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.

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    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!

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    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?

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    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.