Feeling stuck in therapy? Try my Free Therapy Mind Map Tool

Feeling stuck in therapy?

If feeling stuck in therapy try my free tool the therapy mind map

Short plateaus are common. However if you're repeatedly feeling stuck in therapy, try the ideas in my free Therapy Mind Map and shift to a new level.

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

Feeling stuck in therapy

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 followed it up with the '7 Ways of Getting Unstuck' movie where I go into more detail on how to move forward in your therapy.

1. Talking about the same thing over and over again?

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. 

You see, these raw feelings need to be paired with a new experience. That's because the brain only changes via experience. For you,  this new experience might be feeling the positive, warm feelings of being cared for by your therapist. (What's cool is that you can learn how to "re-use" this experience and benefit from greater therapeutic change by using tools. I talk about them in my movie.)

Healing is about generating new memories

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.

2. Work with a shorter list

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. Having tools helps you to stay present as I explain in my 7 Ways Movie.)

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.

Why "baby steps" are better: the principle of titration

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.

Case example from your truly

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.)

3. Strong feelings towards your therapist?

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 🙂 

"Mommy" or "Daddy" issues

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!

Notes

Titration is a relatively new concept that derives its importance from the shift away from cathartic methods in therapy (both psychotherapy and body work) towards an emphasis on "containment".

Unfortunately, too few health professionals use titration to advantage, as the technique is still so very new.

Non-cathartic and holistic treatments such as homeopathy, craniosacral therapy and body psychotherapy are based on the practice of titration.

Related Topics

Here's an article from the NewYorker Magazine that explains how Toyota's small steps enabled it to beat General Motors, one step at a time:

https://www.newyorker.com/magazine/2008/05/12/the-open-secret-of-success

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


Feel free to leave a comment. Click here if you have a question for Shrinklady


  • Susanne says:

    Hi!

    Thanks for a very informative and comforting website!

    I went to a therapist, first to learn to deal with stress, later because of a big loss in my life; I was in a big crisis. We became close, and he started hinting that he would like a personal relationship (even though I was/am married). Suddenly I became terrified of making any mistakes, making him want to end therapy etc. I became obsessed with these thoughts, and finally to get rid of the agony, we agreed to end therapy and see each other privately. A catastrophic decision, I almost had a nervous breakdown.

    I was advised to report him, which I did, even though I felt very dependent on him. I felt literally like I would die without him. That was 3 yrs ago, and he is still on my mind every day.

    Can I ever be free from this? What do you advise me to do? Many thanks, Susanne

    • Shrinklady Shrinklady says:

      Oh my goodness, you’ve been through quite a bit Susanne. You were betrayed and at a time when you were vulnerable. And then you had to deal with the aftermath.

      What might be complicating this situation is that your original transference has been left unresolved. Is that the case? If so, I think it’s powering up your efforts to resolve this later experience with your therapist. That is, until your original transference feelings are dealt with he will remain alive within you.

      That is, if you continue to focus your attention only on the details around him and the circumstances of your therapy with him, you’ll miss addressing the core of your transference issue.

      And I believe you can get beyond this Susanne – by dealing with your transference feelings first. You see, it is possible to deal with a transference even though the object of your projections is not around. Our mind seeks healing in the best way it knows how.

      I wish you the best on your journey,
      Shrinklady

      • Susanne says:

        Hi Shrinklady,

        Thanks for your answer! I definitely think it must be unresolved transference, because I have never felt like this before. It is not romantic feelings, it is rather obsessive thoughts concerning contact or something.

        I am no longer in therapy, but do you still think the therapy bootcamp could be helpful? Should I sort of visualize my experiences?

        Many thanks,

        Susanne

        • Shrinklady Shrinklady says:

          Hi Susanne, oh it doesn’t matter that you’re no longer in therapy. I know that might sound odd but it’s really all about memory and how it’s stored in the brain. And I know a couple of my members that have successfully dealt with negative transferences they couldn’t shake – well after they had ended therapy.

          Your first task though would be to learn to use the tools in Therapy Bootcamp to address the obsessive thoughts. With practice – and knowing what to look for – you’ll have more control over intrusive type thoughts.

          Then once you’ve created sufficient “room” in your nervous system, the next order of business would be to do the healing work that you missed in your therapy in regards to your transference. And yes, you’d use some visualization – this would be wedded to your body practice so the healing goes in at a deep level.

          I truly believe you can get beyond this Susanne.

          Best Regards,
          Shrinklady

  • Anne says:

    “Feeling stuck trying not to feel”

    Hello, thanks for the video clip and extras, I appreciate it. I’m at a stuck place where I realise I’m talking but trying not to let myself feel. My Psychologist said to me that I can text him if I need to and he will reply that he has received it, but the deal was that I then have to discuss the text content in the next session.

    I didn’t consciously realise that by me just offloading via a text I was actually avoiding things, as once it was out there I didn’t have to deal with it. We have dealt with a lot of things but I can feel like we are going into the deep feelings mode, I want to run a mile, the thought of feeling that “thing” that sits in my gut terrifies me, I don’t like to feel and I like to control those feelings, I’m ashamed to say as juvenile as it sounds, I will even discreetly bite my hand until that pain numbs the other and I have control back and I don’t have to feel.

    I have to talk about these things soon and I don’t know what to do with myself. My psychologist is good at his job and I trust him more than anyone, I don’t do the trust thing very well, I always put on a I’m ok front, when if people knew how I really feel they wouldn’t want to be around me.
    Thanks just needed to get that out.
    Take care

    • Shrinklady Shrinklady says:

      Good to hear you like your therapist Anne and thanks for sharing.

      Could I add something here? It sounds like you’re feeling overwhelmed with the idea of “feeling”. Is it possible you’re trying to take it on all at once?

      Like I’d hesitate to label ‘texting’ your therapist as “avoiding”. It’s great that you notice how it seems to offload some of what you’re carrying. That’s not necessarily a bad thing. It sounds to me that when it gets to be too much for you to bear, you text him – knowing that it can be dealt with later in his office and with his support. I much prefer that then biting your hand. I understand this is your attempt to numb yourself – personally I like that in texting you’re putting it out there for later. Not avoidance per se – you’re just needing a bit more time.

      If you tour around my pages you’ll soon learn that the easiest way to navigate emotions is by making your body feel comfortable. You might download the Chill as well. Once you’re in a comfy place, try feeling your way through one not-so-nice thing. In other words Anne it’s okay to take baby steps.

      Take care,
      Shrinklady

  • Jerry says:

    Susan-
    This is an excellent mindmap. As an experienced therapist, I pay attention to Tip #3. Although I know it is a lot to ask, I hope that clients will tell me first when they have questions, doubts, or if they think I am not right for them. I am not right for everyone. My 1st goal is to help a client find the best help available. Knowing what I am doing “wrong,” or what I could do better, helps both client and me. Rejection is not easy, but it’s important to process.
    -Jerry

    • Shrinklady Shrinklady says:

      Thanks Jerry. You’ve touched on an important quality in a good therapist – I like your approach. In looking back at my own personal therapy where I had some regrets is when I didn’t open up to say what I needed. And where I did speak my truth, funny enough, it opened up the relationship to a whole other level.

      Susan

  • Ann says:

    Hello Susan,

    Thank you for all the information on therapy. I have found the explanations in the Therapy Mind Map really useful and it is very reassuring to read, understand and realise many of us experience the same problems.

    Therapy can be a lonely road when working through transference feelings, friends and family cannot understand and for a while I thought “is it just me, am I really crazy?”. So to find your support and community is a blessing. To read that I can use transference feelings to heal and that they are not me being crazy, but just old emotions that can be felt and released gives me great hope.

    But the power and energy of these emotions easily overwhelms me, they feel so real. I have a great connection with my therapist but now I am starting to feel unsafe and doubtful that she can meet my needs. So there is more work for me to do 🙂

    I am grateful for any tips and hope together we can shine much light on our healing journeys.

    • Shrinklady Shrinklady says:

      Oh I’m glad you’re finding the information helpful Ann. Yeah it’s so true, therapy can be quite an isolated experience. Actually comments like yours really help to bridge that gap. Maybe one day we’ll have a global appreciation for the work we do in therapy and enough comments on the Internet that therapy is more of a commonplace activity. Cause I know from experience, it’s so good to hear others are going through the same thing.

      You mentioned you’re now having some fears around feeling unsafe and doubtful about your therapist. These thoughts aren’t unusual Ann and it’s no accident that these fears are popping up just as you’re starting to have a stronger connection. What you’re likely experiencing is the compensatory reaction of the nervous system and the resulting thought mix. (I’ll be explaining more about this in the Transference Series.)

      You asked for a tip? You might already know this…the ideal thing to do at this time is to focus your efforts on soaking up the goodness with your connection to your therapist. And we know from how the brain works that it’s always best at the beginning if you do that in little bits, here and there.

      Thanks again for your question Ann.

      Warm regards,

      Shrinklady

  • George says:

    Hello Susan. I am glad that I found your website and the postings on Facebook and YouTube. I still cannot load pictures, but you sound great. I have to glean what I can because I have little money and not much to be retiring on. But each new idea I find on your site is a fresh breath to me.

    I have depression, anxiety and, now tinnitus; bespoke. Insomnia is a given. I have a therapist who says I need to be in the chair once or twice a month, not three times a year; but the money isn’t there any more.

    Grief counselling via public healthcare was group therapy, a sinking feeling but a one to one costs and with no sight of progress from me. I think I should stop now; I’m talking myself down. That lizard brain’s like people who scream in my tinnitus ear for fun, for them, days of aftershock for me. But I Will recommend your site to others who can get more from it, like the people who who post on your site. A previous therapist, on her retirement, but prior to releasing me back into the wild, to me that, in truth, there is no nothing really REALLY (really?) wrong with me; I’m just eccentric.

    • Shrinklady Shrinklady says:

      Thank-you George for your kind words. Sorry to hear we couldn’t get that movie to load for you.

      I got to thinking about the “eccentric” comment your last therapist made and I wonder if what she was meaning was that you didn’t have any huge emotional issues – just that – and she wouldn’t have a word for it cause few therapists recognize this – your activation is too high. (We all have emotional issues…some issues tho are shouting out and others are more easily tamed.)

      Could I share what a body-based therapist might hypothesize your situation as?

      “Your nervous system is jacked up creating the biphasic mood swings and causing the classic anxiety, depressed mood and sleep problems that generally accompanies high activation.

      Many folks also experience ringing in the ears. We understand this symptom in relation to regulation of the nervous system as it’s believed to be intimately tied with the middle ear problems.” (See Stephen Porges for more information).

      When I meet folks like this in my office, I get quite excited because I know their recovery will be steady (emotional issues can create plateaus here and there). So I hope you don’t give up on yourself George. I know having one-to-one therapy is so much easier. Even so, I hope you’ll continue to find ways to give your brain positive experiences it can learn from. That’s really what it’s all about.

      Take care,

      Shrinklady

      PS. By the way George, I truly believe there’s too much conformity in today’s society and I think we need more eccentrics in the world 😉

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