3 things to do when therapy is not working

When therapy doesn’t seem to be working for you, you may start to ask yourself, “is this worth it?”,“am I doing something wrong?”, “am I just too broken to be fixed?”, and, “whose responsibility is it to move this therapy forward?”

You know you have done difficult things to get connected to therapy. You made the decision to try therapy. You got through that difficult weeding-out process of trying to figure out which therapist may be a good fit. You have been putting in the time and money to attend sessions. Maybe, you even felt some success as you started your therapy journey.

But now…..If it seems like the progress you want is not happening, and your enthusiasm, or worse yet- your hopes- are beginning to wane, do these three things before you decide to end therapy:

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Check your therapy map

Make sure you have a therapy map, that the map has the correct title, and that you and your therapist are referring to the map on a regular basis.

If you are wondering what a therapy map is, this may help: All maps give a birds-eye view of a specific area or region and help us make sense of the larger picture. As the saying goes, “it can be difficult to see the forest for the trees”. Meaning, of course, that when you are in the thick of anything seeing the larger perspective can be hard. A therapy map is based on your goals but it goes further than just naming where you want to be. It also helps you understand where you started, where you are headed, and what you might encounter along the way. It gives you landmarks to look for which can help you mark your progress.

In addition, progress in therapy sometimes occurs in little steps. This means that the view while you are in the forest may look much the same even when there is progress occurring. By both you and your therapist checking your therapy map and agreeing on where you are on that map on a regular basis, it is easier to see the movement that you are making and easier to see if you really have stalled out.

Therapy maps also provide you with the focus for the bigger reasons you are in therapy, which makes making the smaller changes more meaningful. Making sure you have the right map, and then reminding yourself periodically of what your map is all about, are two additional ways to use your therapy map. If you are uncertain about your focus, a fun way to gain some clarity on that is to think about what you would name your map.

For example, there isn’t really a “map to happiness”, despite a book title by that name, nor is there a “map to zero struggle”. “My map of accepting all feelings”, or “my map of staying connected to myself in the midst of struggle” may not sound like snappy titles, but are most likely more accurate, more reasonable, and more attainable. In addition, therapy maps that have a title related to avoiding or discontinuing something are going to render less therapy movement than maps related to facing something or moving toward changes. As an example, a therapy map titled, “my map to having less anxiety”, is not going to be as effective as, “my map to coping with anxiety”.

Creating, understanding, and utilizing a therapy map may seem more like a coaching technique than a therapy technique, but talk to your therapist about a therapy map or have a few sessions with a knowledgeable coach for consultation. When you have the right map, when you know where you are on the map as well as where you are heading, your therapy is going to be more effective, more focused, and go further, faster.

Learn about how therapy works, and capitalize on what you learn 

Based on my observations as a psychologist for several decades, I often use this simple model of therapy: First, think of your psychology as being a variety of layers that are currently bundled together. The more cohesive the bundle, the more difficult it is to change.

Then think of that bundle as having at least five layers. Here are the layers:

  1. Story (what are the facts as you see them),
  2. Beliefs (what you think the story means),
  3. Emotions (how you feel about what you think the story means),
  4. Sensations (the bodily signals you are getting regarding the emotions), and,
  5. Energy (that inexplicable force that animates our flesh and bones).

Therapy tugs at one or more of these layers, helping to un-bundle them (for lack of a better term) and in that way it starts to pull apart the cohesion of the layers, making change more possible. Different therapies concentrate on different layers. Basing the following on my observations as a practicing psychologist, here are some popular therapies and where they generally fit in this model:

Talk therapy in which you give the story or narrative of your life and struggles works primarily with the first two levels, also usually identifying and normalizing emotions. Cognitive Behavior therapy focuses primarily on beliefs. Dialectical Behavior Therapy (DBT), leans more into beliefs, emotions, and sensations, and Internal Family Systems (IFS), incorporate the first three levels and aspects of sensation. Mindfulness works with emotions and sensations. Somatic therapy focuses more on sensation and emotions than stories and beliefs. Energy healers focus on moving those inexplicable forces. Eco-psychology and nature-connected techniques use all five levels. If you decide to use this model of how therapy works, you can then identify what type of therapy you are in and from there understand which layer or layers your therapy is targeting.

Once you have that understanding, utilize it to your advantage. Ask yourself how this particular therapy is helping you specifically. For example, if you are engaged in talk therapy, how does it help you to be with someone who catches your story and understands your take-away from what is happening in your life. Perhaps that helps you organize what your experience is like, which in turn can help you make choices. Perhaps it helps you feel a sense of relief that another person can hear your experience and let you know you aren’t alone. Perhaps it helps to take away the shame of what has occurred as telling your story then becomes less of a secret you have kept from the light of day.

Each therapy targets or is best suited to particular levels of the “bundle”, but knowing what is targeted in your specific therapy helps you understand how your therapy can be helpful. When you ask yourself how your specific therapy helps you, it is easier to use your therapy in a mindful and intentional manner, which helps to see your growth and progress.

Try new things, without stepping away from your current therapy

Experiment with tools and techniques that target a different level of that psychological “bundle” than your current therapy targets. To do this look for online offerings or webinars (some are even free), free introductory classes (such as yoga or meditation), books based on specific emotional themes or psychological viewpoints, or half-day, full-day, or weekend retreat with specific focus. Try out something related to your growth and healing that you ordinarily might be hesitant to experience, but do so on a short-term or limited basis while you continue in your current therapy.

Experimenting can be difficult because ordinarily we are drawn to experience that with which we are most comfortable. Also, we tend to limit ourselves, even more, when we are facing pain and struggle, because our energy is tied up in just trying to manage that pain and struggle. So be gentle with yourself as you do this, and expect that experimentation will not feel all that comfortable. And then do it.

If you have questions about how much to stretch your comfort level-we all know that stepping too far outside our comfort zone can lead to feeling overwhelmed, and that is NOT helpful- you might use this example as a guide: Imagine putting your shoes on the wrong feet, then wearing them like that for the entire day. Initially, it feels awkward and strange and uncomfortable to a certain degree. It isn’t painful, however, and you can still walk. By the end of the day, you may not notice it so much, and although it feels like a relief to put them back on the right feet, you know you managed the experience well. Take that physical example and apply it to your emotional functioning and then find an experience that is at that level of “shoes on the wrong feet” feeling, and try out that new thing. It will most likely bring newness and progress into your current therapy. Feeling a lack of progress in your therapy is frustrating, disappointing, and discouraging. You can feel like you want help and change, and yet change can seem elusive and difficult. Before you step away from your current therapy, try the three things listed above. I, personally, hope that you find answers and resolution resulting in greater peace and strength. 

About Lisa Dahlgren

Lisa Dahlgren, Ph.D. Is a psychologist, nature-connected coach, and certified Transformational Wilderness Guide. She designs and leads profound encounters with nature for healing humans and the Earth-human bond.