George, a 22-year-old who chose to use a pseudonym, says that he was first forced to see a therapist as a child and has seen numerous different professionals but has quit therapy multiple times. “The advice I was being given was stuff I had already heard countless times from my parents and others,” he says. “I fell into this cycle where I’d get these tasks to do that were miles out of my comfort zone and I’d fail to even try them, so I felt this intense guilt.” By the end of his work with most of his therapists, he adds, “I kind of just faked feeling better.”
Similarly, I often felt frustrated with my early experiences in therapy, especially when I found myself rehashing the same issues without seeing any changes. It took me a long time to realize that not every type of therapy will benefit everyone, but a few changes can make all the difference.
When therapy doesn’t work
While therapy is often described as a kind of immediate cure-all, even one of the most common types of therapy, traditional talk therapy, which was pioneered by Sigmund Freud in the late 1800s, can have some serious detractors.
In a 2023 study, Michael Anderson, a member of the Memory Research Group at the University of Cambridge, found that people who suppressed anxiety-inducing thoughts had better mental health outcomes than those who dwelled on them, challenging one of talk therapy’s main premises.
“Traditional talk therapy overweighs the value of talking things over and diving into every distressing thing there is,” he says. While talking through things can certainly help people make sense of specific challenges, he says, “There’s a significant chunk of the unpleasantness that happens to us—the unpleasant thoughts, the unpleasant fears, the angers—that do not deserve to be dwelled on.”
This isn’t to say that talk therapy is useless overall. It just means that certain types of therapy, such as talk therapy, aren’t always going to work for everyone. Sometimes, you just need a different approach.
If you aren’t seeing results, talk to your therapist
Though some therapies may be flawed, across the board, research shows that “therapy works,” says Pim Cuijpers, emeritus professor of clinical psychology at Vrije Universiteit Amsterdam and director of the WHO Collaborating Centre for Research and Dissemination of Psychological Interventions.
Still, he says, it’s important to note that “if you go into therapy, don’t expect automatically that it will work for you.”
If you’ve been in therapy for a while but feel like you aren’t improving, Cuijpers notes that it’s important to remember that this is not a reflection on you, the complexity of your problems or your ability to improve. Sometimes, therapy can simply take time, but a lack of results after numerous sessions could also mean that you might need some changes to your treatment plan.
If this is the case, “It’s important to talk with your therapist about how things are going,” he says. You might have a conversation about your goals, for example, or about what you feel hasn’t been working and what a successful result would look like for you.
Don’t be afraid to try different approaches
Sometimes, it might be necessary to change therapists entirely. “[If] at some point, maybe after 10 sessions, you conclude that the treatment you’re receiving is not for you and this is not a thing that makes you better, you and your therapist might consider whether you want to maybe go to another therapist—perhaps someone who gives a different treatment or who is more specialized in the problems that you experience,” Cuijpers says.
He also acknowledges that while these conversations can feel uncomfortable, your therapist is “professional enough to realize that if [their approach] doesn’t work, that you have to switch to something else.”
There are countless types of therapies, from cognitive behavioral therapy and acceptance and commitment therapy to somatic therapy, expressive arts therapy, psychedelic therapy and EMDR, which is designed specifically for trauma. Each of these will work best for different people.
Finding a new way forward
For George, a turning point in his journey came when he realized that he may have “been trying to tackle the wrong problem all along.” As it turns out, “There’s quite a significant chance that I have ADHD,” he says. “I’d been trying to combat depression this whole time when [ADHD] may as well be the cause of my depression.” Now, he’s looking forward to trying therapy again—this time using an approach tailored specifically toward his own unique mind.
Similarly, it was a therapist who finally helped me realize that I was better off focusing on the present and the future rather than fixating on the past, and after that, I was able to pursue therapy better suited to my own needs.
Clients shouldn’t be afraid of trying different therapists and exploring treatments until they find one that feels right, Cuijpers emphasizes. And while it is helpful to head into therapy with a sense of open-mindedness, he advises using caution when it comes to novel or trendy treatments that claim to be more effective than others.
Across all his research, he has “not seen one therapy that is better than other therapies,” he says. “It’s a matter of just finding what works.”
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