Doctors see other doctors for treatment, dentists see other dentists, and (as it turns out) therapists see other therapists. In my early twenties, before I ever became a therapist, I went to therapy for the first time. And lemme tell you, it was a failure. It ended when I got up in the middle of a session and just walked out and never returned. True story.

Now that I’m a therapist, I look back on that experience and have a lot of thoughts about what went wrong. I also don’t see it as a failure anymore, but more on that later. My “failed” experience with therapy and becoming a psychologist have taught me a lot about what makes therapy work and what makes it not work.

Before we launch into the specific reasons therapy didn’t work for me, it’s important to note that any therapy needs a set of basic criteria to be effective. For one, you need a competent therapist. I had that — now that I’m a psychologist myself, I know my therapist knew exactly what she was doing. Second, that therapist needs to be delivering an evidence-based treatment. I didn’t really know it at the time, but she was absolutely doing the gold standard treatment for my concerns. And third, you need to have a good relationship with your therapist. My therapist was trustworthy and honest and did all the right things to establish rapport with me.

I had all the makings of a good therapy experience. So, why didn’t it work? Here are the five reasons therapy didn’t work for me (at least at that point in my life) and what you can do differently to make therapy work for you.

Why Therapy Doesn’t Work
1. I wasn’t ready.

When I started therapy, I wasn’t actually ready for what therapy was going to require. I was definitely in pain, but I wasn’t ready to let go of the pain yet. I saw it as deserved or even a necessary part of how I was keeping it all together. I couldn’t imagine life without it, so I couldn’t justify why I would change something that (although painful) was keeping me safe.

Now I understand that you don’t necessarily have to be ready when you first show up to therapy — there are actually therapy techniques designed to help you get ready for change, confront the pain, and imagine what life would be like without it.

2. I didn’t understand that change comes from changing.

Although it’s entirely logical when you think about it, I didn’t really internalize that for my pain to change, something else in my life would have to change, too. I couldn’t continue doing everything I had been doing and magically not feel pain anymore. I think I assumed that showing up to therapy and participating would somehow miraculously improve my life, without my having to do anything different. I was wrong.

Now I understand that showing up and participating are step 1; turning the productions of a session into action is where the real change happens. Therapy is one component of an entire lifestyle adjustment — it’s the weekly check-in, problem-solving brainstorm, and skills-building session that helps you identify what you’re going to do differently the entire rest of the week to actually live your life in a more fulfilling and meaningful way.

3. Fears made me resistant.

I was so afraid of therapy that I wasn’t willing to do what therapy was asking of me. I was embarrassed to be in therapy — I was embarrassed to need help, and I was embarrassed to even be in pain. I saw the fact that I was in pain as a personal failure, and I assumed that I must have messed up somewhere if my life was so miserable. It was excruciating to sit in an office and focus exclusively on one of the things that brought me the most shame. I was afraid of judgment, rejection, failure. I was afraid for the therapist to really know how badly I was hurting, how badly I had messed up. And my fear kept me from really engaging at the level that would have been necessary for her to actually help me escape from my pain.

Now I know that those fears are entirely normal and that the therapist isn’t judging me for being in pain. In fact, the therapist is doing the opposite: Cheering me on for being brave enough to confront my pain and work through it. The therapist isn’t my judge, she’s my partner.

4. I didn’t do my part.

I showed up to every single appointment, and I answered every question honestly, and I followed up with a mindfulness group the therapist recommended. I did everything she recommended. But even though I was compliant, I still wasn’t doing my part to increase the effectiveness of therapy. I didn’t understand that therapy is really collaborative. Throughout my life, I was used to just following instructions…I wasn’t used to having my own ideas or opinions or input. I didn’t understand that not only was that encouraged in therapy, it’s really required for the therapy to be effective.

Now I understand that the therapist plays a large role in helping guide you toward the changes that might relieve your pain. But it’s critical that we come to therapy with our own observations about what’s going well and what’s not, what our strengths and areas of need are, and what would bring us fulfillment. That’s why I developed this series of worksheets to guide therapy participants into maximizing their participation in therapy. These worksheets tell you exactly what to do during, after, between, and before each therapy session to maximize its effectiveness. Grab your free worksheets here:

And if you’re ever feeling embarrassed to take notes during a therapy session or whip out one of my worksheets, let me tell you: I love it when my own clients do that. It tells me they’re really serious about making this work.

5. I wasn’t willing to feel pain.

Perhaps the greatest reason therapy didn’t work for me is that I just wasn’t willing to feel any more pain. I was in so much pain already that I wasn’t willing to feel any more. I wasn’t realistic about what it would take to recover from my pain, and if I’m honest, I was looking for an easy solution.

Now I understand that overcoming pain requires a little bit of pain. And therapy isn’t the only place that’s true. The exercises required to heal a sprained ankle are painful; if you avoid the pain by just sitting on the couch, your ankle won’t heal as well. I didn’t know it when I started therapy, but now I know that enduring a little bit more pain is the only way to actually heal the pain you’re living with.

Why Therapy Wasn’t a Failure

I left therapy in just as much pain as I started, and in that sense therapy didn’t work for me. It was a failure. But that experience did a lot for me over the next few years. It helped me put words on what I was experiencing and what was causing my pain, it helped me take greater responsibility for my recovery, and it started me on a path toward figuring out how to actually make the changes I needed to make in my life. A few years later, when I tried therapy again, I was ready — I knew how to make therapy work. And in that sense, my “failed” therapy experience was a total success.

How to Make Therapy Work For You

Learn from my mistakes. Understand that you’ll have to change, overcoming pain is painful, and you’ll have to confront some fears. Be realistic about what it takes to recover, and dedicate yourself to incorporating therapy as part of a larger lifestyle change. And maximize the effectiveness of your therapy sessions by not just showing up and being compliant but by really participating. Grab my worksheets to help with that.

How to Get Started with Therapy

If you’re looking to get started with therapy, check out these previous articles with tips to overcome the jitters that can keep us from scheduling that first appointment:

What I Think During a Therapy Session

One of the things that interfered with my success in therapy was fear of what the therapist was thinking of me. Maybe you’re wondering what your therapist is thinking during session, too. Next week, I’ll tell you exactly what’s going through my mind during session as a therapist. Don’t miss it.

Talk to you soon,

Dr. Finch

P.S.    Remember, this is education, not treatment.  Always consult with a psychologist or therapist about your mental health to determine what information and interventions are best for you.  See the disclaimer for more details.