Covid-19 Update: During this time, Dr. Romanoff is offering telemental health therapy through a HIPAA complaint platform.

Therapy office with couch

The Reality of the Therapy Process

There are a lot of wonderful things about therapy, but it’s natural for it to not be all butterflies and rainbows. In other words, it’s both okay and to be expected that the process of growth might bring up both positive and negative emotions

The process of therapy is typically cyclical, containing many ups and downs. Usually in the beginning, people experience relief as they unburden themselves from the problems that plagued them. They no longer have to suffer alone or in silence, as they begin to feel supported by their therapist and are hopeful about the future. People tend to enter therapy at a point of exasperation, feeling as if they can no longer bear the weight of their problems, they’ve been carrying on their own for so long. With the support of their therapist there is respite to finally begin unpacking and examining conflicts that have been long suppressed and pushed down. This captures the initial high of therapy, as patients make real progress, and are exploring aspects of themselves with a caring and non-judgmental therapist. 

For most, in the beginning of therapy, problems are perceived as weeds, to be simply plucked, and replaced with flowers. As therapy progresses, patients gain more insight into the scope of the complexity of their issues. They begin to trace the deep seeded roots of their problems which tend to be more pervasive and trace back to early life. This realization can feel overwhelming and disheartening. It is important to remember that although problems might feel more widespread at this point, once they are fully identified, they can be better understood which allows you to make more enduring change. 

This is a pivotal point in treatment, where the pain of this insight drives some to consider ending therapy all together. There is a wish to un-due this harsh awakening and return to the functional blindness from which they previously operated. This is when the perseverance to push through really pays off. Enduring the discomfort of insight in order to create a life worth living.

It’s analogous to reorganizing a messy closet. You first have to start the arduous process of taking everything out and concede to the long-amassed mess you’ve been avoiding. This means having a willingness to acknowledge the problem in its entirety, and the chaos it brings to your floor, until you can begin to fix it. Because the truth is – you’ve always carried this mess, it was just sublimated, and out of sight.

For most, staring at that pile of junk on their floor incites a panic. They wonder why they couldn’t just leave things as they were. But if they’re up for the challenge, they can begin to build a life for themselves, item by item, that is more purposeful and organized. 

Therapy is about the willingness to fix the most shameful, discarded, and painful items we’ve pushed down deep into the depths of our closets. Knowing you don’t have to bear the burden of doing this task alone provides measurable relief. And watching your life change for the better affords incremental proof of how committing to deeply knowing yourself and making important changes, especially in the areas you tend to avoid, frees you from self-imposed shackles to begin to live a less restricted life. 

Those uncomfortable feelings can impact how we perceive therapy. 

Therapy tends to uncover intense negative emotions rooted in painful memories. People often feel overwhelmed at this part of the process especially when they expected to feel better about the problems that initially brought them into therapy and not worse when they realize there are deeper issues they must excavate. The way we perceive therapy can become enmeshed with this discomfort especially when the foresight that it is only temporary is uncertain. 

Sometimes you leave therapy smiling and other times it’s with tear-stained cheeks. If you did have a session that left you feeling emotionally run down, that might indicate you’re working through something and this is part of the process.

Consider it a signal that something important has been awakened within you that you’ve previously been wrestling or trying to suppress. Once you look at the problem head on, relief is usually the next step. You no longer have to exert energy to avoid or distort the issue. Once it’s on the surface, you can be certain you are tapping into something important and can begin to decide how to move forward

Remember that change does not always feel good. Some of the most rewarding and influential moments of your life did not originate from stagnation or maintaining the status quo. Alterations in how you feel, whether good or bad, is an indicator you are moving outside of your comfort zone and growing in the process. This is a sign that the work is happening. 

How can you process these big emotions after leaving your therapy session? It can be tough to do, especially if you’re also in a virtual session and not physically leaving your therapist’s office behind. 

I always recommend patients create a buffer before and after session. This means arriving a few minutes before session to unwind from the other parts of their day, and to get into the mindset for therapy. This also involves giving yourself time to return back to your life after session. Whatever you do, try to find a way to be with yourself and emotions. If you’re seeing your therapist in person, walking after therapy instead of getting into a crowded subway or taxi with strangers can be a great way to extend the benefits of treatment and continue to reflect on the session after it ends instead of dissociating.

More specifically, the transitional period after a therapy session is an important time. Before telehealth, the commute home after a session could be just as important as the session itself as the effects of catharsis persist, and you continue to process and relive important moments of the session. After your telehealth session, make sure to actively change your environment. Even if it means just taking a walk around the block. When you change your external environment, your internal processing system adapts respectively. Taking a walk allows you to continue to metabolize the content of your session, consider new revelations, and how you might turn that into concrete change and action. This also helps with transitioning to new tasks, especially for those who work from home, or have other responsibilities to fulfill after session. When in session, you are unencumbered from the strain and expectation that comes with your other roles and responsibilities. It is important to give yourself time and space to unwind from that position as you gradually transition back into your life.  

How can you make the most out of your therapy sessions?

Keep a note in your phone of the ‘hot moments’ of the week in which you noticed experiencing intense emotion, questioned your perception of a situation, or a moment for which you would like to get more clarity. Sometimes we forget the important moments in our week and turn up to therapy with a blank mind. It can be incredibly useful to track your week so you can utilize the session with moments that felt most critical. 

Alternatively, some of the most productive sessions start with the feeling of ‘having nothing to talk about.’ It’s those sessions that create more space to explore areas you may have unconsciously been avoiding through distraction or filler content and can now begin to process. 

When you are feeling ambivalent or have negative thoughts about therapy, bring those concerns to your therapist. Many are socialized to avoid conflict at all costs. In therapy, those rules don’t apply. Speak about your disappointment or frustration with therapy openly with your therapist to reach a greater level of understanding and improve the treatment. 

Know that discomfort is part of the process. Healing involves having a greater capacity to manage discomfort, to become stronger and more resilient on the other side. Ultimately, it’s about not giving up and learning you are much stronger than you think you are. When you are feeling overwhelmed, remember it is only temporary, and that this discomfort in the present is bringing you closer to the life you want to live in the future. 

Realize there are no shortcuts in therapy. You cannot bypass painful memories or emotions. The only way out is through. Tap into this perseverance by reminding yourself of the sense of accomplishment that comes from not giving up. You can do this by referencing other times in your life when you worked really hard toward something, and didn’t give up, no matter how much you wanted to and it paid off.  

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