identity.
Similar to making sure your therapist is the right fit – sometimes their style, approach, and personality may fit what you’re looking for but there can still be something that makes you feel unsafe, invalidated or not understood. Often, this relates to beliefs (religious, cultural, political) and identity (sexuality, gender, BIPOC). Occasionally, you may start therapy with a therapist that checks all the boxes but doesn’t share your religious beliefs, or doesn’t identify as BIPOC when you do and feel like that may not matter – only to find out later on in therapy and you would feel more comfortable with someone that shares theses qualities with you. Sometimes it doesn’t come across until later in therapy when something you share with your therapist gets a response or reaction that makes you feel invalidated or judged. Either way, this is a BIG issue, as you can’t do the work that you are likely wanting to in therapy when you don’t trust, feel safe or don’t feel understood by your therapist.
What you can you do when you feel stuck in therapy?
With the exception of something like feeling unsafe with your therapist – most of these issues can be worked through collaboratively with your therapist. So the main thing you can do to get unstuck? Bring it up in therapy. Your therapist should be able to support you in exploring why you may be feeling this way and helping you try different things until you start to feel like you’re making progress again. This may be something like; revisiting old goals or setting new ones, trying a different approach if your therapist is skilled in a few (i.e. switching from CBT to IFS), trying different interventions and skills, to name a few. You may also need to consider what aspects of your life (major transitions, difficult relationships, etc) are playing a part in your therapeutic work and adjusting your expectations for therapy while you work through or adapt to those.
If you’re finding this is something you aren’t able to work through with your therapist or that’s not an option – considering finding a new therapist and/or finding a therapist who uses a different modality. Your current therapist can provide you with referrals, or you can use any of the therapist databases out there such as theralist or affordable therapy network, or ask people you know/trust for their recommendations.
Conclusion
If you’re feeling stuck or like you’re not making progress in therapy – don’t fret. This is a totally normal experience. These were just 8 reasons you may be feeling stuck in therapy, and what you can do about it.
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