Not getting anywhere in therapy? Have you considered this?

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Feeling stuck in therapy?

I have felt this way as a client and a therapist. The stagnancy and annoyance where it seems like all you do is come in and give an update about your week or complain about the same things that were bothering you the last time. You talk in circles around an issue but stay tethered to the same anchor points.

You start to wonder what you are even doing in therapy — is this even helping?

You are already overwhelmed and have little time and energy left to give. You consider leaving. But is that what's best? Is the problem the therapist? Is it something else? Before making a decision on whether or not to end your work with your therapist, consider the following:

Are you holding back?

Are you sharing your whole self? Are you being honest about where you are at, what you need, how you feel and how you are showing up to your life? Change can only occur in therapy when you are fully open with your therapist. They need to know you — your thoughts, feelings, behaviors, pain points, etc. Otherwise, they will always be working from a different playbook.

Not sharing our whole selves is usually a sign of:

A lack of trust or a fear of judgment. Are you worried they will judge you? I have had clients who have lied about substance use because they were afraid they would be treated differently. I have had clients not disclose parts of their identity because of uncertainty about how I might respond. If you lack trust, consider what it would look like to build it. Tell your therapist about your fears or worries. Seeing how they react to this can give you incredible insight into how they might respond if you share your actual news.

Ask yourself if you have data to support the notion that this person is unsafe to explore this with. If so — if they have said or done things to make you feel like you or the information would not be safe or treated with kindness and compassion — stop reading. You have your answer -- end the relationship as safety is the most important thing in a therapeutic relationship.

But, if you are projecting this fear onto them because of other experiences and anxieties, then you're doing both of you a disservice and keeping support an arm's length away.

Shame. This, in many ways, connects to the fear of judgment. Shame is the fear of being seen as unworthy or not enough. When we feel shame about something we have done or do, how we think, etc, we will work to hide it or avoid talking about it. This might also be the case if you have a hard time naming something as a problem. I have had new moms hesitate to tell me some of the thoughts that run through their heads about their children or being a parent because of their shame. They fear that this makes them a bad parent and worry how I would respond. A friend of mine has never discussed his use of substances in therapy because of his own shame about them and his resistance to naming this as a problematic behavior. He's fine and its under control so why should he talk about it? Anything that you feel like is better left in the shadows is 100% tainted by shame.

Do you know what you're working on?

When you start therapy, you do an intake. Part of the intake goal is to identify your goals for treatment. This is meant to give you a roadmap of where you want to go and then you and your therapist make a plan for how to get there.

I can't tell you how many people have shared with me they have never once had a goals conversation with their treatment provider. Or, they can remember talking about goals but couldn't tell me what they were and haven't talked about them since their intake.

Therapy is a goal-oriented process. It is finite and dependent on reaching milestones. If you are unclear on where you are going, you will find yourself venturing down whatever path looks good to you in session or gets you away from your current state of suffering the quickest. I call this "goal drifting and problem hopping," or the experience wherein your focus and goals change each week depending on whatever is bothering you most.

But this therapy method is incredibly unhelpful as it focuses the work on managing the symptoms rather than addressing the root cause of pain. Productive work is not always focused on what happened between sessions but is about deeper diving into both insight building and action. There has to be some regimentation to the process and an anchoring on the topic or goal. That doesn't mean what is happening outside of that is not stressful. There are absolutely times that the acuity of this pain warrants and sidestep away from your longer-term goals. Still, for the most part, it is about focusing on small, 1% graded changes and not allowing yourself to get swept up in the distress of the moment.

If this is happening to you, talk about this with your therapist. Clarify the goals of your work together and set a proposed timeline. Discuss how to manage and defend against that drive to focus on the loudest pain point each session and instead stay the course to work on the long-term goal.

Are you afraid to move forward?

It may seem strange but many people get stuck in this cycle of "goal drifting and problem hopping" because they get comfortable here. They may not be happy but it is predictable. They know what to expect with their crappy job, unfulfilling relationship, and mediocre friendships. They don't like it but they know how to function in it. And they begin to see their therapist as the person that allows them to vent and reset each session so they can keep circling round and round without making any changes.

This is a tricky place because this is usually motivated by shame and the belief that you are either incapable of making any changes or undeserving of a life other than this coupled by an attachment to this pain. These stories come to define you and if you let these go and try to write something different in your story, how will people see you?

Change can only occur through grieving, preparation, action and healing. There has to be space for all 4 of these phases and it is not easy. I have a client right now who has had conversations with me about this and the fear of what it would mean to be "better" and how their diagnosis and pain has defined them for so long, they're afraid of who they are without it. There is no way to make change comfortable for the brain — we are wired against it. But ask yourself if it's worth it to you in the long run and what opportunities you may be counting yourself out of if you don't allow the possibility things could be better.

Are you and your therapist working towards the same endpoint?

Like knowing where you are going, are you sure you and your therapist are working towards the same goals? I have done this with clients before where they have identified drinking is a problem or agree they have an eating disorder but when I focus our work on abstinence and recovery, I am met with resistance. There is a difference between admitting something is a problem (or maybe a problem) and wanting to do anything about it. Are you and your therapist on the same page about the problems that brought you in and how you want to address them?

One way to ensure that you are on the same page at the end of each session is to both write down or share aloud your summary of what you did in the session, how it connects to your goals and the work for you to do before next session.

Have you already decided this won't work?

In many cases, clients come in to therapy already assuming it won’t work. The two biggest culprits — shame and biases and misunderstandings about therapy. People have heard it won’t work or have had a bad experience in the past so they come in assuming it won’t work now. It can also feel safer to assume it won’t work rather than have hope it could only to feel crushed if things don’t get better. Many clients have come in telling me they hate a certain modality (like Cognitive Behavioral Therapy) and that this won’t “work” for them or set rules about how something will or will not go. They come in defining our relationship before we have even had a chance to meet and dictate the terms of our work. They tell me what they will and will not do or shut down new ideas or seem hopeless about any possibility or idea I may mention in session.

All of this is a result of fear, shame and a drive to maintain a sense of control. That makes total sense. If this has showed up for you, let go of judgment and find compassion. What do you need to do or let go of to allow the possibility therapy might be helpful for you? How can you switch from creating a self-fulfilling prophecy to being in a state of discovery?

Is your therapist working harder than you are?

This is a hard question to sit with but be honest with yourself — who is working hardest in the therapy room and why? As a therapist, I am doing us both a disservice if I am working harder for you than you are for yourself. That doesn't mean I will not put everything I have into our time together. Still, if you are not fighting for life and working towards your goals with greater ferocity than me, then this becomes about me and will only result in resentment and tension between us.

You have to be the one working hardest for your life, both in and out of the therapy room.

Is this the right time?

If you notice that any of the above are true for you but you are resistant to doing anything about it/them or overwhelmed at the thought, it might be time to consider if now is the right time for therapy. I have had many clients come in believing they were ready and/or this was the type of support they needed only to find out it wasn't.

While the work may be helpful and necessary, sometimes we need to consider our lives in the context of everything going on and check in if you can show up the way you need and want to for therapy to be effective. Maybe you have a few steps to take before you are ready to jump in? Perhaps you recognize some internal stories that need to shift in order for you to engage more openly. Or maybe you have to take time to get clear on what role therapy is playing and what you are looking for from it.

The question then to ask yourself is, how would I know when I am ready? And what does it look like to get myself from here to there?

Where do we go from here?

If walking through this, you can see how some of these pieces may be showing up for you, then consider what it would look like to bring them up in session.

Feeling stuck or unsure about how to do that, drop a comment below or send me an email — I would be glad to help! I can also assure you that you are not being a jerk by telling your therapist you need something different or more. We are not supposed to be everything for everyone and oftentimes will get it wrong. Letting us know what you need is a sign you feel safe with us and is such a gift to be able to have that conversation with you.

At the end of all of this, you may still reach the conclusion that your therapist is not the right fit either because of your own comfort with them or the way they engage in therapy. That is entirely normal and happens to a lot of us. The biggest thing is to know that you were willing to consider these pieces for yourself not only to check in with where you are at but because it helps clarify for you in the future what you may be looking for from and in therapy.

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