Is Therapy Making Change? Eleven Ways to Observe Your Progress

One of the worst experiences is investing time, money, and energy into something in order to make a change, but instead of change, we come out at the other end exactly where we started. Wasting time by scrolling through Instagram or binge-watching Netflix might bring about a certain flavor of regret, but feeling that we wasted not only time, but also our dedicated effort and energy, brings about a whole other level of frustration and disappointment.

On a mundane scale, I’ve done this with trying to remove stains (taking the time to Google all the different DIY methods to remove a wine splotch from a couch cushion, buying the products, trying them out, and eventually giving up and turning the couch cushion over because nothing seems to be working). I’ve also had the experience of typing something up, only to have the program crash or otherwise accidentally delete my work, and suddenly every word I had written disappeared in an instant. The emotional turmoil that follows is a true test of letting go, radical acceptance, and self-compassion.

Point being, not seeing any fruits of our efforts is unpleasant. When this happens in therapy, it can be equally frustrating and unpleasant. Something that I have heard from clients in the past is frustration when a behavior or pattern of emotional reactivity re-emerges after a period of emotional stability and reduction of symptoms. The frustration is completely understandable, as we all hate to re-experience old patterns we have been diligently working to reduce – however I disagree whole-heartedly with the conclusion that most people come to, which is, “I must not be getting any better. I’m back at square one.”

As with most large-scale life adjustments, change in therapy does not happen overnight. We may experience some better days, but that does not erase the likelihood of us continuing to experience some bad ones. We may experience a deeper level of connection to our body one day, but that does not erase the possibility of getting caught in fight-or-flight responses the next.

Most times, when we come to therapy, we have been experiencing symptoms for a long time. Behavioral patterns and reactive emotions often have at their core benevolent purposes tied to helping us survive and doing what we think we need to do to gain acceptance, love, and support. Altering or changing our behavior or emotional response patterns takes both an intellectual understanding as well as new felt experiences in the body.

Change will happen slowly as we integrate new ways of experiencing ourselves in the world, and new ways of making sense of our past. In therapy, it’s important that we do have moments of feeling “better” or “relieved” broadly speaking, but by no means is healing and change a perfectly linear process. It’s important to understand that many times symptoms are actually ingrained patterns of survival strategies, and these can be very difficult to unwind from our physiology by their very nature.

Recognizing how change happens in therapy can be helpful to protect against hopelessness and provide a source of resiliency. It can also boost your mood as it will train you to see the positive rather than fixating on the negative. It can help you to become your own cheerleader.

Here are some ways of perceiving change that I go over with my clients when they tell me they fear they aren’t making progress due to the re-emergence of an old behavior or emotional reaction.

1. Time: Did your emotional reaction last a little bit less time than before? Was your anxiety unbearable for 45 minutes instead of an hour?
2. Intensity: Was the intensity of your emotional reaction a little bit less than before?
3. Thoughts: Did you have even one thought that was different, maybe a moment of self-compassion or validation, however brief, where you said, “I know this is so hard for you and you are doing a great job.”
4. Beliefs: Did you bring to the surface a belief that you have about yourself and how that belief might be fueling some of your emotional responses? Could you see that in the moment even though you maybe couldn’t change how you reacted?
5. Action: Did you take action in a different way? Did you reach out to someone, use a benevolent distraction, write in your journal, apologize, ask for an apology?
6. Tolerance: Are you able to tolerate distressing emotions for a longer period of time or in a way where you remain more connected to your body and experience?
7. Recognition: Are you better able to recognize triggers and patterns of responding?
8. Communication: Are you better able to identify and communicate what you are experiencing?
9. Connection to your body: Are you better able to connect to your body in periods of positivity, negativity, and neutrality?
10. Positivity: Did you have moments where you felt okay, calm, clear, grateful, or at peace? However brief?
11. Spaciousness: Did you sense even a small amount of increased spaciousness around the behavior or emotion? Such that, while distress was present, you felt you had a larger container for that distress?

As a note, if you are absolutely not experiencing any change in therapy, I would highly recommend bringing your concern to your therapist, or seeking a new therapist altogether. It’s possible that you aren’t seeing the changes, and by talking to your therapist, they can offer their own perspective on the progress you’ve been making. It’s also quite possible that you could have a better fit and better results working with someone else.