Why therapy doesn’t work for everyone, and what to do when therapy doesn’t work: Going beyond talk therapy
As a therapist myself, I know that the process of therapy can be frustrating. I’ve struggled in my own personal therapy, at times questioning “why isn’t therapy working for me?” And I’ve personally had the thought that therapy isn’t working.
There may be more than one reason, but the first thing I want to recognize is that when you are struggling it can be extra painful to finally start therapy and feel like it isn’t working. You’ve taken a big step in asking for help, and now you’re feeling like therapy isn’t helping. That’s a deeply difficult place to be.
I want to normalize that finding the right therapist can be challenging. I also want to normalize that healing can come in many ways.
I also want to highlight that if you are living with trauma, a lot of times, talk therapy alone doesn’t work. You may have talked through your challenges and explored why they are challenges many times, but your body isn’t getting the message that you are safe. It’s not uncommon to find that talk therapy doesn’t work for trauma.
Sometimes it may mean it’s time to look for a therapist who uses tools beyond talking. This could be somatic therapy, EMDR, or the creative arts therapies. These tools can help our body catch up to our mind when working with trauma.
Why therapy doesn’t work for everyone
There can be many reasons why therapy isn’t working.
You may not have a therapist you feel safe opening up to.
You may not be ready to take the steps that you need (I say this with no judgment; changing is hard, and it’s OK to honor the pace that you are going at).
Your therapist might have the right expertise for your particular challenges.
You may need other healing paths.
You may be trying to outthink your emotional wounds, but your body needs the attention for healing.
Why isn’t therapy making me feel better?
It’s worth taking time to occasionally check in to see if you feel that you are moving towards feeling better. I want to be clear that not every session will feel good. You may have some sessions where you walk away feeling worse. When you check in, it’s important to focus on the bigger arch of the work, instead of just looking at each session individually.
Now, with that said, I want to talk a bit about why you may be feeling that therapy isn’t working, especially if you have a history of trauma.
I should note here that trauma can mean a lot of things to a lot of people. Here I’m generally using the word to mean that you have experiences from the past that are impeding your present. This could mean an accident, physical injury, or it could mean hurts from relationships. These hurts can include parents or caregivers who have neglected or abused you, which impacts your current relationships.
When working with trauma, thinking things through rarely heals your wounds fully. Here’s the thing: if you’ve experienced trauma, and your body is still on high alert, your body is actually doing what it’s supposed to do. It’s really smart, in that it’s trying to protect you from future hurts.
Your body holds memories of past hurts. You may have thought through every pattern and piece of why you acted in certain ways, but if your body hasn’t learned that it’s safe, it may not want to trust how it moves through the world.
This can be an important piece of why talk therapy isn’t working for you. If that’s the case, it may be time to look for a therapist who can work with you somatically, which broadly means integrating your body and its sensations into the therapy work (to be clear, touching is not necessary).
Similarly, accessing your nervous system through other modalities can help shift your body’s experience of trauma. Creative arts therapists use art, music, movement and drama as another way of treating trauma.
If you’ve spent a lot of time in therapy talking, and are thinking to yourself that therapy isn’t helping, it can be a sign that talk therapy isn’t enough to help you on your healing journey.
Here’s my reminder to you that if you feel that therapy isn’t working, it’s OK to let your therapist know this. A good therapist will be able to hear this feedback, and to work with you to either shift your current therapy, or to transition to a therapist who is a better fit for you.
Signs therapy isn’t working
Sometimes it can be hard to figure out if therapy is working for you. Here are some questions you may want to ask yourself if you’re questioning if therapy is working:
Do I feel safe sharing what’s going on with my therapist?
Do I notice that my patterns in relationships are changing?
Do I feel like everyday life is a little less overwhelming?
Am I able to experience and tolerate a wider spectrum of emotions?
Am I able to bounce back from setbacks a little more easily?
Do I notice some of my symptoms lessening a bit?
Am I feeling a little more hopeful about the future?
Is there more room for living beyond just survival?
These are questions for exploration. Therapy is a process, and healing is going to have ups and downs. If you find that you are noticing no movement towards feeling better over time, it may be a sign that therapy isn’t working for you.
What to do when therapy doesn’t work
If you feel that therapy isn’t working for you, the first thing I’d suggest is that you talk to your therapist. Us therapists want to help you in the best way we can, and we want to know if what we’re doing isn’t working.
I should put the disclaimer here that if your therapist is causing you harm, you don’t need to feel obligated to talk to your therapist about it before deciding to leave. It’s important to look at your capacity and need for care as priorities.
Talking to your therapist might help you come up with new action plans to help you move forward differently. It might also help you and your therapist recognize that you aren’t a good match. It’s important that you find the therapist that is the right person for you. This means someone you feel comfortable with, but it also means you may be looking for someone who specializes in what you’re looking for (this can be a specific concern, but can also be a specific approach you want).
I also want to note that sometimes people find other paths to healing. It would be dishonest if someone asks me, “is therapy for everyone?” for me to give the blanket answer of yes. Sometimes therapy isn’t the right path. And while I hate to admit it, there are therapists that do harm. If you are questioning why therapy isn’t working, you owe it to yourself to explore that curiosity.
Final Thoughts for when when therapy doesn’t work
There are many approaches to therapy, and many approaches to healing. I want to emphasize that the most important thing is that if you are hurting, it’s OK to ask for help. And it’s OK to let your therapist know if you’re feeling like therapy isn’t working.
Sometimes you’re not with the right therapist; sometimes you’re not with the right kind of therapy.
Ultimately, the most important takeaway is that you deserve the care that is right for you.
Kate is a licensed therapist in New York. She works with people who grew up in challenging families, who have experienced emotional trauma or neglect, who experience self-abandonment and people pleasing, and grief. Learn more here or schedule a consult call here if interested in working with her.