This came across my desk recently courtesy of an old hairstylist and the post got me thinking, “What do people think they ‘should’ feel as they walk out of a therapy session? Do they expect to feel great?” And as you can probably guess, because I’m writing this, my next thought was “Uh oh…”. (I actually made a face, but it’s hard to translate into text.)
It’s pretty much a given that people come to therapy wanting to feel better. And I’d be thrilled if my clients finished therapy and were genuinely able to say they felt great. So why the uh oh?
Therapy requires a lot of heavy lifting.
Most often, when I speak with clients about how they felt after a good psychotherapy session, the answer was exhausted. And internally, I cheer a little bit (sometimes out loud) because, to me, that means that they worked hard during the session.
I often use the analogy of a gym workout. When I go to do a workout at the gym, I may come out feeling refreshed, better than ever, feeling “great”. But more often, if I’m working at a good intensity, I’m expecting to come out feeling tired and sore. People wouldn’t be surprised if after a particularly hard workout I was sore for a few days afterward.
Therapy involves heavy lifting from an emotional standpoint. A good session will likely leave you feeling somewhat wrung out and exhausted. And just like at the gym, you may feel a little sore for a few days afterward, although in the world of emotions, that can show up as being a little more on edge or feeling like your emotions are closer to the surface.
So how do I know if psychotherapy is helping?
For me, the gym analogy also works for deciding whether psychotherapy is helping. Obviously, if I’m saying that feeling exhausted is a part of the process of feeling better, then you don’t want to judge whether therapy is effective based on how you’re feeling immediately after a session.
Imagine if after working out hard at the gym I said to myself “Oh my goodness, I’m exhausted just walking up the stairs and weak as a kitten. Clearly this heavy lifting is doing nothing for me!” We all know that that’s not how it works.
When assessing whether someone is getting stronger, physically or emotionally, we look for long term trends. Do you have a better sense of what you are and aren’t able to do effectively? Can you identify new skills you’ve developed and feel more confident using them? Can you do things you previously weren’t able to do? Those are the signs that psychotherapy is working and the things you want to look for to decide whether your effort is paying off.
Is all pain good?
There is such a thing as pushing too hard in therapy, and again the gym is a good analogy. Sometimes it’s difficult to tell whether the pain you’re feeling is the good “I’m getting stronger” pain or the unhealthy kind of pain when you’ve gone too far. Just like at the gym, pushing way past your limits isn’t good for your long-term health, so it’s important to keep an eye on your experience to decide if it’s healthy soreness or pain that might be making things worse.
I’ll often say to my clients that I’m expecting that they will feel emotional and exhausted after a session, but then add the caveat of “But please, please, please, keep me updated and let me know as soon as possible if you don’t feel like you can function or if things are getting worse”. And that caveat is super important.
As your therapist, I only know what you tell me or what I see in session — and I am absolutely deciding how hard to push based on what you show me from session to session. Open communication about how you’re feeling after sessions will help your therapist more accurately pace things so that you are maximizing your gains without being pushed past your limits.
Long story short, while we do want you to start feeling better, stronger and healthier, that may not mean that you feel immediately better after a counselling session. If you get home and are feeling exhausted physically and emotionally, congratulate yourself on having worked really hard and, maybe, consider taking a nap.