How do I know if therapy is working for me?
How Do I Know If Therapy Is Working?
Starting therapy can take courage. You may come with a particular hope: to feel less anxious, understand yourself better, improve a relationship, process something painful, or simply feel more like yourself again.
But therapy can sometimes leave you wondering: “Is this actually working?”
There isn't always a straightforward answer. Therapy is rarely a completely linear process, and progress doesn't necessarily mean feeling better after every session. Sometimes, therapy can initially feel uncomfortable because you are beginning to notice feelings, patterns or experiences that you previously pushed away or found difficult to acknowledge.
So, how might you know that therapy is helping?
You may be beginning to understand yourself differently
One sign of progress can be developing a greater understanding of why you respond to situations in the ways you do.
Perhaps you begin to notice what tends to trigger your anxiety, recognise patterns in your relationships, or understand where a particularly harsh inner voice comes from.
You may find yourself thinking:
“I never realised I did that when I felt unsafe.”
or:
“Now I understand why this situation affects me so strongly.”
Understanding doesn't necessarily make difficult feelings disappear, but it can create more choice in how you respond to them.
You may notice a little more space between a feeling and your response
Therapy isn't necessarily about never feeling anxious, angry, sad or overwhelmed again.
Instead, you might begin to notice that you have a little more room to respond differently.
Perhaps you still become anxious, but you recognise what is happening sooner. You might pause before seeking reassurance, communicate a need rather than withdrawing, or notice that a difficult thought doesn't necessarily have to dictate what you do next.
Sometimes progress is subtle:
“I still felt anxious, but I handled it differently this time.”
That can be meaningful progress.
You may become more accepting of yourself
For some people, therapy involves moving away from constantly judging or criticising themselves.
You may begin to speak to yourself with a little more compassion. You may understand that some of the ways you have coped developed for good reasons, even if they are no longer serving you.
You might begin to replace:
“What's wrong with me?”
with:
“What happened to me?”
or:
“What am I needing right now?”
This doesn't mean excusing everything we do. It means developing a more curious and compassionate relationship with ourselves.
Your relationships may begin to change
Sometimes changes in therapy become visible outside the therapy room.
You may find it easier to set a boundary, express what you need, tolerate disagreement, recognise an unhealthy dynamic, or choose relationships that feel safer and more reciprocal.
You might also notice changes in how you relate to other people without consciously trying to make them happen.
You may feel difficult emotions more safely
An important part of therapy isn't necessarily getting rid of difficult emotions.
It can be learning that you can experience an emotion without being completely overwhelmed by it.
You may gradually become more able to stay with sadness, anger, fear or grief, while remaining connected to the present.
This can be particularly important when earlier experiences have left you feeling that certain emotions are dangerous, unacceptable or impossible to manage.
You may still have difficult days
Progress doesn't mean that you will never struggle again.
There may be weeks when anxiety returns, an old pattern reappears, or something happens that brings difficult feelings back to the surface.
This doesn't necessarily mean that therapy has stopped working.
Sometimes, the difference is that you recognise what is happening sooner, understand it differently, or recover more quickly than you once would have.
What if therapy doesn't seem to be helping?
This is an important question, too.
Sometimes the answer isn't that you need to try harder at therapy. It may be that something about the therapy needs to change.
You might need to:
talk with your therapist about what you are finding difficult
revisit your goals
slow the pace down
explore something more deeply
try a different therapeutic approach
consider whether the relationship with your therapist feels right for you
or, sometimes, consider whether another therapist might be a better fit.
A good therapeutic relationship should have room for these conversations.
You don't have to quietly continue with therapy while wondering whether it is helping.
Therapy doesn't have to feel good all the time
Therapy can sometimes feel relieving, but it can also feel uncomfortable, tiring, confusing or emotionally demanding.
The question isn't necessarily:
“Do I feel better after every session?”
It may be more useful to ask:
“Am I beginning to understand myself differently?”
“Do I have more choices in how I respond?”
“Am I becoming more able to tolerate and understand my emotions?”
“Am I relating to myself with greater compassion?”
“Is something changing, even if that change is small?”
And perhaps most importantly:
“Do I feel that I can be honest about what is and isn't helping?”
Therapy is a process. Progress can be gradual and sometimes difficult to see while you are in the middle of it. Small changes can matter, and setbacks do not necessarily mean you are back where you started.
If you are unsure whether therapy is helping, you can bring that uncertainty into the therapy room. It can itself become an important part of the work.