Why Therapy might not always work?

Even with the country in lock-down and quarantine, it is important to remember that our mental health still needs to be stimulated and worked on.  You might feel that the walls around you are starting to feel claustrophobic and that you just want to get out of the restrictions that this pandemic has placed on you.  You might be craving the personal contact and the caring hug from somebody that truly cares about you.  You just want to talk and connect with somebody, anybody that’s willing to listen to you, your struggles, your frustrations and anger that you might be feeling, somebody that will understand you and help you calm your mind and emotions down with the right tools and help guide you through other struggles that places your mental health in jeopardy.

GEM Mental Health Therapy and Coaching has decided to offer Skype Video Calls, WhatsApp Calls and WhatsApp Video Chats in order to reach as many people as possible.  Please do not hesitate to reach out so that we can work together on your mental health as we face these challenging times.

Being in a negative spiral and not being able to vocalise your thoughts is suffocating.  You wish to make improvements in the areas of your life that you are struggling with.  You might not necessarily believe in therapy, but you reach out to a therapist and when you sit in front of this person, you hope for the best.  Your biggest question might be “Will this therapist be able to help me cope with my troubles?”.  But, after a few sessions or even after a year of being in therapy, you feel that you just aren’t getting the results that you were hoping for.  You feel that after all the time, effort and money that you spent, that it just wasn’t worth it, and you feel lost again, discouraged and wondering if this is it.  Is this really all that is out there?

Although therapy can be highly rewarding, especially when you start working through the emotional baggage that is holding you back, it can also be quite daunting.  Why daunting you might ask.  Well, you might find the prospects of diving into vulnerable situations or subjects that is not too flattering quite intimidating and scary.  But here you are, not feeling the satisfaction of growth that you expected to have after being in therapy for a while.  What now?  What causes this?  What are the reasons why therapy isn’t working for you?  Are there any red flags that you should have been aware of before you started the therapy process?

It is always a good idea to do a bit of research.  Visit their website or social media platforms and investigate their qualifications.  This will give you a good indication on whether the prospective therapist will be a good fit for your emotional needs.  By saying this, I do not mean that you should stalk the therapist, just that it might be a good idea to gather a bit of information on your therapist to see if you might be a good fit.  This is unfortunately not the only bridge to be crossed to ensure a healthy therapeutic relationship and below are various reasons why this therapeutic relationship might not work and that you might not be getting the satisfaction out of your sessions as you hoped you would get.

Various reason why therapy would fail:

  • Not the correct therapist for you

Because there are specific needs to each person’s struggles, it is important to find the correct type of therapy for your needs.  There are various reasons why the therapist might not be correct for your therapeutic needs.  The therapist might not be sufficiently qualified to effectively treat your needs.  For example, the therapist might be qualified and specialised to treat children and adolescents with learning disabilities but might not be trained to effectively treat the sexual trauma that you experienced.

Secondly, if a therapist is not able (or unwilling) to adjust their therapeutic approach based on your presenting problem and underlying emotional issues, it would be unhelpful for you as the client to carry on with this therapist.  An example here might be where a client with a narcissistic personality will need help managing their strong feelings instead of connecting with their strong feelings.

Lastly, you might need a higher level of treatment and your therapist might not be able to provide you with your level of requirements.  Should you require medication, for example anti-depressants, anti-anxiety medication or even anti-psychotic medication to work with your therapy, your therapist should refer you to a trusted psychiatrist who will be able to prescribe such medication.  The psychiatrist will be able to look at all your medication that you are taking, together with any allergies and sensitivity and prescribe the best medication to you that will coincide well with your therapy.  Here it is highly recommended that you carry on with therapy and discuss any changes that the medication has on you.  This will enable you to know what changes to expect and how to adjust to such changes.

  • Are the sessions time-based or results-based?

It would be irresponsible for your therapist to leave you to your own devices at the end of your hour session without giving you tools to assist you through the week.  When you are in a session, often very sensitive matters and raw emotions are discussed and if you do not know how to work with those thoughts and emotions throughout the week, it could cause more harm and cause confusion on what is expected of you.  When sessions are time-based, they tend to be drawn out and problems rarely gets resolved.  It’s like putting a plaster on your cut, but instead of the plaster assisting with the healing, it causes the wound to fester and the problems only becomes worse.

Often clients need additional support to help them cope through the week and be able to show progress in the next session.  It is like a little bit of homework that you get to do in the period between your sessions.  It could be that you might be asked to start a journal or that you start to implement certain tools and conscious thought throughout the week, whatever the case might be, it is highly recommended that you use these tools as it will only benefit you at the end of the day.  This is called results-based sessions and this is the best type of therapy that you want.

  • There is a personality clash between you and your therapist

If a healthy bond isn’t formed between you and your therapist, it could cause tension and stress and therefore the therapy would likely be unsuccessful.  It happens that clients get along with various different therapist, but sometimes clash with a specific therapist on an interpersonal level.  Say you are a people pleaser and sensitive to criticism, you might clash with a therapist who confronts you with negative feedback.  You might perceive this therapist as devaluing you, which could cause more frustration and therefore limit growth.

  • You frequently argue or debate with your therapist

It is our job as therapist to challenge you.  We will point out unhealthy patterns to help you see that these patterns are hindering your growth and self-development.  Yes, sometimes therapists do get it wrong.  Do you get angry or deflect when you are confronted by these unhealthy patterns?  Or do you take the time to acknowledge and allow yourself areas in which you can grow and become self-aware?

If you have been to a few therapists, you might have a better sense of whether the therapist was wrong or whether your preconceived conceptions of therapy are skewing your perceptions.

  • You don’t speak up when something happens in a session that upsets you

What if your therapist says something to you that rubs you the wrong way?  If you feel uncomfortable to give feedback or say something to the therapist if something isn’t working for you, the therapeutic relationship will fall apart.  Because communication in therapy is highly important, it would be good to take this opportunity to learn and practice effective communication, but if you don’t “click” with your therapist, it might be a good idea to find an alternative therapist with whom you can talk comfortably.

  • You have grown emotionally, as much as, or past your therapist

They say that you can take a horse to the water, but you cannot make it drink.  The same applies to therapists.  If you feel that you have outgrown your therapist, it might be time to find another therapist.  All therapist should be continuously growing their knowledge and working on their own personal growth.  By committing and being passionate about their own personal development and growth, they will be able to assist you more.  This will allow them to evolve into better and more emotionally stronger individuals which in turn will allow them to support and help you more effectively.

  • You are not integrating what you learn in therapy into your daily life and are the interventions accessible to you

As a therapist I give my clients a bit of homework to do during the week.  For example, it might be starting a gratitude-journal or asking them to give attention to their thought processes.  Whatever the case, it is important for clients to integrate the therapeutic tools into the times that they aren’t in the room with the therapist.  It is also important that these tools and the equipment that the clients might require to practise are accessible to the clients.  If the client doesn’t have a journal to write in or don’t have people around them to practice their new communication tools, then the homework will be a fail and alternative options should then be discussed and implemented.

It is important for you to be able to test these tools in the “real” world and be able to practise what you have learned in therapy.

  • You have learned helplessness

Sometimes clients can get addicted to therapy.  If your therapist tells you that you are suffering from anxiety and that you should get used to it as you will suffer from it for the rest of your life, it is time for you to find a new therapist.  It might also be that the therapist only tells you what you want to hear and support your helplessness, you will eventually find yourself in a hopeless situation where you will struggle to dig yourself out of.  Remember that you are trusting somebody else with your emotions and that you have reached out to get help.  To feel discouraged is not healthy, especially if you’ve been in therapy for a few months or even a few years.

  • Your therapist forgets who you are

Many therapists have to many clients and if not managed and recorded correctly, they can lose track of the different needs, goals and situations of their clients.  If you find yourself in the situation where you have to remind your therapist what was discussed in the previous session or that you have to repeat yourself numerous times, it should be a sign for you to find somebody else.  You do not want to feel that your therapist doesn’t care about you.  You want to feel that your time, money and effort is respected and used in a constructive and positive manner.

  • You drop out of treatment, frequently cancel sessions or are often late

Sometimes life responsibilities necessitate us to move our schedules around.  We may need to move our Monday afternoon session to Wednesday mornings, depending on the demands in our lives.  Flu might knock us down into bed or an urgent meeting at work is scheduled where we do not have any control over.  But sometimes it is the prospect of discussing uncomfortable matters in therapy that causes clients to reschedule or cancel sessions.  It is that urge to avoid therapy and the thoughts and feelings that accompanies it.  It would be a good idea to talk to your therapist if sessions become to tense and ask your therapist to make the sessions less intense to a pace that is more comfortable for you.

Therapy is often hard.  It takes long, are emotionally draining and can sometimes be expensive.  Sometimes clients will drop out of therapy because the therapist doesn’t always validate every feeling or doesn’t agree with everything the client says.  Unfortunately, by dropping out of therapy or cancelling sessions doesn’t lead to success, especially if you have agreed on goals that you and your therapist are working towards.

  • You only want to complain

One of the misconceptions of therapy is that it is a place where you can vent about your problems.  It will not be healthy towards you, your therapist nor your therapeutic relationship if you expect your therapist to only listen and validate your actions, thoughts and behaviour.  Because change takes time, many clients do not want to work towards positive change and growth.  To be able to become self-aware, we have to work towards self-awareness and growth.  We need to come face to face and come to terms with areas in our lives that we need to improve on.

  • You are not honest or realistic about your issues

Therapist aren’t mind-readers, we cannot see into your mind and we do not know what happened in your past unless you tell us.  What you tell us is your decision, but when a client feels shame or experience anxiety about telling the therapist about the problematic behaviours and thoughts and doesn’t honestly share these emotions and thoughts, the therapist will not be able to help you.

I have a beautiful carnival mask in my office.  I always explain to my clients that when we talk, I would like them to take their masks off so that only their true self becomes visible.  It is up to them whether they want to put their “masks” back on after the session and that after the end of all our sessions, that it would be my hope that they would not need to put the “mask” back on.

  • It might not be time yet for your next step of growth

Sometimes we need to master one step before we can move onto the next step.  Imagine you want to become a professional cyclist.  You need to master the skill of cycling first (possibly with training-wheels).  Then the training-wheels comes off and you need to work on your balance without the training-wheels.  Then you start with short distances and work yourself up to longer and more challenging routes until you can participate in races.  It is not only building your physical abilities, but also building your emotional determination, positive self-talk and self-esteem.  It takes time, there are steps that you need to follow to be able reach your goals and that is how therapy also works.  You need to master one skill or at least become proficient in it to be able to move onto the next step.

You need to build your emotional supports that comes from your heart and mind.  Sometimes to build these supports takes time and can cause frustration, especially if negative thoughts have been imprinted into you from childhood.  Be honest with yourself and with your therapist so that you can both agree on when the time might be right for the next step.

  • Have you and your therapist identified clear goals that gives you a way of measuring improvement?

When there are no goals established and when these goals are unrealistic, you might feel that therapy isn’t working for you.  It is important to establish goals in therapy so that you and our therapist knows what the ultimate goals is that you are working towards.  The big goals need to be broken down into smaller target specific goals to make the ultimate goal easier achievable.  These smaller goals need to be realistic and we need to keep tracking them to keep your recovery on track and to give you encouragement when you do see how these smaller goals fits into the big goal.

  • Do you have a fear of judgement, rejection, assuming greater responsibility, success or even a fear of intimacy?

It can be quite scary to share some of our most revealing truths to somebody else.  We become hesitant and may even twist the story a bit to make the truth not seem so harsh.  It takes a lot of trust to tell your therapist the truth and it takes faith to believe that your revelation will be treated with kindness and respect.  Remember, therapists are trained to be non-judgemental and who knows, your revelation might just be exactly what is needed to get you unstuck.

The fear of judgement and the fear of rejection works very closely together.  You might not only have the fear of rejection from your therapist after revealing your raw truths, but what will you do if your family and friends reject you for the changes that you are working towards implementing into your life?  Will that fear drive you to change towards positive growth or will it halt the progress that you really want to make?

Some clients might not want to change to become emotionally healthy well-integrated people.  They became used to relying on other people to carry them and taking care of them.  They might not want to take that responsibility on as it makes them feel uncomfortable.  It is that dependency on others that hinders growth and change and if that dependency isn’t softened or broken, therapy might not be as effective as what you hoped it would be.  It is important to take greater responsibility, take risks and believe in ourselves to be more reliant on ourselves to become the people that we are destined to become.

But what if we don’t want to succeed?  What if the pure thought of success frightens us?  You get so used to failing that it becomes your comfort zone.  But what if you get better in therapy and your new life is frightening you?  You might then get stuck in therapy because you might feel uncomfortable in your newly found happiness.

Then there is the point of the fear of intimacy.  When you share your truths, whether it is non flattering or showing your vulnerability, is part of what intimacy is about and that could be scary.

  • You are looking for an inexpensive solution

Therapists are educated to share their knowledge, personal experience and tools with you to initiate healthy change.  This education comes with associated costs and because therapists are required to continue their learning and professional development, it requires revenue to do so.

As a therapist, I do not only share one hour of my time a week with you during our session.  I do research, complete my notes, write reports, do planning for our next session when you are not in my office, further my education and keep my administration up to date in the time that I have available between clients.  Even though we would love to help our clients wherever possible and out of the goodness of our hearts, we have to make a living in our chosen career, similar to other professionals who needs to make a living in their choses career.

  • You and/or your family has inaccurate preconceived notions about therapy

Unfortunately, we cannot just fix somebody by giving them a tablet to drink.  Therapy takes time because of the various tools and processes that it entails.  If you’ve been in therapy before and the wrong approaches and tools were used, you might think that all therapy is the same which could then demotivate you to fully participate in the therapeutic process.

In therapy, as therapists, we can only address the issues of our clients once it has been uncovered and sometimes this uncovering process can take time.  It is unrealistic to expect proper healthy change within a short period as some approaches can take months to uncover underlying core issues.

  • You believe that you know better than the therapist

It is quite possible that you could have been with a therapist in the past that did not have the correct knowledge and experience to be able to help you in an effective manner.  The internet is also helpful to some degree, but it takes years of studies to help our clients and not a few minutes on the internet to do a quick read on what our clients are going through.

I must mention though that there are some wonderful self-help material in the market.  It is highly suggested to combine this self-help material with your therapy so that it works in conjunction with one another instead of clashing or confusing you as a client.

  • You might not want to be in therapy right now

Sometimes you might feel that you need a break from therapy because you need to process everything that you have learned up to that point and want to slightly adjust the tools to fit your lifestyle.  Here you might want to take a break and only return to therapy once you feel comfortable again to do so.

Sometimes you might be in therapy because family and/or friends are forcing you to be in therapy due to ultimatums that were put in place.  You might not think that you need therapy but succumbed to the pressures from your loved ones just to keep them happy and maybe, out of curiosity, want to see what therapy is all about.  You might not be ready for change as you believe that there is nothing wrong with you nor your actions.

  • You don’t try to cope with problems until you are in your sessions

As therapists, we try to empower you to take these tools to heart and implement them into your life, but sometimes you might feel that your life is out of control.  You may not feel strong enough to handle things and that is when you might become reliant on your therapist to get you through this period.  It is then the time to remember the techniques and tools that you discussed in therapy to help you through those times and to discuss them with your therapist when you see them again.

  • You rely on substances to get through your sessions

Because therapy requires you to confront uncomfortable, sensitive and sometimes scary feelings, some clients make use of substances to mask raw emotions like anger, sadness or even shame.  This can impede your progress.  The use of marijuana or alcohol delays or masks your true emotions and if your therapist does not know or cannot notice these emotions or know what the triggers are, effective therapy techniques cannot be implemented.

I love to end my blogs with a quote or two and the following really resonated with me.  The first one is Tammy Duckworth saying “Sometimes it takes dealing with a disability – the trauma, the relearning, the months of rehabilitation therapy – to uncover our true abilities and how we can put them to work for us in ways we may have never imagined.”, and off course this one from Irvin D. Yalom who said “The ultimate goal of therapy … it’s too hard a question.  The words come to me like tranquillity, like fulfilment, like realizing your potential.”.

Remember that therapy can help by providing a non-judgemental and safe environment where you can discuss matters openly and get the correct tools to assist you with your life challenges.  Don’t wait until it is too late.

I mentioned this close to the beginning but thought that it may be a good idea to repeat it again.  GEM Mental Health Therapy and Coaching has decided to offer Skype Video Calls, WhatsApp Calls and WhatsApp Video Chats in order to reach as many people as possible.  Please do not hesitate to reach out so that we can work together on your mental health as we face these challenging times.

Thank you very much for reading my blog.  I truly hope that it helped somebody, somewhere.  Please send any feedback or comments to info@gemtherapy.co.za and remember to have a look out for a new blog every week.

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