When Therapy Gets Hard: Navigating Therapy Sessions And Mental Health

Therapy can be challenging at times. While therapy can ultimately help many individuals improve their mental health and quality of life, taking the steps toward those improvements may not always feel easy or comfortable, as therapy often involves digging into vulnerable topics, processing past wounds, and confronting difficult emotions. Still, many people find it vital to stay with the process and their therapist to reach the success they desire. 

Finding ways to navigate the potential challenges of counseling (even when it might feel hard) can enable you to reap the full benefits of treatment and make meaningful changes in your life. 

The therapeutic treatment process when therapy gets hard

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Why it can feel worse before it feels better

In therapy, you may notice that you don’t feel better after each session. Therapy is often a long-term treatment option, so there could be distressing feelings or symptoms that arise throughout the process, which may be painful in the moment but productive in the long term.

The benefits of therapy may start to appear after a few sessions or after some time has passed. If you have questions about this phase of in-person or online therapy, you may consider speaking with your therapist regarding progress in therapy. A good therapist can work with you through the difficulties and help you to stick with the therapy sessions, embracing every area of growth as it arises.

Physical effects of stress

If you experience a stressful therapy session, you may also experience some physical manifestations of stress. For instance, talking about a past traumatic event during a therapy session may bring up a range of difficult emotional reactions, including stress. Research shows that stress can affect all body systems, including the nervous system, cardiovascular system, endocrine system, and more. As such, when you experience acute or short-term stress, you may notice physical changes like an increased heart rate, shortness of breath, rapid breathing, sweating, and muscle tension.

Why does it feel like therapy is hard?

In therapy, you might start processing your feelings and life circumstances in ways you haven't before. This experience can occur across therapy types. For instance, you could have been repressing your emotions in the past and decided to attend therapy to mitigate the mental and physical health effects of doing so. 

Facing difficult emotions

Therapy can cause you to acknowledge emotions like sadness and anger, and you may feel more vulnerable as a result. You might begin to talk about topics you’ve avoided for years, bringing up hidden emotions and new emotional responses. This situation might be the first time you’ve had the space to feel grief or anger about a certain topic, even if it is from the distant past. Though the eventual outcome of “feeling your feelings” can be positive, it may not always feel good or seem like you’re making progress, especially when you first start digging up past wounds and have to confront the difficult feelings they bring up. This is one example of what could make therapy hard.

Uncovering defense mechanisms

Another dynamic that can make therapy feel difficult at times is the presence of certain defense mechanisms. Defense mechanisms refer to the unconscious patterns used by the ego to protect itself from stress and decrease internal conflict. In therapy sessions, your therapist may help you uncover defense mechanisms, such as denial or avoidance, that you have been using to try to manage internal stress. Uncovering and disarming these defense mechanisms, while ultimately beneficial, can feel difficult in the moment. 

Experiencing delayed reactions after therapy

Therapy can also be a catalyst for change in your interpersonal relationships, including romantic relationships. As a result of counseling, you may start to set boundaries for the first time, practice self-care, or communicate more effectively, for example. While often positive, these changes can come with an adjustment period, and they may cause you to reevaluate your close relationships.

Signs therapy is working, even when it feels hard

When therapy feels hard, it can sometimes be difficult to continue trusting the process. But, even when it feels challenging, there are a variety of signs to look for that often indicate therapy is working: 

• You are cultivating greater awareness of your thoughts, emotions, and behaviors.
• You feel comfortable opening up to your therapist.
• You are incorporating healthy coping skills outside of sessions. 
• You have noticed a reduction in mental health symptoms.
• Your relationships with others have started to improve.

How to move forward when therapy is becoming hard

Therapy is sometimes challenging. Below are some tips to consider when therapy feels hard: 

Try relaxing activities after your sessions

Soothing activities can differ from person to person. Some people might find it helpful to take a bath or shower, spend time outdoors, take a walk, talk to a friend about your thoughts, engage in other physical activities, or journal after therapy. You might find it equally comforting to work on an art project, play, or listen to music, or meditate. 

Allow for reflection time after mental health treatment

It can be normal to feel tired after therapy. Consider keeping this in mind when scheduling therapy. Some people prefer to schedule sessions when they don't have to do anything afterward. They might do this if they want to work on topics that are emotional or challenging for them. On the other hand, if you are going through a difficult time, you may also consider having someone you can call or spend time with if you need a distraction or support later that day.

Even though it may be uncomfortable, experiencing ups and downs during therapy can be a healthy sign. It could mean you're processing the lessons you learned in your session. Your therapist may also give you homework, which some people choose to complete immediately following a session. Others may choose to do these at-home activities the following day or later in the week.

Some therapists might allow you to send messages or emails after a session to check in if you require support. This option could be beneficial if you want a quick suggestion or reminder regarding the coping skills you discussed during your talk. 

Take inventory of your needs

You may have heard the saying, "Most of the work you do in therapy happens outside of therapy". As you work with a therapist, you may begin to better understand your needs. These could include physical needs (e.g., going to bed early so you can get enough sleep) or emotional needs (e.g., setting boundaries with loved ones), among others. If you aren't used to asserting or recognizing your needs, this process could take time and energy. However, it may be worthwhile, and it could become easier over time. 

Celebrate your successes 

When topics feel tough in therapy, it may be rewarding to celebrate the successes and achievements you've made. Success in therapy can take many different forms. Examples of successes and achievements you might celebrate include:

• An increase in positive self-talk
• The ability to identify and reframe maladaptive thoughts
• Feeling more in touch with your emotions, your body, or both 
• The ability to identify and name your emotions and needs, whether internally or externally
• An increased ability to reach out to your support system, including friends, family, and community members
• Improved anger management and distress tolerance skills
• An increase in participating in self-care activities
• Better communication

You and your therapist can work together to set goals and revisit them periodically. This practice could give you the opportunity to acknowledge your successes, and you can reflect on them whenever you want. 

When therapy gets hard: Consider seeking additional support for mental health

You might need additional support when therapy gets hard. Therapy can bring about many different internal changes, so there may be times when other forms of support could be advantageous. For example, you might sign up for a support group or attend an anger management class.

Support groups can be beneficial, and they are often free. Your therapist may be able to recommend a support group or help you look for one where people can talk about their experiences. Some therapists manage support groups outside of their practice. These groups might occur online or in person. You can get additional support by adding other medical and mental health professionals, such as a psychiatrist, clinical social worker, or doctor to your support team.  

Accept that therapy can take time

It may also be helpful to try to be gentle with yourself and allow yourself to move at your own pace in therapy. Emotional work can be challenging. It may not be uncommon to experience the following: 

• A mix of difficult and exciting realizations 
• A feeling that some therapy sessions are more productive than others
• Wondering if you're making progress or not 
• Suddenly realizing how far you've come
• Feeling that emotions have gotten worse before they get better 

Consider other modalities with a therapist when it feels like therapy is hard

Treatment methods, therapists, and approaches can vary in effectiveness depending on the individual. Therapists are often trained to handle this possibility, so it can be normal to switch counselors if you decide you need to. Therapy can come in diverse forms, including: 

• Individual therapy 
• Group therapy or support groups  
• Couples counseling  
• Family therapy

For each type of therapy, there can be many different modalities that might be used. A therapeutic modality refers to the approach that a therapist takes. Additionally, therapy can be conducted in person or online. 

How to talk to your therapist when you are struggling

If therapy sessions are feeling challenging or emotionally draining for you, it may also be helpful to talk to your therapist about what you are experiencing. A great therapist will generally be open, receptive, supportive, and committed to creating a safe space for your self-discovery and growth. As such, they may be able to offer you specific tips and guidance for how to best care for yourself when sessions feel difficult, and they may be able to incorporate specific practices during sessions to help you have a good therapy experience even when digging into difficult topics. 

Navigating your mental health journey with online therapy

If you’re feeling like therapy is difficult, online therapy platforms provide a convenient way of making progress on your mental health journey.

If you are not currently in therapy or are considering switching therapists, you may consider multiple avenues of support. Those who face barriers to treatment that might make therapy harder,  such as finances, distance, or availability, may appreciate the availability of affordable counseling. Online therapy can be a convenient way to find, choose, talk, and work with a therapist from the comfort of your home or anywhere else with a reliable and stable internet connection.

Furthermore, internet-based therapy is backed by research and has been shown to be effective in improving mental health outcomes for various conditions, including anxiety and post-traumatic stress disorder. Whether you want to work on interpersonal relationships, symptoms of a mental health condition, or general well-being, online therapy may be the right fit for you.