The inconvenient truth about why therapy takes so long

You had high hopes when you signed up for therapy. You imagined the end result where problems were manageable, relationships were healed, and your mental health was top notch. With these goals in mind, you began the journey of connecting with a therapist, saying: “Help me change. Make this stop hurting.”

But, now you’re starting to realize that therapy can take its sweet time in order to work. Perhaps you’ve already invested several sessions (or several months of sessions) into this healing experience. You may be feeling a tad frustrated. When are you finally going to start seeing some progress? When will you be “healed”? Why does therapy take so long?

If you’re in this stage, I know it’s really hard to be patient. Clearly, you’re motivated to get better. Despite all of your good intentions, you’re not seeing the change you want to see. It can be incredibly frustrating when you’re giving it your best efforts, and it still feels like you’re stuck.

Unfortunately, the answer for why therapy takes so long is complicated. The progression you experience in therapy can be influenced by a variety of different factors, such as: the complexity of your needs, your comfort with your therapist, fears of change, external pressures, and your expectations (just to name a few!).

The Real Reasons Why Therapy Takes Time

1. Working with ambivalence

    Therapeutic change means we have to process some of the most challenging moments of your life. We have to face the emotional burdens and beliefs that you’ve carried from a tender age. While this may sound fair and reasonable, it is easier said than done. It takes a lot of courage and willingness to speak to a therapist about our shame, our insecurities, and our painful stuck points. There may be parts of you hesitant to discuss these facets of your history, while other parts of you are eager to get on with it. This tug of war is normal.

    Rather than forcing yourself to talk, let your therapist know you’re struggling with this internal battle. Your therapist can help you work with this ambivalence first. Doing this extra step helps to reduce overwhelm and resistance, and allows you to safely address these challenging topics.

    move at the speed of trust. why therapy takes so long- building trust with internal parts. internal family systems therapy online and in kitchener, ontario.

    2. Building Trust

    Your trust may have been tested (and burned) in other relationships. Your experiences in the past have led you to be cautious about opening up. Once bitten, twice shy, so to speak. Rather than put yourself through this again, it feels safer to stay on the surface level, and focus on “easy” topics during therapy. While there are some benefits to this decision (e.g. you’re in your comfort zone), there are also costs. You don’t get to deal with the issues that are actually bothering you.

    In these situations, be honest with your therapist. Name this block, and allow it to be there in the therapy space. Your mind won’t question why therapy is taking so long when you’re acknowledging that the trust isn’t quite there. It’s okay to stay with the surface level topics until trust is built. Your therapist can gently guide you into working with these blocks in a safe and effective way. This process will take time, and that is okay.

    But can I trust my therapist?

    It takes a lot of courage to open up to a virtual stranger. Here you are showing up with your most vulnerable wounds, and you’re supposed to blindly trust that this person can handle it? Of course you’d feel cautious!

    Trust in therapeutic relationship. blocks in therapy. why therapy takes so long.

    You don’t know me outside of these blogs and the therapy space. It’s absolutely fair that you take all the time you need to judge and assess if I can be trusted.

    With any therapeutic relationship, you have to consider: Is your therapist consistent? Will your therapist judge you? Can your therapist handle what you’re about to share?

    I recommend providing a few tidbits about yourself to see how your therapist reacts. Therapy can take time because it’s a relationship. As with any relationship, you need time to build trust.

    3. What’s happening in your world?

    When you’re in the safe confines of a therapy room, you can show up. You can let your guards down. You can be expressive and messy. You can stop being so responsible. There’s nothing to do or accomplish during the hour other than talk to someone who really wants to hear you and help you feel understood. So, if you do all of this, why doesn’t it feel better?

    These hours in therapy may be rich and nourishing for your system. However, what is your world like outside of these hours? Who do you have to face when you go home? What hardships, threats and vulnerabilities are waiting for you as soon as you walk out that door?

    Therapy can do a significant amount of healing in your internal world. But, it can be hard to appreciate this change when you’re returning back to the same daily hardships. In these situations, healing means making changes in your internal and your external world in order for your mental health to improve. Again, this takes time. It takes time to decide if you want to leave an abusive relationship, find a new job, or move to a safer neighbourhood. It takes time to carry out these changes.

    4. Can I give therapy the time and effort it needs?

    therapy takes time. barriers to healing. IFS in kitchener, ontario and online.

    If you’re attending therapy regularly, you’re taking the time out of your busy day to arrive and do the work. Beyond the hour of therapy, you may be encouraged to do some homework such as journalling or meditation. Therapy requires your patience and persistence.

    Doing this type of work regularly can come at a cost. There are many obstacles to address, like finding the time, energy, finances, and childcare to make this all work. That’s no small feat. You are doing the best you can, and this should be celebrated not judged.

    Therapy takes time when you’re not able to attend regularly. When this is the case, I encourage you to focus on the progress you’ve made (both big and small), rather than the amount of work that is yet to be done. This will help to keep you motivated and on track towards achieving recovery.

    5. Is this the right therapist or the right type of therapy?

    Not every therapist is going to be a good fit. Your therapist might not have the right set of skills to meet your needs. Perhaps your schedules don’t align. Maybe you’re just not a fan of the way this therapist communicates. These are all barriers to moving forward.

    Similarly, not every therapy style is going to be right for you. You may prefer a cognitive approach instead of using mindfulness. You might want a therapy style that is directive and tells you to try x, y, and z steps for homework. Maybe you just want to chat with someone and explore your unconscious thoughts and feelings. Get to know your preferences and what feels effective for you.

    There are dozens of therapeutic approaches to use. There are many therapists available. It’s okay to shop around and find out what best suits you.

    How You Can Make the Most of Therapy

    Despite the length of time it takes, there are a number of ways you can make the most of the therapy process.

    1. Remember why you are doing therapy in the first place and to stay focused on this goal. What are you hoping to achieve?
    2. Keep track of what’s different in your emotions and behaviours. Do you get triggered in the same way? Do you respond to situations differently? Do you feel calmer inside? Are you able to notice your emotions without feeling overwhelmed?
    3. Let your therapist know what would help build trust in this relationship. While you should always be courteous and kind, it’s not an attack to tell your therapist that you’re feeling cautious about opening up. This lets your therapist learn more about your comfort in trusting new people.
    4. Therapy will often require difficult conversations and working through uncomfortable feelings and memories. Be clear with yourself and your therapist about what you’re ready to process, and what feels inaccessible. Respect your boundaries, and trust your therapist to guide you in the next steps.
    5. Take care of yourself and foster healthy relationships. Therapy takes time. In the interim, get enough sleep, spend time with loved ones, and follow self-care practices to keep you going.

    Reach out

    Trust yourself and your ability to be patient and persistent in this process. Therapy is a journey. There are opportunities to meander, get lost, or go back a few steps before heading back on track. The work can be slow, but you can get there.

    Kasi Shan, MSW, RSW

    Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

    Why am I feeling stuck in my trauma?

    Even years after a traumatic experience, we can feel stuck in a place of emotional distress. In therapy, I noticed that many trauma survivors would struggle to find self-compassion. They would get caught in an endless loop of self-blame and resentment. Other clients were keen to begin therapy; however, they were easily overwhelmed once they started to talk about the trauma. Many clients felt unable to deal with their past because their current coping mechanisms (e.g. self-harm, substance use) were causing so many problems.

    Feeling stuck in trauma, therapy. Internal family systems therapy

    These clients are intelligent, capable, and well-versed in therapy lingo. Many of the folks I see can recite CBT and mindfulness principles to me. Despite knowing how they “should” think or behave, they were still feeling stuck. As a clinician, learning Internal Family Systems therapy (IFS) transformed my counselling practice and helped me better understand these stuck points. I hope this blog post will help you recognize what may be affecting your own recovery.

    Healing wounds

    Feeling stuck in trauma, therapy. Internal family systems therapy

    When it comes to trauma, we develop strong emotions and negative beliefs about ourselves. We carry these wounds with us, not always recognising the subtle ways in which they influence our behaviours and actions. For example, after a rape, a survivor could start to believe “I deserved this”, “I did something wrong”, or “I am unlovable”. She may feel an intense level of shame or fear. If she is carrying these beliefs and emotions, she will develop protective methods in order to adapt. These protective habits ensure that the beliefs and feelings stemming from the traumatic event are never experienced again.

    A Parts-led System

    Before we dive into the topic, let me give a brief explanation of Internal Family Systems Therapy. IFS recognizes that our mind is divided into sub-personalities; each “part” or personality can be active at different points in time. When I am calm, confident and feeling at peace, I feel like myself. However, there are times during the day when I get triggered and parts of my personality get activated. At work, the therapist-part of my personality likes to coach me in what I should say to clients. When I’m home, my mother-part can narrate all the ways I need to my take care of my child. My self-conscious part gets loud when I am shopping for a new pair of jeans. My over-achiever part can take over when I’m signing up for courses, agreeing to tasks, or managing my calendar.

    Having our mind divided likes this is not the same as multiple personality disorder. We all have parts. At various points in time, these parts get triggered and feel the need to push a certain agenda (e.g. attending therapy, avoiding treatment).

    Managerial Parts

    Feeling stuck in trauma, therapy. Internal family systems therapy

    In the IFS model, we recognize that there are two types of protective parts that develop following a trauma. The first type of protective parts are called managers. Managers are the parts of our personality that try and prevent bad things from happening. Managers are proactive in preventing us from feeling the same emotions that we experienced in the time of trauma. They try to ensure safety by keeping our environments and relationships in balance.

    A sexual assault survivor may create one or many managerial parts to prevent an assault from happening again. Her managers will try to avoid triggers that bring about similar emotions and beliefs to her experiences following the trauma. For example, she may have a part that refuse to go anywhere by herself at night, a part that turns down dates, a part that numbs emotions, and a part that is fearful of strangers. All of these parts protect her from being vulnerable again.

    How do managers affect therapy?

    Managers can show up in a variety of ways in the therapy context. From their perspective, they are attempting to the help the client. Bear in mind that these reactions are not always within our awareness. These parts of our personality become triggered and react oftentimes outside of our conscious decision-making. These parts are not intentionally trying to cause harm, but using their own capacity and knowledge to keep us safe.

    Before we can start processing trauma, my job is to work with these protective parts of your system. You have survived all these days by using these protective mechanisms. Unless every part of you is on board saying, “Yes! Let’s talk about this!”, it is perfectly natural for some type of blocking to show up.

    Common manager blocks:

    • People-pleasing parts: This part tends to agree to all of the therapist’s comments despite not truly believing the therapist’s feedback. It may often accept a task or homework, despite knowing that other parts of the system are not ready to take on a certain challenge
    • Avoidant parts: This manager often misses appointments, or is late to therapy. In attempts to prevent the client from talking about a difficult experience or feeling vulnerable, this part can take over and avoid therapy all together.
    • Achievement-oriented parts: This part tries very hard to ensure that the client is doing his or her best. This part will often read therapy textbooks, learn about different diagnoses, and speak about trauma 24/7, if allowed. Unfortunately, the client can easy become overwhelmed or burned out if this part takes over all the time.
    • Critical parts: This part is often trying to be a cheerleader to the client; however, its words are harsh. The client can feel too distressed by the criticisms to work on the traumatic memory.
    • Denying parts: This part often minimises traumatic events in order to protect the client from truly recognising the impact of these horrific moments. Often these clients will say “it’s not a big deal”, or “that’s just normal at my house.”
    • Socially-avoidant parts: In fears of experiencing another distressing social encounter, this part will avoid any situations in which the client may stand out. This can prevent clients from spending time with friends, attending school, or dating. This socially avoidant part can also avoid situations where the client has to speak assertively or set boundaries.
    • Caretaker parts: This part will often forego the client’s own healing in order to take care of others. I often see this manager role in many postpartum parents as they learn to balance their own needs with that of their newborn child.
    • Intellectualising parts: This part will focus on analysing the situation, or thinking of the right answer versus allowing the client to sit with, or experience an emotion.

    Firefighters

    fireman standing near fire on building
    Photo by Tobias Rehbein on Pexels.com

    IFS explains that there is a second type of protective personalities that they refer to as firefighters. Whereas manager parts are in the role of preventative care, firefighter parts are reactive. They see a fire, and quickly work to put it out. In this way, firefighter parts are extremely helpful. Rather than letting the client feel burdened by traumatic wounds, firefighters are quick to find ways to stifle these intense feelings and beliefs.

    Consider an example where an individual has recently been dumped. The impact of this breakup can be incredibly intense, worthy of hours of sadness, loneliness, and perhaps, hopelessness. This individual may also start to develop beliefs about himself following this experience, such as: “I don’t deserve love”, “I am ugly”, or “I am not good enough.” In reaction to this vulnerability, firefighters try to quickly eliminate these thoughts and emotions. They do this through any means, irrespective of other consequences that can arise. For example, this individual may have a part that is angry at his ex, a part that pushes others away when they talk about feelings, or a part that has him moving out of this neighbourhood.

    Common Firefighter Blocks:

    Feeling stuck in therapy. feeling stuck in trauma. IFS, internal family systems therapy

    Photo by Alexander Krivitskiy on Pexels.com
    • Cancelling appointments parts: Following a difficult appointment, this part may feel it’s too vulnerable to return to therapy.
    • Angry parts: In response to feeling vulnerable, these parts want a way to feel empowered and lash out through anger, oftentimes projecting on to safe people.
    • Dissociative parts: These parts have the client “check out” during or after therapy. They can also cause clients to forget parts of traumatic experiences. Clients may present as distracted, or they have limited recollection of what happened.
    • Self-harm/Suicidal parts: In hopes of distraction or reducing pain, these parts practice self-harm or focus on suicidal urges.
    • Substance-dependent parts: In order to numb out emotions and thoughts, these parts turn to alcohol and drugs.
    • Food-dependent parts: These firefighters turn to food for comfort (e.g. binge eating, purging, excessive exercise). In hopes to feel some semblance of control, some firefighter parts focus on caloric restriction. Unfortunately, this food-dependent part tends to get push back from other parts of the system (e.g. parts that are ashamed in having to cope this way, part that resents being stuck in treatment because of food).
    • Body sensations/Illness: These parts can take over during sessions through headaches, body pains, upset stomachs, and other uncomfortable body cues. This can make it hard for the client to be fully present during the therapy experience.

    Working with a Self-led System:

    There is a common phrase in IFS, which is “all parts are welcome”. When it comes to therapy, every part of you is welcome to show up. Your therapist recognizes, like a family, you have various members in your internal system. As with families, each member has a different role, a different set of fears, and (sometimes) a different agenda. In IFS, we are not fearful of these managers and firefighters. Instead, your therapist will focus on the intentions of these parts to keep you safe. By taking the time to slowly work with these parts of your personality, your system begins to build more trust and there are fewer “stuck points”. It is at this point that we have permission to work on our underlying traumas.

    IFS believes in the concept of “Self”. This is the true version of you. Not the one addled by anxieties and symptoms, but you at your very core. This is the confident, calm, curious, compassionate version of you that has been hidden due to firefighters, managers, and traumatised parts taking over. In IFS, we work to have a better relationship with our protective and traumatised parts so that there is more space for your true Self to come forward.

    Parts-led versus Self-led

    When we have a chaotic leader guiding us, our nation reacts with volatility. We become divided with one party screaming that their perspective matters most, and the other side counteracting with the same level of intensity. In similar ways, when our internal system is led by our managers, firefighters, or wounded parts, the rest of our system goes into a fight-or-flight mode. When we are led by Self, the system believes this leader has our best intentions at heart. There is more space to trust, listen, and negotiate.

    When there is enough trust between Self and our protective layers, managers and firefighters can step back so that we work with the actual traumatic wounds. This process can take a session, or it can take a few months. The more vulnerable you felt during and after a traumatic experience, the more intensely your firefighters and managers will work to ensure these vulnerabilities are locked away safely. Therefore, therapy can take time in order to build trust with these protective parts of your personality.

    Your therapist’s parts

    The last piece that can create stuck points in therapy is your therapist. As your therapist is human, it is natural for him or her to also have managers, firefighters, and traumatised parts. In order to stay Self-led, I am regularly assessing whether my parts are interrupting the work in order to protect my own wounds. If a part of me reacts, then I am no longer feeling open-minded or curious. Instead, I am deterred by the agenda of my own anxieties.

    If a therapist is triggered, this can impact a client from receiving effective and genuine support. Clients may feel that their therapists do not understand, and that they seem impatient or defensiveness. If this is the case, please know that this is not your fault. It may not be your therapist’s fault either, especially if he or she is unaware of these parts taking over.

    Shifting away from feeling stuck

    When we take the time to get to know our internal managers and firefighters, we build trust with these parts of our personality. We allow space for these parts to assess if it is safe to stop their protective roles. With this trust and safety, they no longer feel the need to react as strongly. We are finally able to move past these stuck points in healing.

    If you are interested in learning more about IFS, or if you would like to discuss stuck points in therapy, please feel free to reach out.

    Cheers,

    Kasi

    Kasi Shan, MSW, RSW
    Kasi Shan, MSW, RSW

    Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

    Race and Culture in Therapy

    Given the atrocities that have cost lives in the past few weeks (e.g., George Floyd, Breonna Taylor), race and ethnicity are at the forefront of many minds. I have been thinking a lot about racial and cultural sensitivity within a counselling space, and I wanted to take some time to share how I address both in therapy.

    I am a woman of color, and in many ways I will understand and empathize with your experiences. In many ways, your experiences will be fundamentally different from mine. My understanding will then come from the openness to learn and engage in nonjudgmental conversations with you. This is not a pressure to share and talk about race and culture, but the invitation to do so. I will not presume to know what life has been like for you. I can provide compassion, but I have not walked in your shoes and lived out your years of experience. At the end of the day, our relationship grows from continued dialogue. Your healing comes from feeling the safety to share, and gaining skills to address the traumas that you have experienced. It is fostered by the knowledge that there is mutual respect and kindness between you and your therapist.

    Race and cultural sensitivity in counselling
    Photo by ATC Comm Photo on Pexels.com pexels-photo-305530

    I practice cultural sensitivity by engaging in continuous conversations of how your history has shaped you into becoming the person you are today. It’s essential in therapy to understand context. It is important to understand how your traditions, religion, culture, socioeconomic status, family values, beliefs, and other factors all work together to influence your experiences and worldview. We need to acknowledge how all of these pieces create unique benefits and barriers to accessing the life you would like to live. There is no space for judgement in therapy; whatever choices you made or actions you took to get yourself here are all moments of survival.

    Race and cultural sensitivity in psychotherapy

    I am always hesitant to self-disclose, whether in blogs or in sessions, because I do not want our sessions to be about me. This is your time for healing, and my job is to support. However, trust is an integral part of counselling, and now more than ever, talking about race and culture is pivotal.

    So here is my story: My family and I are refugees from Sri Lanka. I came to Canada at a young age and experienced the pains and joys of being a first generation Canadian. We lived in a financially-constrained household as my parents began to build roots and security in a new country. The first time I travelled, I was shocked to experience more racism abroad than I had ever experienced in my ethnically-diverse hometown (Scarborough). I have been told that I am not Canadian-enough and picked over for a Caucasian-peer. I have also been selected for roles due to tokenism. None of these experiences feel positive. I am married to a Caucasian, and we have had some interesting times learning to grow as a couple, while also working to recognize that interracial couples are not always accepted. I also have many privileges, such as my education, having a safe home, a loving family, and being able-bodied. These are my experiences, and they are unique to me. Just like your experiences are your own.

    If you would like to engage in dialogues about cultural sensitivity in therapy, or other counselling needs, please reach out.

    Kasi