Sassy Psychologist: Top 3 things to consider when therapy isn't working

OK, so you finally decide to seek therapy despite your reservations.  You go to your appointments with an open-mind and maintain that you are willing to do what it takes to finally feel better and reduce your uncomfortable symptoms. Your therapist assesses your primary concerns, conducts a proper evaluation, collects and shares necessary info, and offers a treatment that seemingly harmonizes and compliments your therapeutic goals.  But…it is just not working.  What do you do?  I’d like you to consider these three things.

1)    Therapist-Client Mismatch
Please do not go to therapy once and say, “that therapist just didn’t get me!”   I want you to consider that fact that therapists are people and you simply may or may not like their style. You may or may not like their face period.  Working through your dislike with that same therapist would be very cool (and golden as a therapeutic endeavor) but I realize that many people are uncomfortable with this. So, if you do not like your therapist, feel free to seek another.  Boom.  Simple.  Therapist-client mismatches happen all the time so do not feel guilty about wanting to see someone different.  However, I side-bar this with the following:  If you find yourself not liking any therapist, the problem may very well be yours and you will have to sort out the nature of your interpersonal struggle.

2)    Medication or Supplements
Sometimes, my clients are swimming in their symptoms.  What I mean is that symptoms can be very strong and cause people to focus solely on their discomfort.  If this happens, psychological and emotional resources are limited, making therapeutic work impossible. Therapy would therefore not work at this stage and it would be unfair (and unethical) to engage in therapy when symptoms are so significantly clinical.  If symptoms reach this level of discomfort, I recommend that my clients see a psychiatrist.  I’m not an advocate for or against medication, but I would be doing my client a disservice to omit my observation that therapy will not work without some kind of medical or homeopathic or nutritional intervention.  So if therapy isn’t working, it might be because your symptoms need to be treated with an intervention outside of therapy for a temporary period of time until they become manageable.  

3)    Self-Sabotage
Now, what happens if you have a good therapeutic relationship with your therapist and you don’t necessarily need medication but still find that your therapy is going nowhere?  So, you’ve learned about applicable theories and appropriate treatment and have even received homework from your therapist but still can’t seem to get anywhere.  If this sounds like you, hear this: It’s time for you to consider that the culprit might be self-sabotage.  Put simply, our primary psychological problems (like anxiety, or obsessions, or bad patterns and habits) may be hard to let go.  They might even serve a purpose for us; a purpose that might remain unconscious until we truly begin putting puzzle pieces together.  For example, one of my clients was working very hard at decreasing her symptoms of panic during long car rides.  She learnt all of the necessary theories and interventions necessary to treat her panic.  When she acknowledged feeling stuck in her therapy and acknowledged her inability to complete necessary homework activities, we discussed the nature of her blockage.  We talked about what was stopping her from doing what she needed to do to finally feel better after all of these years.  After some reflection, she finally realized that “anxiety was [her] friend.” It had been around forever, seemingly protecting her and making sure she never got hurt.  This notion was responsible for her resistance in therapy and practicing her interventions at home to finally change her old patterns.

The above example perfectly illustrates how our unconscious feelings can very well sabotage our therapeutic endeavors.  It can be very difficult to get a window into your buried feelings, insecurities, commitments, and desires.  However, uncovering these things will help unlock the blockage to becoming un-stuck and finally feeling better.

Anna-Maria Tosco, or our Sassy Psychologist, has two masters degrees in the field of psychology and has studied and worked coast to coast. She has worked in both psychiatric and community settings in some of Montreal's most respected healthcare organizations and institutions, and has also given a variety of talks and workshops on neuroplasticity, meditation, and uncovering barriers to love.