Feeling stuck in therapy?

(No email required. Will open in new window.)

It's not unusual to get stuck in therapy. Impasses can surface around many issues. I created the Therapy Mind Map to give you a starting base from which to assess what aspects might be missing in your work.

I've received emails and comments from folks in therapy for over a decade now and it seems there's one problem that stands out: there's too much "talk" and not enough healing going on.

What do I mean by that?

When we "talk" about something, we gather the details, sit back and identify patterns, maybe analyze our reactions, and the events themselves - and sometimes - emotions get stirred up. This is great. You're half way there.

If you move through the emotions that get stirred up, you start the letting go process. However, what's often missing in therapy, is the healing that needs to take place at this point. It won't help if you merely unload your tears. 

So to reiterate, what's necessary is that you take in a new memory, a positive one that in effect, helps buffer you against the negative one that's there.

Yeah . . . a warm, safe connection with your therapist. That's your new "memory". (It's not the only one available but for most people it's the one that's utilized most often.)

When we access raw emotions we're opening the brain up for new learning - learning that will occur at a deep level. It's important that you "take in" the goodness that's with you in that moment as you access these emotions.

That's how you're building yourself up from the inside!

Sometimes your therapist will say just the perfect thing at that moment. That's like icing on the cake. Because that message is going into an area that's hurting within you and her words will have a healing effect.

You've been waiting all week to see your therapist. Your life feels so complicated and yet you want to share every detail. You rush in the door and plop down on the chair. You wonder how you're going to get it out all in one session.

If this describes you, stop right there and take a step back. Consider a smaller list.

It's far more effective to explore one topic than it is to rush through many. The value of therapy is less in making sure your therapist knows all the details than it is in experiencing parts of your story with your therapist.

Good therapy isn't about your therapist figuring you out. It's about creating healing experiences your brain can learn from so you won't have to keep going back to therapy for the same thing. (You might go for other reasons tho 😉

Give yourself plenty of time to process what happens - as it happens - in the session as you talk about your concerns and as your therapist responds. (BTW, this takes some learning to know exactly how to do this.)

Allow yourself to settle in at the beginning, during, and at the end of any subject. In other words, let your body catch up to your words.

The process of titration* (ie. working with small amounts of emotional material at a time) completely transformed my practice when I came upon it several years ago in my training as a body psychotherapist. My clients enjoyed faster results and the work got easier for both them and me.

There's an even better reason to use titration though. It heals the nervous system!

By reducing the amount of emotional material we worked on (i.e. chunking the work in smaller bits), paradoxically it had the effect of creating a better healing environment. Not only did they start healing from their main problem area, they generally started improving other areas as well - even for aspects of their life we never talked about.

We accomplished more with less!

In the therapeutic process, titration refers to easing the amount of material you are working on e.g. activation/arousal, emotions etc. so it's easier for your nervous system to handle. 

For example, a psychotherapist would help you to move away from material that he or she felt could trigger too much activation. "Too much" would be anything that moves you outside the window of your body's capacity to cope and into fight, flight or freeze.

In the second session with my new therapist, I was raring to go. I wanted to finally talk about my abuse history in detail. I've geared up for it and now I just want to get it off my chest. 

However, she suggests we wait until I have established a stronger connection with her. I'm a bit miffed thinking "I feel fine, I trust you". But I gave her the benefit of the doubt. 

What I was to learn much later is that she knows that at this point in my work, the activation associated with my history would be too much for my nervous system to deal with.

And she was so right! 

What I didn't know at the time is that - whether we notice it or not - our body (and nervous system) will be triggered by merely talking about a subject. Even just thinking about a hot topic will do the same thing.

In the end I learned that it was a lot easier for me to process a small piece of emotional material that was distantly related to my abuse than diving into the deep end. 

In fact, by the time I got around to sharing details about my trauma we had done so much 'baby stepping' it wasn't the big deal I thought it was going to be. 

By guiding me in this way, she was working with the principle of titration. (And I was forever grateful to her for that.)

Issues can often surface around the nature of the relationship with your therapist (referred to as 'transference'). Indeed, you may have developed strong feelings towards your therapist that are not what you might have expected initially.

(Yes, developing a transference is a bit of a shock. No worries, transference can be worked through. And if done successfully, you're going to feel even better than before.) (That link goes to my program, Therapy Bootcamp - go ahead check it out 🙂 

Some clients feel their therapist is like a mother or father they never had. Others find themselves being strongly attracted to their therapist and feelings of a romantic or sexual nature are not uncommon.

Transference is fairly common especially in long term therapy.

Some transference relationships are experienced negatively. Maybe you worry your therapist will leave you. Maybe you feel like you're in a power struggle with him or her. You might ask, is she too cold? Is he unresponsive?

And don't forget, some of these feelings may be pronounced because you're with the WRONG therapist. This where understanding how good therapy works helps. You're able to better identify if, what the therapist is saying, is actually come from his or her own stuff - and not you.

The challenge is to get unstuck. As a beginning, you might review these 7 basic ways of getting your therapy back on track (using the Therapy Mind Map) and decide if you can take some steps to move you along.

Therapy is one of most under utilized resources we have for making fundamental change. I hope you'll learn what you can do in your therapy to be sure you're progressing at a steady pace - because it's worth it!

Here's another article from the New York Times. Janet Rae-Dupree explains how any change potentially triggers the fear response. Yet, by working in small, incremental steps we can achieve more and keep our creative juices flowing:

Unboxed: Can You Become a Creature of New Habits?

By reducing the charge in the nervous system around a fear a spiders, these clients were able to hold a tarantula!

The more newsy part to me however...was how this experience changed not only their fear associated with spiders - it lowered their overall fear state in the brain:

Overcoming Phobias with Brief Therapy (". . . the regions of the brain associated with fear response -- the amygdala, insula, and cingulate cortex -- lit up with activity in an fMRI scan).