Psychotherapy is the art of using words to heal. Throughout the sessions, a collaborative relationship is established that provides a supportive space for the person to speak openly about the problems that concern them. The psychologist and the patient work together to identify and change the patterns of thought and behavior that are affecting mental balance.
Studies on the effectiveness of psychotherapy have shown that around 80% of people report significant positive psychological changes. In fact, it has been found that for some disorders, such as depression, phobias and panic attacks, psychotherapy is much more effective in the long term than medication.
However, we cannot deceive ourselves; psychotherapy is not a simple process and therefore does not always go as planned. There are times when treatment does not help and can even be iatrogenic.
How do you know if therapy isn’t working?
1. You don’t get better. Psychotherapy doesn’t usually bring immediate results; you can’t expect problems to magically resolve themselves in a few sessions. In fact, it’s estimated that only 50% of people experience noticeable improvement after six months of treatment; some people have to wait a little longer.
However, the psychologist must close each session appropriately, so that the person feels that they are making progress. Even in the first consultations, which are normally aimed at diagnosis, the person is encouraged to trust that they will solve the difficulty that motivated them to ask for help. Therefore, if several weeks have passed and you feel that you have not made any progress, it may be time to tell your psychologist so that they can change their strategy.
2. You don’t feel comfortable talking about your problems. The psychologist is a complete stranger to the person seeking help, so it is understandable that during the first sessions they don’t feel completely comfortable talking about their difficulties. However, as the relationship with the therapist becomes more established, the person loses their inhibitions and is able to talk freely about their problems.
If you feel that you are not connecting with your psychologist, it is likely that there was a failure in the rapport building process or that the psychologist did not show enough empathy. Therefore, if this situation is not resolved quickly, psychotherapy will not be successful, since one of the factors that predicts success is precisely the person’s degree of openness.
3. You feel criticized or judged. One of the fundamental principles of therapy is not to judge. When the psychologist judges, he ends up sending small extraverbal signals that the person can pick up on and that will make him feel uncomfortable. In the worst case, the patient will not dare to reveal his secrets for fear of being criticized by the psychologist.
However, in psychotherapy, a climate of acceptance must be established, only then will the person be able to speak openly about the problems that concern him or her. In fact, studies on the effectiveness of psychotherapy have found that the similarity between the psychologist and the person, in terms of personality, values and attitudes, is an indicator that can predict the success of the treatment. Therefore, it is always recommended that before choosing a psychologist, the person assesses whether he or she has “connected emotionally” with the professional.
4. You experience more negative emotions. In some cases, therapy requires bringing up certain negative or painful experiences so that the person can process and accept them. Sometimes these sessions are very intense and can cause a certain amount of uneasiness or confusion, but the psychologist must make sure that, in the end, they allow the person to grow. Otherwise, it will simply be iatrogenic.
So, if you feel worse after several sessions and emotions such as anger or frustration have increased, it is likely that the therapy is not going in the right direction. Usually, when you leave a session, even if you do not always feel happy or content, you feel calm and confident that you will solve the problem.
5. You start having problems in other areas of your life. Sometimes, psychotherapy opens new doors, making the person adopt different perspectives that can bring to light dissatisfaction in certain areas of life, such as relationships or work.
However, most psychologists are bound by one rule: you should not confront a person with new problems that they are not prepared to solve. So, if you feel more confused than before and new problems have appeared in your life, it is probably because psychotherapy is not working or because the psychologist has brought up conflicts that you cannot yet deal with.
6. You blame yourself for things that go wrong in psychotherapy. Therapy is a complex process and although the therapist tries to maintain control of what happens, some situations can get out of hand. However, if things go wrong in therapy and you blame yourself for it, it is likely that the treatment is not going well.
If you feel guilty about the problems that arise during the sessions, it is advisable to talk about it with your psychologist so that you can explore what is happening. In fact, it is not therapeutic for the person to blame themselves for their therapist’s lack of skill. However, it should be noted that there are cases in which this feeling of guilt is due to resistance or transference; in any case, it is the psychologist’s job to prevent it from happening.
7. You don’t trust the techniques. Unfortunately, many popular myths have been created around Psychology, which is why many people are wary of going to therapy. For example, one of the most common beliefs is that during hypnosis, the person is at the mercy of the hypnotist’s will. In reality, this is not the case, but if the person has this idea, they will not feel comfortable undergoing this technique, and will feel that their privacy is being violated. The same can happen with techniques such as tapping, EMDR, group therapy or visualization.
Therefore, a good psychologist must be able to convince the person of the effectiveness of the technique and, if the person resists, he must resort to other techniques. He must not pressure the patient to submit to techniques with which he does not feel comfortable.
Find another psychologist?
Just because psychotherapy isn’t going well doesn’t mean you can’t change course. The best thing to do is talk to your psychologist about it and make a decision together. You should keep in mind that 70% of people drop out between the fourth and tenth session simply because the results aren’t coming as quickly as they expected. So before you stop treatment, you should ask yourself if you’re doing so because psychotherapy isn’t really working or because you had unrealistic expectations about the results.
If you decide to change psychologists, search carefully and evaluate the profile of the different professionals before choosing. There are several platforms where you can find psychologists and medical centers from more than a dozen countries. In addition to accessing their profiles to learn about their specialty and work methods, you can read opinions from other patients and ask questions online about specific topics that concern you.
Reference:
Castro, A. (2001) ¿Son eficaces las psicoterapias psicológicas? Psicodebate; 3: 59-90.
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