Does Therapy Even Work?

I get it, before you spend time, energy, money, and emotion – you want to know if therapy even works! Let’s dig in.

Does therapy actually work?

Therapy can be a very effective tool for treating symptoms of psychological disorders, increasing self-esteem and self-awareness, and becoming healthier in relationships. Therapy effectiveness depends on many factors, including but not limited to, finding a therapist and modality that fit for you, sharing honestly during session, reflecting on sessions throughout the week, and implementing any agreed upon changes or coping skills outside of session– this can get easier over time. Therapy takes time. We often repeat the same patterns, forget all coping skills the second session ends, and can struggle sometimes to speak our truth – even to ourselves. That is okay! But hopefully as you get to know your therapist more and become more comfortable with the process, that will become easier for you, and you’ll see more and more progress! Sometimes people do need medication in addition to therapy, this is especially true for psychotic disorders or bipolar disorders, however many clients see effective results with therapy alone. Emotions suppressed in the body will find ways to show up in your life and all the unhelpful unconscious beliefs we hold due to adverse experiences in our life will seep into our thoughts, feelings, and behaviors unknown to us. Being able to share with a safe other, release stored emotion, and build insight can help us feel better and live better.

How is talking about my problems supposed to help?

Talking about our problems can help us feel less alone. The more we bottle up our fears, insecurities, and woes, the more powerful they become. I often work with clients who are successful and put-together on the outside but struggling with anxiety, low self-esteem, feeling not good enough or like too much, and sad on the inside. These clients can often go years hiding these things from others, and perhaps even staying busy enough to hide these things from themselves. But everything suppressed comes up eventually and often manifests as anxiety, depression, anger, and feelings of loneliness. Talking about problems allows us to release instead of just hide. Having a caring, supportive other person to hear us, to help us make sense of things, to feel with us, can lead to a lot of relief. Many times, clients have told me they feel better after talking things through and having someone else listen, care, and validate even if nothing external has actually changed and they still have the same problems at the end of session that they had before – clients will still say they feel lighter. It can also decrease a lot of shame to tell someone about the things we usually hide and have those things be met with kindness and understanding. Shame increases when we keep things secret.

Talking about our problems can also help us gain new insight. A lot of people mistake overthinking and self-criticism with insight. With a therapist there to ask reflective questions, people can look at things in different ways or make connections they didn’t see before. I can’t tell you the number of times my brilliant, reflective clients have left a session saying “huh, I never realized that before” and being able to come at a problem from a new angle or with more self-compassion.

What if therapy doesn’t help me?

This is a scary one. What if our problems are too big or we are too damaged or it’s just too hard? Therapy isn’t a cure-all. Your life won’t magically be fixed by going to therapy. But imagine being able to just not have to deal with it all alone. Imagine being able to have someone else to share the burden of life’s difficulties, that in itself can be a huge relief. Imagine still having depression or anxiety or conflict in relationship but knowing what to do to help yourself feel even a little better when that comes up. And therapy is a broad spectrum. Just because one therapist or modality isn’t a good fit for you, doesn’t mean another one won’t. Therapists can also help give other suggestions referring you for a medication evaluation (if you’re open to it) or other things to try outside of therapy.

I’d like to reframe your question though, instead of what if therapy doesn’t help me, ask yourself, what if it does? What if you can feel better? What if that is possible? What if putting in the work to find the right therapist and speaking uncomfortable truths and doing all the stuff that feels really overwhelming right now, what if it changes your life?

Is therapy just venting?

Oh man, I love me some vent sessions – as a therapist and as a client. Sometimes that feels good and is exactly what is needed. But no, therapy is not just venting. It is building a stronger mind-body awareness, learning coping skills, developing new insight – getting to the root of why we feel the way we feel and why we do the things we do, healing the parts of us that have been wounded so we can feel and act differently. Sometimes it’s drawing or listening to music or collaging or deep breathing. Sometimes it’s exploring dreams or finding ourselves in fairytales to deepen our self-understanding. Sometimes it’s having our narrative gently challenged to facilitate growth and evolution. Therapy is not just venting. It’s an art in which you are able to connect with yourself on a deeper level, see things from a new perspective, become kinder to yourself, and have more tools to navigate this challenging world.

What if I already know what’s wrong with me?

I am a therapist. And, I have been in and out of therapy for years. I know my patterns, my fears, my wounds, and I know where they come from. And still, I occasionally go to therapy because even though I KNOW, sometimes, I need a gentle reminder or redirection from someone who I know gets it and care about me. Also, at this point in my therapy, I rarely get huge new insights (although I still get some) but I value having someone to help me connect what I know logically with what I feel. And it is very healing for me to cry it out and not be alone in those feelings. Or even help me cry when I can’t get the tears to come on my own. Just having someone to listen to me talk about the same thing over and over if I need to and say “I understand” - just that can lift me from the darkness and into the light.  

Also, knowing what is “wrong” with you is not the same as feeling and healing.

What if therapy makes me feel worse?

This actually can happen, but don’t panic! Sometimes, we have survived this long by suppressing feelings and memories and when we go to therapy where we are suddenly giving attention to all that has been ignored, we feel worse. But that might not be a bad thing!

 If you had a medical condition that required a surgery, the surgeon is arguably putting your body in a worse state when they cut you open - exposing your organs and leaving you even more vulnerable. But they get in there and fix what they need to fix, sew you back up, and give you time to recover – and you end up better off, right?

Therapy is like that too. We go in there to look at the wounds and do some work on them. That might hurt more in the moment but once we’ve actually learned how to heal and soothe those wounds, you won’t have to spend the rest of your life distracting yourself from them or acting from them.

And if therapy is truly causing more harm than help, you can try a different therapist, a different modality, take a break, or stop altogether and find other methods to healing.

How long does therapy take to work?

This depends on the person, the issue, and what “working” means.

I have been in and out of therapy for about a decade, but I stopped having panic attacks after only three months of therapy when I first started and haven’t had one since. Most of my symptoms got better within a few months, but then new challenges would come up. The symptoms would return, and I would go back to therapy. I did my most intensive therapy during graduate school and about 2 years of that led to extreme changes for me. Now, I rarely have severe symptoms. And, even on my worst day, I still feel pretty able to regulate. Yet, I continue going back to therapy periodically to get support during challenging times. It helps me take care of myself, so I am better able to take care of you. And sometimes it provides me with new insights that can help my life and my practice.

So, how long does therapy take is a difficult question to answer because not only does it depend on your situation, but also on your goals. Since most of my clients come to me for a deeper level of healing and self-awareness rather than symptom management, most of my clients stay years, not months. But it really is up to you!