... Maybe this second part should be titled, instead, "Why therapy might not be working...."

It's a sticky situation I'm about to describe.  And when I tell you this, please know that there's no judgment on part.  Things just are what they are.

Sometimes we think therapy is a good idea.  Sometimes we recognize our own distress and make that initial phone call to a counselor, complete our first session, and get started.   But therapy is a funny thing.  Therapy can be validating, affirming, life changing and challenging in all the best ways.

Therapy is also a lot of work.  We usually don't go to therapy because things are going swimmingly well.    There's discomfort.  Dis-ease.  Something isn't working.

And maybe for some people, the simple act of sitting down and talking to somebody helps.  Eases distressing thoughts and emotions.  Is enough.  That's not usually the case though.   Therapists have different views on this, but my own is that therapy is a place where we come to be validated (yes and absolutely), but it is also a place where we come to change.  Change takes work. We learn new skills.  New ways of being.  New thoughts and new ways of thinking.  New coping strategies.  Change requires we are vulnerable enough to talk about what is going well ... and what it is not.  Change requires practice during the week.  It requires therapeutic homework.  It requires being in an emotional place where you're ready to try something new ....

It is work.
(Good work, and it does work, but still work.)

I once had a very, very, very irate client tell me that this "Bullshit therapy isn't working at all."  (There were more choice words than that, but you get the idea.)  This client had come to three therapy sessions.

Change usually takes more time than three weeks, loves.

So we can say we need therapy, right?  We can make that call, come to counseling, and sit in the chair. But sometimes we're just not ready to do the work - sometimes for very understandable reasons.  (And there is no prescription for that.  That's up to clients and their providers.  It might work to keep going.  It also might work to break for awhile.  That's not my place to decide.)

Look.  A little bit of self disclosure and honesty here?  After the Big Divorce in 2007 I saw a counselor for about a year and a half.  And it helped some.  But I held back.  A lot.  I held back a lot because this counselor and I were part of the same faith community and I was having some very big faith doubts I didn't feel like I could be honest about.  It's not that counseling in that season of my life wasn't helpful, but it really was nowhere near as helpful as I could have made it.  (My own answer should have been to probably establish care with a different clinician.  I was afraid of hurting the counselor's feelings.  It wasn't a very healthy person / clinician relationship.)  All this to say, I've been there.  Counseling seemed like a good idea, but I wasn't as invested as would have been most helpful.


Your comments in the last post were lovely reminders that sometimes we need friends.  Sometimes we need people who are going to sit with us, laugh with us and cry with us.  Sometimes we don't need a professional's clinical tools .... we need somebody who, as Eliz! put it, has been where we've been.  I've been there, too.  The fluttery feeling of solidarity and recognition that happens when we find someone who really understands us ... is gold.  It's not that counselors cannot provide that, but counselors should probably not engage in high levels of self disclosure.  Right now, in this season, I am more replenished from talking to someone who has been through a divorce, or grad school, or fertility problems (my own examples.)

So.  Where does that leave us?
Counseling can be amazing.  It truly can.  I wish I could go into detail about the almost spiritual moments that have happened in my office.   I've seen it work many, many, many times (and "working" by the client's definition.)  Sometimes it really doesn't ever take off.  And that can be ok, too.

I guess my ending for these last two posts would be this:
An admonishment in love to take care of yourself.
If you take care of yourself in therapy, then fantastic.  (I love being a therapist; it can be magical; I get it.)
And if there are other ways to take care of yourself, ok.  Do coffee with your friends.  Do yoga.  Do roller derby.  Do your poetry group.  Do Crossfit.  Do it.  But do something.

(Additionally, as I'm wrapping this up, as a community outpatient mental health provider, I'm having reminder thoughts that some of us are mandated to therapy through different court systems.   As a reminder to us all, I am not giving clinical advice to anybody in this moment; rather, I am exploring thoughts on therapeutic possibilities.   If you have a court order to attend therapy, take medication, etc, or are currently in care with a clinician and these things are part of your treatment recommendation, please follow through.   Please take care of yourself in these ways.)


  1. Anonymous on October 4, 2014 at 3:26 PM

    I've also been in the challenging position of having the only available therapists in my community be my colleagues that I can't engage in therapy with...or the ones I truly trust...are my friends. But I call this "Margarita Therapy"...which is, of course just a "session or two" with a trusted therapist friend over coffee or a meal to get some perspective. Sometimes that's all I need to get myself back on track, or to gain or regain perspective, or to hear "it's just something you have to move through...no quick fix".

    And when I was doing energy healing, just like traditional "talk therapy", I would feel pretty much what direction the client might be needing to examine initiating a change process, but they came to me to "fix it" not to do the work. Energy healing is supposed to be like magic right? Mystical and effortless. Sometimes yes, but just as often I am intuitively led to say what I'm sensing which sometimes means there is work to be done. I also think there is a misperception, say with a family member, that the one who is acting out is the one we send in to be "fixed" (or interpret that as "silenced" or "tamed" or "made less problematic for the rest of us"...and the family has nothing to do with it. And I also think there just may be a difference between "counseling" and "therapy"...does that make sense? It sure is complex, huh?

  2. Andrea on October 5, 2014 at 8:29 PM

    Again - wise words! :) And whew - yes change is work, and I hear you on needing an ear that is completely disconnected from your personal life. I've been to sessions that gave me solid building blocks for coping with my struggles, and I once had a session that was merely unloading everything I was dealing with, both were equally helpful! I am so thankful for the hearts and ears that enter this profession, you are truly amazing.

  3. Lisa on October 10, 2014 at 3:01 PM

    W - So very complex. I so appreciate your thoughts about the family systems! As a kid therapist, I always let families know from intake that child therapy must include some component of family support. And just your words about being sought out to "fix things" are very healing for me in this very moment. This week has been super tough in that regard. It's soothing just to hear somebody else name that! I appreciate knowing you - YOU are very therapeutic for me!

    @Andrea - I love those moments of unloading as well. It's such a blessing to come alongside people who have so much to say. :)


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